Research library / Clinical trial
Ketamine versus ECT for Nonpsychotic Treatment-Resistant Major Depression
Anand A, Mathew SJ, Sanacora G, et al. New England Journal of Medicine 2023;388(25):2315-2325
Clinical trialKetaminetreatment-resistant depression
This trial compared intravenous ketamine with electroconvulsive therapy (ECT), a standard treatment for severe depression, in 403 people already referred for ECT. Over three weeks, 55% of the ketamine group and 41% of the ECT group responded, so ketamine did at least as well as ECT. ECT caused a temporary dip in memory that ketamine did not. Ketamine caused dissociation; ECT caused muscle and joint side effects. The authors conclude that ketamine was noninferior to ECT for treatment-resistant depression without psychosis.
What it found
- 55.4% responded to ketamine and 41.2% to ECT; ketamine was noninferior to ECT (difference 14.2 percentage points, 95% CI 3.9 to 24.2)
- ECT was associated with a drop in memory recall after 3 weeks that gradually recovered; ketamine was not
- ECT was associated with musculoskeletal side effects, ketamine with dissociation; quality of life improved similarly