2018
DOI: 10.2147/ndt.s157233
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A review of ketamine’s role in ECT and non-ECT settings

Abstract: Up to 20% of depressed patients demonstrate treatment resistance to one or more adequate antidepressant trials, resulting in a disproportionately high burden of illness. Ketamine is a non-barbiturate, rapid-acting general anesthetic that has been increasingly studied in treatment resistant depression (TRD), typically at sub-anesthetic doses (0.5 mg/kg over 40 min by intravenous infusion). More recent data suggest that ketamine may improve response rates to electroconvulsive therapy (ECT) when used as an adjunc… Show more

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Cited by 11 publications
(10 citation statements)
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“…We also added one further (post hoc) subgroup analysis. Specifically, given recent findings that ketamine may accelerate the effect of ECT in patients with treatmentresistant depression (Jankauskas et al, 2018), we excluded those studies in which ketamine was administered as part of ECT treatment. a1,a6,a10 Excluding these trials did not materially affect either the direction or magnitude of effect for ketamine for any time point.…”
Section: Subgroup and Sensitivity Analysesmentioning
confidence: 99%
“…We also added one further (post hoc) subgroup analysis. Specifically, given recent findings that ketamine may accelerate the effect of ECT in patients with treatmentresistant depression (Jankauskas et al, 2018), we excluded those studies in which ketamine was administered as part of ECT treatment. a1,a6,a10 Excluding these trials did not materially affect either the direction or magnitude of effect for ketamine for any time point.…”
Section: Subgroup and Sensitivity Analysesmentioning
confidence: 99%
“…6,45 Likewise, ketamine's effect has been identified in patients who are currently taking other antidepressant medications, as well as those who are drug-free or have completed a washout period. 6,41,46,49…”
Section: Unipolar Depression and Mddmentioning
confidence: 99%
“…All systematic review or meta-analytic articles noted rapid onset of ketamine's antidepressant effect among patients with MDD. 3,4,[6][7][8][9]14,15,[40][41][42][43][44][45][46][47][48][49][50][51][52][53] Meta-analyses, which primarily focused on a single intravenous infusions, identified lower mean depression severity and remission in ketamine groups relative to placebo, with onset between 1 and 24 h post-infusion, 6,9,14,40,41,43,45,47,50,52 and typically persisting for 1-2 weeks. 3,8,9,14,[41][42][43]45,47,49,50 Repeated administrations of ketamine of up to six doses produce a more pronounced antidepressant effect at the 2-week follow-up relative to a single administration, 43,44,50 and prolonged time to relapse.…”
Section: Unipolar Depression and Mddmentioning
confidence: 99%
“…On the other hand, even if ketamine prolongs the duration of seizures, according to some reports, ketamine is not better than other anesthetics in reducing depressive symptoms or improving cognition [16,[20][21][22][23]. The effect of ketamine on the duration of seizures during ECT has been evaluated differently in each study, and the ECT protocols vary from institution to institution making efficacy assessment difficult [11]. The additional problem is that the assessment items (seizure duration, early stage of rapport, or cognitive improvement) do not match.…”
Section: Information On Ketaminementioning
confidence: 99%