Comparative efficacy and tolerability of different anesthetics in electroconvulsive therapy for major depressive disorder: A systematic review and network meta-analysis

Ren, Li; Yu, Jian; Zeng, Jie; Wei, Ke; Li, Ping; Luo, Jie; Shen, Yiwei; Lv, Feng; Min, Su

doi:10.1016/j.jpsychires.2024.01.031

Cited by 3 publications

(2 citation statements)

References 62 publications

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“… 31 The other study has shown that the use of ketamine in electroconvulsive therapy is efficacious in improving the remission rate of depression. 32 Still, a higher incidence of adverse events accompanies it. 32 Therefore, this study chose propofol combined with esketamine for ECT.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Effects of Propofol Combined with Different Doses of Esketamine for ECT in the Treatment of Depression: A Randomized Controlled Trial Protocol

Chen,

Zhou,

Lan

et al. 2024

NDT

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Major depressive disorder (MDD) is a common mood disorder. Electroconvulsive therapy (ECT) has a significant effect on treatment-resistant MDD. Esketamine may have potential advantages in improving the efficacy of ECT, and the strong affinity of this compound for NMDAR renders it a viable therapeutic option for the management of depression. This study aims to compare the effects of different doses of esketamine combined with propofol anesthesia versus propofol anesthesia alone in ECT, aiming to provide further insights for optimizing ECT and enhancing comprehensive treatment outcomes for depression. Study Design and Methods: This study was a prospective, randomized, controlled, double-blind trial involving subjects and evaluators. One hundred eleven patients scheduled for ECT were randomly assigned to three groups. In Group P, propofol at 1mg/kg was administered intravenously. In Group P+E, propofol at a dosage of 0.5mg/kg and esketamine at a dosage of 0.5mg/kg was administered intravenously. Patients in Group P+SE received propofol at a dosage of 0.75mg/kg and esketamine at a dosage of 0.25mg/kg. The same anesthesia protocol was used for the same patient until the end of the last treatment. The primary outcome measures were the Hamilton depression scale (HAMD) and the Patient Health Questionnaire-9 (PHQ-9), the Columbia-Suicide Severity Rating Scale (C-SSRS), and the Digit symbol substitution test (DSST). Secondary outcomes included length of hospital stay, readmission rate, hemodynamic status, recovery, and adverse events. Discussion: This study aimed to compare the effects of propofol combined with different doses of esketamine for ECT. The results may provide a better choice for ECT anesthesia.

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Section: Discussionmentioning

confidence: 99%

“… 32 Still, a higher incidence of adverse events accompanies it. 32 Therefore, this study chose propofol combined with esketamine for ECT. This choice was made to avoid the combination of barbiturates and consider that esketamine, a novel NMDA receptor antagonist, is associated with fewer adverse effects than ketamine.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Effects of Propofol Combined with Different Doses of Esketamine for ECT in the Treatment of Depression: A Randomized Controlled Trial Protocol

Chen,

Zhou,

Lan

et al. 2024

NDT

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Ketamin in Anästhesie und Intensivmedizin

Himmelseher,

Meyer-Frießem

2024

Springer Reference Medizin

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A Survey of ECT Anesthesia Practice Variation in Finland

Huoponen,

Sisa,

Taittonen

et al. 2024

J ECT

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Objective This study examines the extent of variation in anesthesia practices among Finnish neuromodulation units providing electroconvulsive therapy (ECT) and investigates recent changes within individual units. Methods An electronic survey was carried out among Finnish neuromodulation units exploring staff demographics, anesthesia practices (including agents and adjuvants), patient physiology monitoring, observed adverse effects, patient follow-up times, and recent anesthesia protocol changes. Results Finland has 26 neuromodulation units providing ECT, of which 18 (69%) responded to our study. The research uncovered significant differences in anesthesia practices, including induction agent choice, convulsion motor component monitoring, staff educational backgrounds, and reported adverse effects. Propofol was the most commonly used anesthetic in 14 units (78%). Three units (17%) reported using methohexital in 80%–100% of their patients, whereas in contrast, methohexital was not used at all in 10 units (56%). Electromyography seizure activity was quantitatively measured in 6 units (33%), whereas 10 units (56%) did not measure electromyography seizure activity at all. The remaining 2 units assessed seizure activity through visual observation. Headache requiring medication was the most commonly reported adverse effect, and it was reported as a frequent problem in 3 units (18%). Conclusions Based on the variation in anesthesia practices identified in the study, we suggest there may be benefits to developing a national guideline for standardizing treatment.

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Comparative efficacy and tolerability of different anesthetics in electroconvulsive therapy for major depressive disorder: A systematic review and network meta-analysis

Cited by 3 publications

References 62 publications

Comparison of Effects of Propofol Combined with Different Doses of Esketamine for ECT in the Treatment of Depression: A Randomized Controlled Trial Protocol

Comparison of Effects of Propofol Combined with Different Doses of Esketamine for ECT in the Treatment of Depression: A Randomized Controlled Trial Protocol

Ketamin in Anästhesie und Intensivmedizin

A Survey of ECT Anesthesia Practice Variation in Finland

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