Intermittent administration of low dose ketamine can shorten the course of electroconvulsive therapy for depression and reduce complications: A randomized controlled trial

Psychiatry Res. 2019 Nov:281:112573. doi: 10.1016/j.psychres.2019.112573. Epub 2019 Sep 23.

Abstract

This study aimed to investigate the efficacy and safety of intermittent low-dose ketamine on improving the efficacy of ECT. Patients diagnosed with Major Depressive Disorder (MDD) (n = 134) were randomized into 3 groups: routine ECT group (group E, n = 45); repeated ketamine-assisted ECT group (group RK, n = 43), and intermittent ketamine-assisted ECT group (group IK, n = 46). Patients in group RK were given ketamine at the dose of 0.3 mg/kg for each ECT treatment, patients in group IK were given ketamine once a week during ECT course. The depressive symptoms were assessed using the Hamilton Depression Rating Scale (HAM-D) at baseline, the end of ECT course, after 1 and 3 months, followed by an analysis of the psychiatric complications. Results indicated that ketamine-assisted ECT achieved a higher remission rate (P < 0.05), and no difference was observed between repeated and intermittent ketamine administrations. The total incidence rate of psychiatric complications in group RK (20.93%) was higher than that in group E (0%) and group IK (4.35%). In conclusion, intermittent administration of low dose ketamine in ECT significantly improved the effects of ECT and decreased psychiatric complications compared with repeated ketamine addition.

Keywords: Complication; Curative effect; Depression; ECT; Ketamine.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anesthetics, Dissociative / administration & dosage*
  • Combined Modality Therapy
  • Depressive Disorder, Major / psychology
  • Depressive Disorder, Major / therapy*
  • Dose-Response Relationship, Drug
  • Electroconvulsive Therapy / methods*
  • Female
  • Humans
  • Ketamine / administration & dosage*
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Treatment Outcome

Substances

  • Anesthetics, Dissociative
  • Ketamine