A systematic review and meta-analysis of the efficacy of ketamine compared to electroconvulsive therapy for treatment-resistant depression.

IF 2.3 4区医学 Q2 PSYCHIATRY

International Journal of Psychiatry in Clinical Practice Pub Date : 2026-03-01 Epub Date: 2025-10-21 DOI:10.1080/13651501.2025.2576205

Guoguang Song, Ugwah-Oguejiofor Chinenye Jane

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引用次数: 0

Abstract

Background: Electroconvulsive therapy (ECT) has long been considered the main method of treatment for patients with resistant major depressive disorder (MDD). Recent studies have shown that ketamine infusion can also effectively improve treatment-resistant MDD. Thus, we conducted this meta-analysis to compare the efficacy of ketamine with ECT for treating treatment-resistant depression.

Methods: We systematically searched PubMed, the Cochrane Library, Scopus and Web of Science from the inception to 2 October 2024, to identify clinical trials and randomised controlled trials comparing the effect of ketamine with ECT on treatment-resistant major depression.

Results: Six studies with 353 individuals in the ketamine group and 323 individuals in the ECT group were included. No significant differences were observed between ECT and ketamine in terms of response to treatment (RR 1.03, 95% CI (0.78, 1.37), I² = 77.14%, T² = 0.08), MADRS score (weighted mean difference (WMD) 0.98, 95% CI (-5.04, 7.00), I² = 94.74%, T² = 26.52), remission (RR 0.65, 95% CI (0.16, 2.64), I² = 89.77%, T² = 1.19), relapse (RR 0.93, 95% CI (0.50, 1.72), I² = 20.13%, T² = 0.04) and the number of those experiencing adverse events (RR 0.72, 95% CI (0.47, 1.10), I² = 0.00%, T² = 0.00).

Conclusion: These findings suggest that ketamine is not inferior to ECT for treating MDD; however, future studies are needed for validation.

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氯胺酮与电惊厥治疗难治性抑郁症疗效的系统回顾和荟萃分析。

背景：电痉挛疗法（ECT）一直被认为是治疗顽固性重度抑郁症（MDD）的主要方法。最近的研究表明，氯胺酮输注也可以有效改善治疗抵抗性重度抑郁症。因此，我们进行了这项荟萃分析，比较氯胺酮与ECT治疗难治性抑郁症的疗效。方法：我们系统地检索PubMed、Cochrane图书馆、Scopus和Web of Science从成立到2024年10月2日，以确定临床试验和随机对照试验，比较氯胺酮与ECT对难治性重度抑郁症的影响。结果：共纳入6项研究，氯胺酮组353例，ECT组323例。之间没有显著差异观察ECT和氯胺酮对治疗的反应(相对危险度1.03,95%可信区间(0.78,1.37),I2 = 77.14%, T2 = 0.08), MADRS得分(加权平均差(WMD) 0.98, 95%可信区间(-5.04,7.00),I2 = 94.74%, T2 = 26.52),缓解(相对危险度0.65,95%可信区间(0.16,2.64),I2 = 89.77%, T2 = 1.19),复发(相对危险度0.93,95%可信区间(0.50,1.72),I2 = 20.13%, T2 = 0.04)和那些经历不良事件(相对危险度0.72,95%可信区间(0.47,1.10),I2 = 0.00%, T2 = 0.00)。结论：氯胺酮治疗重度抑郁症的疗效不逊于ECT；然而，需要进一步的研究来验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Psychiatry in Clinical Practice 医学-精神病学

CiteScore

6.00

自引率

3.30%

发文量

审稿时长

>12 weeks

期刊介绍： International Journal of Psychiatry in Clinical Practice provides an international forum for communication among health professionals with clinical, academic and research interests in psychiatry. The journal gives particular emphasis to papers that integrate the findings of academic research into realities of clinical practice. Focus on the practical aspects of managing and treating patients. Essential reading for the busy psychiatrist, trainee and interested physician. Includes original research papers, comprehensive review articles and short communications. Key words: Psychiatry, Neuropsychopharmacology, Mental health, Neuropsychiatry, Clinical Neurophysiology, Psychophysiology, Psychotherapy, Addiction, Schizophrenia, Depression, Bipolar Disorders and Anxiety.