## Ketamine Injections as Effective as Electroconvulsive Therapy for Treating Depression, New Study Shows
A recent randomized trial conducted in the United States has shown that injections of ketamine are at least as effective as electroconvulsive therapy (ECT) when it comes to treating non-psychotic forms of major depression. The trial involved 158 patients receiving ECT and 180 patients receiving ketamine injections. After starting either treatment, patients reported an almost immediate improvement in their quality of life. Side effects like nausea and poor memory were common for both treatments, albeit short-lived.
### Ketamine: A Safe and Effective Treatment for Depression
Ketamine, a dissociative anesthetic, has been used in clinical settings for sedation and pain relief because it lulls patients into a trance-like state of euphoria. However, the psychoactive substance has also shown some remarkable mental health benefits in recent years. Clinical studies have shown that a low-dose infusion of ketamine administered over an hour or so can relieve symptoms of depression for weeks at a time. That’s remarkable, given that many antidepressants take a month or so to kick in with less potent effects.
### ECT vs. Ketamine: Which Treatment is Better?
For nearly 80 years, ECT has remained the standard gold treatment for severe depression that doesn’t respond to other drug treatments or therapies, making ketamine the first real contender ECT has faced. Previous studies comparing ECT and ketamine have found each therapy safe and efficacious in treating resistant depression. But while some trials suggest ECT is “significantly superior” to ketamine when it comes to remission, other studies indicate ketamine retains 90 percent of the effect seen from ECT treatments.
### The Latest Trial: Ketamine vs. ECT
The latest trial from the US comparing the two treatments used a larger sample size and only focused on non-psychotic forms of depression. Interestingly, when researchers randomly split patients into two treatment groups, ECT or ketamine injections, those assigned to the ECT group dropped out at a higher rate. That might have to do with the fact that ECT requires general anesthesia, whereas ketamine injections take about 40 minutes and can be administered while the patient is awake.
### The Results of the Trial
In the end, 55 percent of patients responded to ketamine treatments, while 41 percent responded to ECT treatments. Moderate-to-severe side effects were slightly more common among the ECT group at a rate of just over 30 percent. The trial saw 158 patients with resistant depression receive three weeks of ECT three times a week, and 180 patients receive three weeks of ketamine injections twice per week. These patients were enrolled for the trial at multiple institutes along the east coast, including Yale University, Johns Hopkins, and Baylor College of Medicine.
With so few options available to treat resistant forms of depression, we can’t afford to ignore these leads. The study was published in NEJM. Initial trials on ketamine have been so promising that in 2019, the United States Food and Drug Administration approved a ketamine-based nasal spray for those with intractable depression and chronic suicidal thoughts. Previous studies have shown ketamine can rapidly reduce suicidal thoughts in over two-thirds of patients, suggesting this new form of treatment could possibly save lives.