Significant treatment effect of add-on ketamine anesthesia in electroconvulsive therapy in depressive patients: A meta-analysis.

Dian-Jeng Li, Fu-Chiang Wang, Che-Sheng Chu, Tien-Yu Chen, Chia-Hung Tang, Wei-Cheng Yang, Philip Chik-Keung Chow, Ching-Kuan Wu, Ping-Tao Tseng, Pao-Yen Lin

Journal: European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology 2018;27(1):29-41

PMID: 27908572

Full Text on Elsevier Science View on PubMed

Abstract

Add-on ketamine anesthesia in electroconvulsive therapy (ECT) has been studied in depressive patients in several clinical trials with inconclusive findings. Two most recent meta-analyses reported insignificant findings with regards to the treatment effect of add-on ketamine anesthesia in ECT in depressive patients. The aim of this study is to update the current evidence and investigate the role of add-on ketamine anesthesia in ECT in depressive patients via a systematic review and meta-analysis. We performed a thorough literature search of the PubMed and ScienceDirect databases, and extracted all relevant clinical variables to compare the antidepressive outcomes between add-on ketamine anesthesia and other anesthetics in ECT. Total 16 articles with 346 patients receiving add-on ketamine anesthesia in ECT and 329 controls were recruited. We found that the antidepressive treatment effect of add-on ketamine anesthesia in ECT in depressive patients was significantly higher than that of other anesthetics (p<0.001). This significance persisted in both short-term (1-2 weeks) and moderate-term (3-4 weeks) treatment courses (all p<0.05). However, the side effect profiles and recovery time profiles were significantly worse in add-on ketamine anesthesia group than in control group. Our meta-analysis highlights the significantly higher antidepressive treatment effect of add-on ketamine in depressive patients receiving ECT compared to other anesthetics. However, clinicians need to take undesirable side effects into consideration when using add-on ketamine anesthesia in ECT in depressive patients.

Address: Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan; Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan.; Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan.; Department of Psychiatry, Puli Branch, Taichung Veterans General Hospital, Taiwan.; Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.; Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Taiwan.; Department of Adult Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan.; Department of Child and Adolescent Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan.; Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai׳s Home, Taiwan.; Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai׳s Home, Taiwan. Electronic address: [email protected].; Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan; Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. Electronic address: [email protected].

DOI: 10.1016/j.euroneuro.2016.11.008

Link outs

Free resources

Medical:

Other Literature Sources:

https://scite.ai/reports/27908572

Subscription / membership required

Full Text Sources:

MeSH Terms: Databases, Bibliographic, Depression, Electroconvulsive Therapy, Excitatory Amino Acid Antagonists, Ketamine