Antidepressant effects of ketamine and ECT: A pilot comparison
| Autor: | Gajanan Kulkarni, Shyam Sundar Arumugham, Sayantanava Mitra, Channaveerachari Naveen Kumar, Ravi K Sharma, Urvakhsh Meherwan Mehta, Milind Vijay Thanki, Jagadisha Thirthalli, Venkataramaiah Sudhir |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Convulsive Therapy
behavioral disciplines and activities law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Rating scale mental disorders medicine Humans Ketamine Electroconvulsive Therapy Adverse effect Depression (differential diagnoses) Psychiatric Status Rating Scales business.industry Ketamine hydrochloride Beck Depression Inventory Antidepressive Agents 030227 psychiatry Psychiatry and Mental health Clinical Psychology Treatment Outcome Anesthesia Antidepressant business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Journal of Affective Disorders. 276:260-266 |
| ISSN: | 0165-0327 |
| DOI: | 10.1016/j.jad.2020.07.066 |
| Popis: | To compare the antidepressant effects and cognitive adverse effects of intravenous ketamine infusion and Electro-convulsive therapy (ECT) in persons with severe depressive episodes.This assessor-blinded randomized control trial included 25 patients (either sex; 18-65 years) meeting ICD-10 criteria for severe depression (bipolar or unipolar). Patients received either ECT (n = 13) or intravenous infusions of ketamine hydrochloride (0.5 mg/kg over 45 min; n = 12) for six alternate day sessions over a period of two weeks. Severity of depression was assessed at baseline and on every alternate day of intervention using the Hamilton Depression Rating Scale (HDRS) and self-reported Beck Depression Inventory (BDI).Baseline socio-demographic and clinical variables including HDRS (ECT: 25.15±6.58; Ketamine: 23.33±4.05, p = 0.418) and BDI (ECT: 37.07±6.58; Ketamine: 33.33±9.29; p = 0.254) were comparable. Repeated-measures analysis of variance revealed that ECT patients showed significantly greater reduction in HDRS (group*time interaction effect; F = 4.79; p0.001) and BDI scores (group*time interaction effect; F = 3.83; p0.01). ECT patients had higher response rate than ketamine patients [HDRS: ECT- 13/13(100%) vs ketamine- 8/12 (66.70%); p = 0.04]. This was true for remission as well [ECT- 12/13(92.30%) vs ketamine- 6/12(50%), p = 0.030; both HDRS and BDI]. Performance on Digit Symbol Substitution Test (as part of the Battery for ECT-Related Cognitive Deficits scale) significantly improved in ketamine patients (p = 0.02) while that in ECT patients worsened non significantly (p = 0.30).Relatively small sample size; higher proportion of dropouts in the Ketamine arm.This study favoured ECT over ketamine for a better efficacy over six treatment sessions in severe depression. The results need to be replicated in larger studies.CTRI/2019/09/021184. |
| Databáze: | OpenAIRE |
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