Ketamine Anesthesia in Electroconvulsive Therapy

Electroconvulsive therapy (ECT) is highly effective for both major depressive disorder and bipolar disorder. Ketamine, an NMDA receptor antagonist, has antidepressant properties. This chapter reviews the literature on the effectiveness of ECT and ketamine, including whether ketamine-anesthetized ECT is more effective than conventional ECT, and whether ketamine can serve as an alternative to ECT for treatment-resistant depression.

Study at a glance

Abstract

Electroconvulsive therapy (ECT) is highly effective both Major Depressive Disorder (MDD) and Bipolar Disorder (BD). Ketamine, an antagonist of the N-Methyl-D-aspartate receptor, has been described to have antidepressant properties. There is a hypothesis that ECT performed with anesthesia using ketamine is more effective than conventional ECT. Also, although ECT is the gold standard for BD and MDD, there are questions about which is more effective, ketamine treatment or ECT, and whether ketamine is more effective when used in combination with ECT. In this chapter, we review the current literature on the effectiveness of ECT and ketamine. Furthermore, we discuss whether ketamine can be an alternative treatment to ECT for patients with TRD.