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A recent study with 50 patients demonstrated that Ketamine has a more rapid efficacy with less cognitive decline than does ECT.

What is ECT? Here is a Youtube Video demonstrating it:

ECT Video Ted-ED

ECT video 2

 

https://www.youtube.com/watch?v=LPBTEHYlZK4

https://www.youtube.com/watch?v=AcmarVpo2xE

electroshock probes

Although both treatmens work with similiar results of depression decrease in the end, ther eis less cognitive decline with Ketamine infusions in terms of attention, visual memory, and executive functions.

See the article link below :

J Psychiatr Res. 2020 Jan 16;123:1-8. doi: 10.1016/j.jpsychires.2020.01.002. [Epub ahead of print]

Antidepressant and neurocognitive effects of serial ketamine administration versus ECT in depressed patients.

Basso L1Bönke L2Aust S3Gärtner M3Heuser-Collier I3Otte C3Wingenfeld K3Bajbouj M3Grimm S4.

Author information

Abstract

BACKGROUND:

While electroconvulsive therapy (ECT) is considered the gold standard for acute treatment of patients with otherwise treatment-resistant depression, ketamine has recently emerged as a fast-acting treatment alternative for these patients. Efficacy and onset of action are currently among the main factors that influence clinical decision making, however, the effect of these treatments on cognitive functions should also be a crucial point, given that cognitive impairment in depression is strongly related to disease burden and functional recovery. ECT is known to induce transient cognitive impairment, while little is known about ketamine’s impact on cognition. This study therefore aims to compare ECT and serial ketamine administration not only with regard to their antidepressant efficacy but also to acute neurocognitive effects.

METHODS:

Fifty patients suffering from depression were treated with either serial ketamine infusions or ECT. Depression severity and cognitive functions were assessed before, during, and after treatment.

RESULTS:

ECT and ketamine administration were equally effective, however, the antidepressant effects of ketamine occurred faster. Ketamine improved neurocognitive functioning, especially attention and executive functions, whereas ECT was related to a small overall decrease in cognitive performance.

CONCLUSIONS:

Due to its pro-cognitive effects and faster antidepressant effect, serial ketamine administration might be a more favorable short-term treatment option than ECT.

LIMITATIONS:

As this research employed a naturalistic study design, patients were not systematically randomized, there was no control group and patients received concurrent and partially changing medications during treatment.

CLINICAL TRIALS REGISTRATION:

Functional and Metabolic Changes in the Course of Antidepressive Treatment, https://clinicaltrials.gov/ct2/show/NCT02099630NCT02099630.

Basso L, Bönke L, Aust S, et al. Antidepressant and neurocognitive effects of serial ketamine administration versus ECT in depressed patients. J Psychiatr Res. 2020;123:1-8.

Short Term Treatments for Depression: Ketamine vs ECT

 

While electroconvulsive therapy (ECT) and ketamine are both effective treatments for depression, ketamine was found to have a faster onset of action and better short-term cognitive outcomes than ECT, according to study results published in the Journal of Psychiatric Research.

The study included 50 patients with major depressive disorder (MDD) who were hospitalized at the department of psychiatry, Charité-Universitätsmedizin in Berlin, Germany, and treated with ECT 3 times a week for 4 weeks (n=25; mean age, 49.96±11.82 years; 11 women) or ketamine 3 times a week for 2 weeks (n=25; mean age, 49.08±10.45 years; 15 women). The investigators assessed depressive symptom severity using the Montgomery-Åsberg Depression Rating Scale at baseline, mid-treatment (after 6 ECT sessions or 3 ketamine infusions), and at treatment termination (after 12 ECT sessions or 3 ketamine infusions). They also assessed cognitive performance (eg, attention, visual memory, and executive functions) at baseline for both groups, mid-ECT treatment, and at ECT and ketamine treatment end.

The investigators found a greater reduction in patients’ depressive symptoms after 1 week of ketamine treatment (mean decrease, −47.45±23.43%) compared with 2 weeks of ECT (mean decrease, −34.86±21.29%). Both treatments were equally effective in terms of symptom reduction at the end of treatment (ketamine: mean decrease, −49.88±27.30%; ECT: mean decrease, −55.70±23.63%), but the same antidepressant effects that were achieved within 4 weeks of ECT treatment could be achieved within 2 weeks of ketamine administration.

Overall, patients treated with ketamine showed improved cognitive performance, particularly attention and executive functions, whereas patients treated with ECT showed a small decrease in cognitive performance.

Patients in the study were not systematically randomized, and there was no control group. Many of the patients were also taking concurrent antidepressants during the study. The investigators acknowledged that “a randomized controlled trial with a large sample including long-term follow-up measurements seems advisable.” However, ketamine may be a useful treatment option when there is an urgent need for symptom improvement and for patients with pre-existing cognitive impairments.

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