Comparison of Effects of Propofol Combined with Different Doses of Esketamine for ECT in the Treatment of Depression: A Randomized Controlled Trial Protocol.
Xuemeng Chen, Rui Zhou, Lan Lan, Ling Zhu, Cheng Chen, Xianjie Zhang, Jia Han, Leqiang Xia
Neuropsychiatric disease and treatment January 1, 2024 DOI: 10.2147/NDT.S463028 via PubMed
Summary
AI-generated from the abstractElectroconvulsive therapy (ECT) is effective for treatment-resistant major depressive disorder. Combining esketamine with propofol anesthesia during ECT may improve outcomes. In a randomized, double-blind trial, 111 patients were assigned to receive propofol alone (1 mg/kg), low-dose esketamine (0.25 mg/kg) with propofol (0.75 mg/kg), or higher-dose esketamine (0.5 mg/kg) with propofol (0.5 mg/kg). Outcomes included depression scales, suicide risk, cognitive function, hospital stay, readmission, and side effects. The results may guide better ECT anesthesia choices.
Study at a glance
| Characteristics | Randomized controlled trial Double-blind Peer reviewed |
|---|---|
| Sample size | 111 |
| Population | Patients scheduled for electroconvulsive therapy |
| Interventions | Propofol Esketamine |
| Dose | propofol 1 mg/kg; propofol 0.5 mg/kg plus esketamine 0.5 mg/kg; propofol 0.75 mg/kg plus esketamine 0.25 mg/kg |
| Topics | Depression Esketamine |
| Keywords | Curative effect Electroconvulsive therapy Depression therapy Electroconvulsive treatment |
| Citations | 4 |
| Key finding | Combining different doses of esketamine with propofol for ECT anesthesia may offer advantages over propofol alone, but specific results are not yet reported. |
Abstract
Major depressive disorder (MDD) is a common mood disorder. Electroconvulsive therapy (ECT) has a significant effect on treatment-resistant MDD. Esketamine may have potential advantages in improving the efficacy of ECT, and the strong affinity of this compound for NMDAR renders it a viable therapeutic option for the management of depression. This study aims to compare the effects of different doses of esketamine combined with propofol anesthesia versus propofol anesthesia alone in ECT, aiming to provide further insights for optimizing ECT and enhancing comprehensive treatment outcomes for depression. This study was a prospective, randomized, controlled, double-blind trial involving subjects and evaluators. One hundred eleven patients scheduled for ECT were randomly assigned to three groups. In Group P, propofol at 1mg/kg was administered intravenously. In Group P+E, propofol at a dosage of 0.5mg/kg and esketamine at a dosage of 0.5mg/kg was administered intravenously. Patients in Group P+SE received propofol at a dosage of 0.75mg/kg and esketamine at a dosage of 0.25mg/kg. The same anesthesia protocol was used for the same patient until the end of the last treatment. The primary outcome measures were the Hamilton depression scale (HAMD) and the Patient Health Questionnaire-9 (PHQ-9), the Columbia-Suicide Severity Rating Scale (C-SSRS), and the Digit symbol substitution test (DSST). Secondary outcomes included length of hospital stay, readmission rate, hemodynamic status, recovery, and adverse events. This study aimed to compare the effects of propofol combined with different doses of esketamine for ECT. The results may provide a better choice for ECT anesthesia.