Ketamine Noninferior to Electroconvulsive Therapy for Depression

Ketamine Noninferior to Electroconvulsive Therapy For DepressionKetamine is noninferior to electroconvulsive therapy (ECT) for managing treatmentresistant depression, defined as depression that does not respond to 2 or more antidepressants, according to results from a randomized clinical trial of 365 participants without psychotic symptoms.The drug is currently approved for use as a sedative, general anesthetic, and analgesic by the US Food and Drug Administration.After 3 weeks, about 55% of participants who received twice weekly ketamine reported at least a 50% improvement in their depression symptoms compared with about 41% of participants who received ECT.During the 6-month follow-up period, about 35% of participants treated with ketamine and about 56% of those treated with ECT relapsed.Adverse effects included musculoskeletal issues among those in the ECT group and dissociation among those in the ketamine group.In addition, participants treated with ECT exhibited worse memory recall than those treated with ketamine immediately after treatment, although memory performance was similar between the groups after 1 month.An associated editorial in the New England Journal of Medicine warned of ketamine's potential for dependency and abuse, and noted that by 6 months after treatmentwhat the author called a "brief period in a lifetime of depression"-the quality of life between the treatment groups was no different.-Emily