An estimated one in three people with clinical depression do not respond to antidepressants, limiting their treatment option to electroconvulsive therapy (ECT), which has been linked to physical and mental side effects and social stigma.

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A close-up photo of intravenous bags, a syringe, and several medicine vials.

However, the PCORI-funded ELEKT-D study team reported that patients with nonpsychotic, treatment-resistant depression who received ketamine intravenously fared just as well as those who received ECT. The findings were published in the New England Journal of Medicine.

In the clinical trial with 365 participants—which took place between March 2017 and September 2022 at five sites—55 percent of those receiving ketamine and 41 percent of those receiving ECT reported at least a 50 percent improvement in their depressive symptoms. The ketamine treatments caused fewer side effects and they were easier to administer to participants.

While the U.S. Food and Drug Administration has not approved ketamine as a treatment for psychiatric disorders, it has been approved as a sedative and general anesthetic. Previous studies have found the drug to have rapid antidepressant effects on people with treatment-resistant depression, but those studies did not conduct a comparison with ECT.

Principal investigator Amit Anand, M.D.—who is at Mass General Brigham/Harvard Medical School in Massachusetts—was at Cleveland Clinic in Ohio when the study was funded.

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Posted: June 5, 2023

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