The following is a summary of “Efficacy and Safety of Ketamine vs. Electroconvulsive Therapy Among Patients With Major Depressive Episode” published in the October 2022 issue of Psychiatry by Rhee et al.

It was uncertain if ketamine was equally effective as electroconvulsive treatment (ECT) in treating people experiencing severe depressive episodes. For a study, researchers sought to comprehensively assess and meta-analyze information on the therapeutic effectiveness and safety of ECT and ketamine in people who have had severe depressive episodes.

From the creation of the database to April 19, 2022, PubMed, MEDLINE, Cochrane Library, and Embase were all thoroughly searched using Medical Subject Headings (MeSH) terms and text keywords. Additionally, two writers personally and independently searched Google Scholar, clinical trial registries in the US and Europe, and all pertinent studies. Studies with a depressive disorder diagnosis using standardized diagnostic criteria, ECT and ketamine intervention/comparator groups, and depression symptoms as an efficacy outcome using standardized measurements were all included. Two extractors separately extracted the data, and their work was cross-checked for accuracy. Depressive symptoms were improved using Hedges g standardized mean differences (SMDs). Fixed or random effects models were used to estimate SMDs with matching 95% CIs. The reporting guidelines for Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) were adhered to. Depression severity, cognition, and memory function were all effective outcomes. Serious adverse events (such as suicide attempts and fatalities) and other adverse events were included in the safety results.

The evaluation comprised six clinical studies with 340 participants (n = 162 for ECT and n = 178 for ketamine). Five research were randomized clinical trials, 6 studies took place in inpatient settings, and 6 studies included patients who were qualified to undergo ECT.

Reference: jamanetwork.com/journals/jamapsychiatry/article-abstract/2797209