A new study suggests that ketamine infusions may work just as well as electroconvulsive therapy (ECT) for improving symptoms in people dealing with severe depression.
Lead study author and director of psychiatry translational clinical trials at Mass General Brigham in Boston, Amit Anand, MD, said in a statement, “ECT has been the gold standard for treating severe depression for over 80 years. But it is also a controversial treatment because it can cause memory loss, requires anesthesia, and is associated with social stigma.”
Dr. Anand and his team were working to compare ECT with ketamine, which is a surgical anesthetic approved by the U.S. Food and Drug Administration (FDA) in 2019 as a nasal spray medication for treatment-resistant depression. This is depression that isn’t alleviated by at least two different types of antidepressant therapies.
Dr. Anand said, “This is the largest study comparing ketamine and ECT treatments for depression that has ever been done, and the only one that also measured impacts to memory.”
The study had around 400 adult participants who were diagnosed with treatment-resistant depression. The scientists randomly assigned participants to receive ECT three times every week, or ketamine infusions twice weekly, for three weeks.
Ketamine vs ECT in Severe Depression Treatment
The researchers reported on May 24 in the New England Journal of Medicine that overall, 55 percent of people in the ketamine group and 41 percent of those in the ECT group claimed at least a 50 percent reduction in depressive symptoms by the end of the study period.
They shared that the goal of the study was to figure out whether ketamine worked just as well as ECT, which the results show seems to be the case.
Moreover, patients in the ECT group also experienced memory loss and musculoskeletal effects like seizures. Meanwhile, those in the ketamine group didn’t experience any of these. During treatment, one side effect of the ketamine was dissociation, where people felt detached from their bodies, the people around them, or their environment.
The study authors also shared that one limitation of the new study is that researchers relied on participants to accurately recall and report any changes in the severity of frequency of their depressive symptoms.
Luke Jelen, a neuropharmacology researcher at King’s College London who wasn’t involved in the new study said, “ECT is often stigmatized as a treatment option, and there has been a lot of media hype and hope surrounding ketamine’s potential, so it is possible that treatment preference and expectations could have influenced the results,”
He adds that beyond this, the study focused on the subset of patients who were dealing with treatment-resistant depression but didn’t experience episodes of psychosis. It’s possible that the results would be different in these patients, he says.
Better Treatments for Sever Depression are Highly Needed
Regardless of the limitations of the study, its findings suggest that ketamine could possibly meet the urgent need for better therapies for severe depression. According to a study in the March 2021 Journal of Clinical Psychiatry, around one-third of people with severe depression who use medications to ease their symptoms don’t get food results for treatment.
Jelen says, “Ketamine could potentially be considered a less invasive and more accessible alternative for treatment-resistant depression. However, it’s important to note that additional research is needed to confirm these findings and evaluate the long-term effects and safety of ketamine treatment.”
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