1. In this systematic reappraisal and meta-analysis, electroconvulsive therapy (ECT) resulted successful less slump symptoms compared to ketamine.
2. However, successful studies that assessed cognition/memory oregon superior adverse events, determination were nary important differences betwixt ECT and ketamine.
Evidence Rating Level: 1 (Excellent)
Electroconvulsive therapy (ECT) is the golden modular for treating treatment-resistant large slump (TRD). However, ECT has been underused owed to assorted nonrecreational and patient-related barriers. As an alternative, intravenously delivered ketamine has shown committedness to efficaciously dainty TRD. Currently, nary survey has quantified and compared the effect size, safety, and efficacy betwixt ECT and ketamine. As a result, the nonsubjective of the contiguous systematic reappraisal and meta-analysis was to comparison these 2 therapies successful patients with large depressive disorder.
Of 1248 screened articles, 6 trials (n=340 patients; 162 for ECT, 178 for ketamine) from database inception to April 2022 were included. Studies were included if they evaluated the effects of ECT oregon ketamine connected depressive symptoms successful patients gathering diagnostic criteria for large depressive disorder. Studies were excluded if they utilized non-human participants and if they did not usage standardized measures of depression. Risk of bias and survey prime were evaluated utilizing the Cochrane Collaboration Risk of Bias tool. Improvement successful depressive symptoms was calculated utilizing Hedges g standardized mean differences (SMDs) and fixed oregon random-effects models. The reappraisal was successful accordance with PRISMA guidelines. The superior result was betterment of slump symptoms and severity.
Results demonstrated that ECT was superior to ketamine crossed assorted depressive symptoms measured. However, 3 studies showed that ketamine had faster antidepressant effects than ECT. Furthermore, the broadside effect load differed betwixt some treatments: ketamine had a little hazard of definite adverse events specified arsenic headache and musculus symptom portion ECT had little risks of blurred vision, vertigo, diplopia, etc. However, the survey was constricted by the inclusion of studies with tiny illustration sizes which whitethorn person led to them being underpowered. Nonetheless, the results of this reappraisal item the imaginable superiority of ECT to ketamine successful improving depressive symptoms.
Click to work the survey successful JAMA Psychiatry
Image: PD
©2023 2 Minute Medicine, Inc. All rights reserved. No works whitethorn beryllium reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire astir licensing here. No nonfiction should beryllium construed arsenic aesculapian proposal and is not intended arsenic specified by the authors oregon by 2 Minute Medicine, Inc.
English (US)