
While electroconvulsive therapy (ECT) and ketamine are both effective treatments for depression, ketamine was found to have a faster onset of action and better short-term cognitive outcomes than ECT, according to study results published in the Journal of Psychiatric Research.
The study included 50 patients with major depressive disorder (MDD) who were hospitalized at the department of psychiatry, Charité-Universitätsmedizin in Berlin, Germany, and treated with ECT 3 times a week for 4 weeks (n=25; mean age, 49.96±11.82 years; 11 women) or ketamine 3 times a week for 2 weeks (n=25; mean age, 49.08±10.45 years; 15 women). The investigators assessed depressive symptom severity using the Montgomery-Åsberg Depression Rating Scale at baseline, mid-treatment (after 6 ECT sessions or 3 ketamine infusions), and at treatment termination (after 12 ECT sessions or 3 ketamine infusions). They also assessed cognitive performance (eg, attention, visual memory, and executive functions) at baseline for both groups, mid-ECT treatment, and at ECT and ketamine treatment end.
The investigators found a greater reduction in patients’ depressive symptoms after 1 week of ketamine treatment (mean decrease, −47.45±23.43%) compared with 2 weeks of ECT (mean decrease, −34.86±21.29%). Both treatments were equally effective in terms of symptom reduction at the end of treatment (ketamine: mean decrease, −49.88±27.30%; ECT: mean decrease, −55.70±23.63%), but the same antidepressant effects that were achieved within 4 weeks of ECT treatment could be achieved within 2 weeks of ketamine administration.
Overall, patients treated with ketamine showed improved cognitive performance, particularly attention and executive functions, whereas patients treated with ECT showed a small decrease in cognitive performance.
Patients in the study were not systematically randomized, and there was no control group. Many of the patients were also taking concurrent antidepressants during the study. The investigators acknowledged that “a randomized controlled trial with a large sample including long-term follow-up measurements seems advisable.” However, ketamine may be a useful treatment option when there is an urgent need for symptom improvement and for patients with pre-existing cognitive impairments.
Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
Reference
Basso L, Bönke L, Aust S, et al. Antidepressant and neurocognitive effects of serial ketamine administration versus ECT in depressed patients. J Psychiatr Res. 2020;123:1-8.
TMS
by Deb (age 64)
Category: generalThe hoops I jumped through in order to be evaluated were straightforward and efficient. I met with PA Kaitlin for about an hour to discuss my history and previous medications. Then Dr. Amato joined us to further discuss my history, the TMS treatment, and answer any questions. Myrna gathered all of the information and submitted it to my health insurance company to request coverage for TMS. Fortunately, insurance approved the treatment and I was able to begin the next week. I’m sure most people have anxiety about starting a treatment like TMS. No matter how many times it’s described to you, there are many unknowns. How will I feel during treatment? Is it painful? What if this doesn’t work? What if it works for a while but then stops? In all honesty, I was very uncomfortable during the first couple of weeks of treatment. The alternating two seconds of tapping sensation caused some pain during treatment, and at the end of the first week I thought about quitting. But I had sworn to myself that TMS was a last resort and I HAD TO complete the treatment and give it a chance to work. My technician, Heather, told me that some people don’t feel the tapping at all, they only hear it. Guess I wasn’t one of those people! But as the days went by, it became easier to tolerate the treatments. During this time I also saw Lauren weekly for CBT (cognitive behavioral therapy). This is highly recommended for people undergoing TMS treatment, and it was a positive complement to my total of 100 minutes each week “under the helmet”. The weekend between weeks three and four, I started to notice subtle improvements in my mood, increased belief in my self-worth, and enthusiasm for simple things like going for walks, meeting friends for lunch, and taking on volunteer work in the community. I hesitated at first to believe that TMS was helping me. I was afraid that I was convincing myself it was working because I so desperately wanted it to! But now that I am past the treatment I can say with cert
TMS
by Barbie (age 68)
Category: generalI feel so blessed to participate in the TMS protocol at MT Psychiatry. After struggling so many years with depression and not getting significant results from medication, particularly of late, I noticed positive results in the first two weeks of treatment. TMS can literally give you back the beauty & joy in living as well as the courage to make positive life changes and improvements in your daily living situation. I heartily encourage anyone to put yourself into the hands of the amazing TMS team who so gently and graciously make this journey with you out of the black hole that is depression. It is my honor and privilege to give the TMS treatment the highest recommendation.
TMS
by Shayne (age 66)
Category: generalI am grateful for the support and caring I have received from Dr. Amato (and Heidi, Heather and Myrna) in my quest for mental health and a fuller more productive life. While the TMS results have been subtle, I feel more positive about my future and I would recommend this team absolutely. Thank you!
TMS
by Carrie (age 65)
Category: generalNot realizing how fuzzy my head was, I thought I was only going through severe anxiety and depression. Through the insight of Pat, I was able to go through TMS treatments which brought down the anxiety and depression immensely and has cleared up the fuzzy, far off substantially. All the personnel treated me with kindness and I’m sure their attitudes helped in my recovery.
TMS
by Bridget (age 47)
Category: generalThe first outcome of TMS I noted happened early in my treatment, at about the beginning of week two. I felt as though my “brain fog” had been chipped away. I wish I could report that I feel my mental health issues are in “remission”, but I can’t do so yet. My hope is that I will see improvement in the weeks to come, now that my TMS cycle has ended. I can say that my brain feels – in some way – different; I can’t explain exactly how. I continue to struggle at this point in time but sill have hope for more improvement.
Powered by Crystal Clear Digital Marketing Reviews


