Comparative Efficacy and Safety of Ketamine Versus Electroconvulsive Therapy in Major Depressive Disorder: A Meta-Analysis of Randomized Controlled Trials.

IF 2.7 4区 医学 Q2 PSYCHIATRY
Zhijian Ma, Fengle Wu, Wen Zheng
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引用次数: 0

Abstract

This meta-analysis aimed to compare the efficacy and safety of ketamine versus electroconvulsive therapy (ECT) in patients with major depressive disorder(MDD). A comprehensive literature search was conducted across PubMed, Embase, and Web of Science databases up to November 2024. The randomized controlled trials evaluating the efficacy and safety of ketamine and ECT in MDD patients were included. Pooled standardized mean differences (SMD) and risk ratios (RR) were calculated with 95% confidence intervals. The Cochrane's Risk of Bias Tool was employed to assess study quality. Six studies encompassing 643 patients were analyzed. No significant difference was observed in depression symptom severity scores between ketamine and ECT groups (SMD: -0.02, 95% CI: -0.53 to 0.48, P = 0.92). Response rates also showed no significant difference between the two interventions (RR: 1.08, 95% CI: 0.67 to 1.72, P = 0.76). Notably, ketamine demonstrated superior memory function improvement compared to ECT (SMD: 2.02, 95% CI: 1.64 to 2.48, P < 0.001). In terms of adverse events, ketamine was associated with significantly higher rates of dissociative symptoms, blurred vision, and dizziness(all P < 0.001), while demonstrating a lower incidence of muscle pain(P < 0.001). The meta-analysis revealed ketamine as a non-inferior therapeutic option for patients with major depressive disorder, with potential advantages in memory function. While promising, the limited number of included studies necessitates further large-scale randomized controlled trials using standardized assessment scales to validate these findings.

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来源期刊
Psychiatric Quarterly
Psychiatric Quarterly PSYCHIATRY-
CiteScore
8.10
自引率
0.00%
发文量
40
期刊介绍: Psychiatric Quarterly publishes original research, theoretical papers, and review articles on the assessment, treatment, and rehabilitation of persons with psychiatric disabilities, with emphasis on care provided in public, community, and private institutional settings such as hospitals, schools, and correctional facilities. Qualitative and quantitative studies concerning the social, clinical, administrative, legal, political, and ethical aspects of mental health care fall within the scope of the journal. Content areas include, but are not limited to, evidence-based practice in prevention, diagnosis, and management of psychiatric disorders; interface of psychiatry with primary and specialty medicine; disparities of access and outcomes in health care service delivery; and socio-cultural and cross-cultural aspects of mental health and wellness, including mental health literacy. 5 Year Impact Factor: 1.023 (2007) Section ''Psychiatry'': Rank 70 out of 82
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