Comparing IV Ketamine to Electroconvulsive Therapy for Depression

Studies can help us understand whether different treatments for the same condition are better or similar to each other. These studies (sometimes called ‘non-inferiority’ studies) can be helpful when you are considering which type of treatment is best for you. An exciting study published this week in the New England Journal of Medicine looked at determining whether IV ketamine is comparable to electroconvulsive therapy (ECT) for patients with treatment resistant depression.

ECT has been commonly used to treat depression for over 80 years. During this treatment, electrodes are placed on the scalp to induce seizure activity in the brain. This treatment often provides quick relief from severe depression symptoms. While effective, treatment can have several drawbacks. Patients require general anesthesia for the treatments, which carries several risks and can be logistically more difficult. ECT can also cause side effects such as muscle pain, fatigue, and memory or cognitive problems. For many patients, these are temporary, but for others they can last longer.

IV ketamine has been studied for the past two decades as a treatment for depression. These treatments are shorter, do not require anesthesia, and have fewer side effects. These scientists wanted to show whether this treatment could be as effective as ECT.

This study enrolled over 400 patients with treatment resistant depression and gave them either six IV ketamine infusions or nine ECT treatments over a 3 week period. Their symptom response was monitored with surveys. They were also monitored for common side effects including cognitive problems and memory issues. They were followed for 6 months after treatment to watch for symptom recurrence.

More than 55% of patients who received IV ketamine had decreased (or resolved) depression symptoms, compared to only 41% in the ECT group. This effect was consistent over time, with ketamine patients showing a lower relapse rate over the next 6 months. Patients who received ECT had more cognitive symptoms and memory impairment, but this improved over time. Both groups showed improvements in quality of life.

For many people considering the side effects of these treatment options, IV ketamine may be a safer and more desirable treatment. This is an important study that shows that ketamine just as effective, if not better, for many patients with depression. You can read more about this study by clicking the link in the photo above!