APA: Ketamine Noninferior to ECT for Treatment-Resistant Depression

WEDNESDAY, May 31, 2023 (HealthDay News) -- For patients with treatment-resistant major depression without psychosis, ketamine is noninferior to electroconvulsive therapy (ECT), according to a study published online May 24 in the New England Journal of Medicine to coincide with the annual meeting of the American Psychiatric Association, held from May 20 to 24 in San Francisco.

Amit Anand, M.D., from Brigham and Women's Hospital in Boston, and colleagues conducted an open-label, randomized, noninferiority trial involving patients referred to ECT clinics for treatment-resistant major depression without psychosis. Participants were recruited and randomly assigned to receive ketamine or ECT (200 and 203 individuals, respectively); patients received ECT three times per week or ketamine twice per week during an initial three-week treatment phase. Ketamine was administered to 195 patients and ECT to 170.

The researchers found that 55.4 and 41.2 percent of patients in the ketamine and ECT groups, respectively, had a response to treatment (decrease of ≥50 percent from baseline in the score on the 16-item Quick Inventory of Depressive Symptomatology-Self-Report; difference, 14.2 percentage points; P < 0.001 for noninferiority of ketamine to ECT). After three weeks of treatment, ECT seemed to be associated with a decrease in memory recall, with gradual recovery during follow-up. The two groups had similar improvement in patient-reported quality of life.

"People with treatment-resistant depression suffer a great deal, so it is exciting that studies like this are adding new options for them," Anand said in a statement. "With this real-world trial, the results are immediately transferable to the clinical setting."

Several authors disclosed ties to the biopharmaceutical industry.

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