ECT may be more effective than ketamine in treating severe depression

Electroconvulsive therapy may be a more effective treatment for individuals with severe depression than intravenous ketamine. The report follows a recent study by researchers at Sweden’s Lund University.

“The previous studies have all been small with a short follow-up period, so this is the first major randomized clinical study,” says study lead Pouya Movahed Rad, researcher at the university and a consultant psychiatrist, in a statement.

Ketamine has been a prevalent treatment option in recent years following studies demonstrating its efficacy, but researchers have found that the current preferred approach of treating very severe depression with ECT may be more beneficial to patients. 

“Ketamine is a controlled drug and needs to be given under supervision, while ECT can cause temporary memory side effects and is resource-intensive as the patient needs to be anesthetized,” Rad says.

In their study, researchers analyzed ketamine’s antidepressant effect compared to electroconvulsive therapy. 63% of patients in the ECT group recovered after treatment. Comparatively, the group receiving racemic ketamine intravenously saw 46% recovery. 

Both treatments have been successful in treating severely depressed patients, but the recurrent nature of depression makes it so that neither treatment may necessarily cure the underlying condition. Approximately equivalent numbers in both groups experienced a relapse within 12 months of the study.

“We did not see the rapid effect of ketamine that other studies have shown. Instead, our results indicate that the effect is cumulative, and increases with the number of treatments,” Rad says. “Older people generally responded less well to ketamine, while younger people responded as well to ECT as to ketamine.”

Researchers found that full recovery with either treatment required six sessions, but participants in the ketamine group were more likely to remove themselves from the study than those treated with ECT.

“The group we studied had been offered ECT, but about half of them were now randomized to participate in the intravenous ketamine group,” said Rad. “This may have been important because some of the participants chose to discontinue the ketamine treatment prematurely.”

However, side effects such as persistent memory difficulties were more common among patients treated with ECT.

“Our results suggest that intravenous ketamine does not cause serious side effects in this patient group. No treatment should be overused, but ketamine should be an acceptable alternative for patients with severe depression,” Rad said. “We want to continue by studying the blood samples and other data that we have collected, to see if we can find markers that help us choose the right treatment for the right patient.” 

This study is published in the International Journal of Neuropsychopharmacology.

Article written by Anna Landry

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