Is ketamine an appropriate alternative to ECT for patients with treatment resistant depression? A systematic review

Ketamine has repeatedly shown to have rapid and robust antidepressant effects in patients with treatment resistant depression (TRD). An important question is whether ketamine as effective safe the current gold standard electroconvulsive therapy (ECT). The literature was searched for trials comparing ECT Pubmed/MEDLINE database Cochrane Trials Library. A total of 137 manuscripts were identified, 6 articles included this review. Overall quality studies diverse relevant risk bias some studies. Results suggest that might give faster but perhaps less durable effects. Side differed from ECT, particular cognitive impairment apparent treatment. limited sample sizes, use different protocols most trials, longer term follow up lacking. Furthermore, allocation appears likely non-randomized trials. Current available does not yet provide convincing evidence consider an equally alternative TRD. There are indications a more favourable short side effect profile after Methodologically well-designed larger sizes duration warranted.