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Ketamine or ECT? What Have We Learned From the KetECT and ELEKT-D Trials?

Ekstrand, Joakim LU ; Takamiya, Akihiro ; Nordenskjold, Axel ; Kirov, George ; Sienaert, Pascal ; Kellner, Charles H. and Movahed Rad, Pouya LU (2024) In International Journal of Neuropsychopharmacology 27(1).
Abstract

1. Two recent clinical trials, KetECT and ELEKT-D, compared the effectiveness of ketamine and electroconvulsive therapy (ECT) for major depressive disorder. Notably, these trials reported marked differences in ECT's clinical outcomes of, with remission rates of 63% for KetECT and a strikingly lower rate of 22% for ELEKT-D, while the remission rates for ketamine were 46% and 38%, respectively. Considering that the primary objective of both trials was to compare the standard treatment (ECT) with an experimental intervention (ketamine), it is crucial to highlight the pronounced disparities in ECT's clinical outcomes. This article offers a comprehensive comparison of these trials while also exploring how patient characteristics, treatment... (More)

1. Two recent clinical trials, KetECT and ELEKT-D, compared the effectiveness of ketamine and electroconvulsive therapy (ECT) for major depressive disorder. Notably, these trials reported marked differences in ECT's clinical outcomes of, with remission rates of 63% for KetECT and a strikingly lower rate of 22% for ELEKT-D, while the remission rates for ketamine were 46% and 38%, respectively. Considering that the primary objective of both trials was to compare the standard treatment (ECT) with an experimental intervention (ketamine), it is crucial to highlight the pronounced disparities in ECT's clinical outcomes. This article offers a comprehensive comparison of these trials while also exploring how patient characteristics, treatment protocols, and study designs may contribute to such pronounced outcome discrepancies. These differences highlight the heterogeneous nature of depression and underscore the need for personalized treatments. These studies also provide valuable insights into identifying the most suitable candidates for ketamine and ECT.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
clinical trials, electroconvulsive therapy, Major depressive disorder, racemic ketamine
in
International Journal of Neuropsychopharmacology
volume
27
issue
1
article number
pyad065
publisher
Cambridge University Press
external identifiers
  • scopus:85184037882
  • pmid:38114073
ISSN
1461-1457
DOI
10.1093/ijnp/pyad065
language
English
LU publication?
yes
id
0e033156-5169-43de-a5d7-f17bdc5a7bc2
date added to LUP
2024-02-27 10:30:36
date last changed
2024-06-21 18:37:56
@article{0e033156-5169-43de-a5d7-f17bdc5a7bc2,
  abstract     = {{<p>1. Two recent clinical trials, KetECT and ELEKT-D, compared the effectiveness of ketamine and electroconvulsive therapy (ECT) for major depressive disorder. Notably, these trials reported marked differences in ECT's clinical outcomes of, with remission rates of 63% for KetECT and a strikingly lower rate of 22% for ELEKT-D, while the remission rates for ketamine were 46% and 38%, respectively. Considering that the primary objective of both trials was to compare the standard treatment (ECT) with an experimental intervention (ketamine), it is crucial to highlight the pronounced disparities in ECT's clinical outcomes. This article offers a comprehensive comparison of these trials while also exploring how patient characteristics, treatment protocols, and study designs may contribute to such pronounced outcome discrepancies. These differences highlight the heterogeneous nature of depression and underscore the need for personalized treatments. These studies also provide valuable insights into identifying the most suitable candidates for ketamine and ECT.</p>}},
  author       = {{Ekstrand, Joakim and Takamiya, Akihiro and Nordenskjold, Axel and Kirov, George and Sienaert, Pascal and Kellner, Charles H. and Movahed Rad, Pouya}},
  issn         = {{1461-1457}},
  keywords     = {{clinical trials; electroconvulsive therapy; Major depressive disorder; racemic ketamine}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Cambridge University Press}},
  series       = {{International Journal of Neuropsychopharmacology}},
  title        = {{Ketamine or ECT? What Have We Learned From the KetECT and ELEKT-D Trials?}},
  url          = {{http://dx.doi.org/10.1093/ijnp/pyad065}},
  doi          = {{10.1093/ijnp/pyad065}},
  volume       = {{27}},
  year         = {{2024}},
}