Electroconvulsive therapy vs Esketamine among patients with Major Depressive Episode

Introduction Major depressive disorder is one of the most common and disabling mental disorders. More than 30% individuals do not achieve remission after several trials antidepressants treatment-resistant depression (TRD) associated with premature mortality. Electroconvulsive therapy (ECT) considered gold-standard for TRD treatment,unfortunately it´s underused due to health care barriers association adverse cognitive impairment. So, scientists have sought identify alternative treatments that approach ECT-equivalent efficacy. Trials Ketamine more recently its S-enantiomer (Esketamine) has been made, revealing a rapid robust antidepressant effect, emerging as an option treatment. Objectives We we aim conduct qualitative review, comparing clinical efficacy, tolerability acceptability between use Esketamine ECT Methods non-systematic review recent evidence treatment, using PubMed/Medline database. Results To compare treatment analyzed outcomes interest. First,ECT was superior improving symptoms. Comparing suicidal ideation suicide attempts, results were statistically different. About cognition impairment, performed better ECT, particularizing attention, verbal memory, executive functions; no differences found immediate memory or visual memory.About effects less risk headache muscle pain, but higher reports transient, dissociative depersonalization symptoms, blurred vision, diplopia nystagmus. An important consideration clinicians comparative safety vs ECT; involves full dose anesthesia,it expected would be tolerated safer ECT. But study assessed relative these different effect profiles.The best strategy relapse prevention appears continuing pharmacotherapy, some combination both; effective too. Conclusions may severity in acute phase, long-term are considered. There just two studies follow-up trial completed:one difference during 3-month follow-up, other reported rates groups by 12-month period.Therefore,future research needed further optimize both prevent relapse. Until then,treatment options should individualized patient-centered. Disclosure Interest None Declared