Rapid antidepressant effects of repeated doses of ketamine compared with electroconvulsive therapy in hospitalized patients with major depressive disorder

Dec 31, 2013Psychiatry research

Fast antidepressant effects of repeated ketamine doses compared to electroconvulsive therapy in hospitalized patients with major depression

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Abstract

Depressive symptoms significantly improved within 24 hours in patients receiving ketamine compared to those receiving electroconvulsive therapy (ECT).

Ketamine was administered as three intravenous infusions at a dosage of 0.5 mg/kg over 45 minutes.
Eighteen hospitalized patients with major depressive disorder (MDD) participated in a blind, randomized trial.
The Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HDRS) measured depressive symptoms at multiple time points.
Improvements in depressive symptoms were significant at 24 hours after the first ketamine dose compared to ECT.
The reduction in symptoms after the second ketamine dose was also lower than after the second ECT session.
Ketamine demonstrated rapid antidepressant effects and was found to be as effective as ECT in reducing depressive symptoms.

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Accumulating evidence suggests that N-methyl-d-aspartate receptor (NMDAR) antagonists (e.g. ketamine) may exert rapid antidepressant effects in MDD patients. In the present study, we evaluated the rapid antidepressant effects of ketamine compared with the electroconvulsive therapy (ECT) in hospitalized patients with MDD. In this blind, randomized study, 18 patients with DSM-IV MDD were divided into two groups which received either three intravenous infusions of ketamine hydrochloride (0.5 mg/kg over 45 min) or ECT on 3 test days (every 48 h). The primary outcome measure was the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HDRS), which was used to rate overall depressive symptoms at baseline, 24 h after each treatment, 72 h and one week after the last (third) ketamine or ECT. Within 24 h, depressive symptoms significantly improved in subjects receiving the first dose of ketamine compared with ECT group. Compared to baseline level, this improvement remained significant throughout the study. Depressive symptoms after the second dose ketamine was also lower than the second ECT. This study showed that ketamine is as effective as ECT in improving depressive symptoms in MDD patients and have more rapid antidepressant effects compared with the ECT.

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Rapid antidepressant effects of repeated doses of ketamine compared with electroconvulsive therapy in hospitalized patients with major depressive disorder

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