Ketamine Treatments Found to Be At Least as Effective as ECT

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Published on 
July 26, 2023
Updated on 

A recent study has come out of Mass General Hospital that shows that ketamine treatment is at least as effective as electro-convulsive therapy (ECT), the current gold standard in managing treatment-resistant depression.

In a study of 403 patients, ketamine treatment was proven to be effective in helping with treatment-resistant depression, and shown to be non-inferior to the current gold standard, ECT. 

We have explored the potential of ketamine therapy for treatment-resistant depression previously, and it is exciting to see the largest study of its kind to date further validating this.

Treatment-resistant depression means that a clients symptoms have not positively responded to previous clinical, therapeutic, or pharmacological interventions.

Beyond this, a benefit of ketamine treatment is that it does not come with the side effects of ECT, which include memory loss, the necessity of anesthesia, and comes with social stigma. 

Results of the Study

"For the ever-growing number of patients who do not respond to conventional psychiatric treatments and need a higher level of care, ECT continues to be the most effective treatment in treatment-resistant depression," said Murat Altinay, MD, Psychiatrist and lead of the trial site at Cleveland Clinic. 

"This study shows us that intravenous ketamine was non-inferior to ECT for treatment of non-psychotic treatment-resistant depression and could be considered as a suitable alternative treatment for the condition."

Some key takeaways from the study include: 

  1. Ketamine is at least as effective as electroconvulsive therapy (ECT)
    The researchers found that 55 percent of ketamine recipients and 41 percent of ECT recipients reported at least a 50 percent improvement in self-reported depressive symptoms. However, ECT was associated with memory loss and musculoskeletal adverse effects while ketamine was only linked to transient dissociation at the time of treatment.

  2. ECT Patients Can Experience Adverse Side-Effects
    The study is the largest one comparing ketamine and ECT for depression treatment and also measured impacts on memory. This is noteworthy because ECT has been linked with memory loss, requires anesthesia, and carries a social stigma.

  3. A Viable Option for Treatment-Resistant Cases
    The study concludes that intravenous ketamine could be considered a suitable alternative for treating non-psychotic treatment-resistant depression, providing an option for those patients who do not respond to conventional treatments.

Ketamine Therapy & Mental Health

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

Having additional clinical treatments to assist those who are suffering, with comparable healing outcomes, and fewer negative side-effects highlights the emerging potential and power of ketamine treatment for mental health conditions.

A final important point to note from this study is that it also demonstrated ketamine’s efficacy in helping to manage treatment-resistant depression, showing that where other clinical and pharmacological interventions may fail, ketamine has promise and potential to help those still in need.

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This article is for informational purposes only and is not intended to be a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. If you are in a life-threatening situation, call the National Suicide Prevention Line at +1 (800) 273-8255, call 911, or go to the nearest emergency room.

Important FDA Safety Information

Ketamine is not FDA-approved for the treatment of depression or anxiety. Learn more about off-label uses here.

Side effects of ketamine treatment may include: altered sense of time, anxiety, blurred vision, diminished ability to see/hear/feel, dry mouth, elevated blood pressure or heart rate, elevated intraocular or intracranial pressure, excitability, loss of appetite, mental confusion, nausea/vomiting, nystagmus (rapid eye movements), restlessness, slurred speech, synesthesia (a mingling of the senses).

Do not proceed with ketamine treatment if any of the following apply to you:

  • Allergic to ketamine
  • Symptoms of psychosis or mania
  • Uncontrolled high blood pressure
  • CHF or other serious heart problem
  • Severe breathing problem
  • History of elevated intraocular or intracranial pressure
  • History of hyperthyroidism
  • Other serious medical illness
  • Pregnant, nursing, or trying to become pregnant

Ketamine has been reported to produce issues including, but not limited to, those listed below. However, lasting adverse side-effects are rare when medical protocols are carefully followed.

While ketamine has not been shown to be physically addictive, it has been shown to cause moderate psychological dependency in some recreational users.

  • In rare cases, frequent, heavy users have reported increased frequency of urination, urinary incontinence, pain urinating, passing blood in the urine, or reduced bladder size
  • Ketamine may worsen problems in people with schizophrenia, severe personality disorders, or other serious mental disorders.
  • Users with a personal or family history of psychosis should be cautious using any psychoactive substance, including ketamine, and discuss potential risks with your MindBloom® clinician before proceeding with treatment.
  • The dissociative effects of ketamine may increase patient vulnerability and the risk of accidents.

To promote positive outcomes and ensure safety, follow these ketamine treatment guidelines:

  • Do not operate a vehicle (e.g., car, motorcycle, bicycle) or heavy machinery following treatment until you’ve had a full night of sleep
  • Refrain from taking benzodiazepines or stimulants for 24 hours prior to treatment
  • Continue to take antihypertensive medication as prescribed
  • Avoid hangovers or alcohol intake
  • Refrain from consuming solid foods within 3 hours prior to treatment and liquids within 1 hour prior to treatment
  • Ketamine treatment should never be conducted without a monitor present to ensure your safety

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