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Adjunctive ketamine and electroconvulsive therapy for major depressive disorder: A meta-analysis of randomized controlled trials
Zheng,Wei1; Li,Xiao Hong2; Zhu,Xiao Min3; Cai,Dong Bin4; Yang,Xin Hu1; Ungvari,Gabor S.5,6; Ng,Chee H.7; Ning,Yu Ping1; Hu,Yong Dong8; He,Shu Hua9; Wang,Gang2; Xiang,Yu Tao10
2019-05-01
Source PublicationJournal of Affective Disorders
ISSN0165-0327
Volume250Pages:123-131
AbstractBackground: Adjunctive ketamine with electroconvulsive therapy (ECT) has been investigated for treating major depressive disorder (MDD), but the findings have been inconsistent. Aim: This is an updated meta-analysis of the efficacy and safety of ketamine augmentation of ECT in the treatment of MDD. Methods: Randomized controlled trials (RCTs) reporting on the efficacy and safety of ketamine and ECT were identified and analyzed. Results: Seventeen RCTs (n = 1,035) compared ketamine alone or ketamine plus other anesthetic drugs (n = 557) with other anesthetic agents (n = 478) in MDD patients who received ECT. Ketamine+other anesthetic drugs was superior in improving depressive symptoms over other anesthetic medications at early study time point, but not at post-ECT or end of study time points. Ketamine alone was not more efficacious in treating depressive symptoms than other anesthetic drugs at early study, post-ECT and end of study time points. Sensitivity analysis and 19 of the 20 subgroup analyses also confirmed the lack of significance of these findings. Eleven RCTs testing the effects of ketamine on neurocognitive functions with various test batteries found mixed results. Ketamine alone significantly increased blood pressure more than other anesthetic drugs in MDD treated with ECT. Conclusion: Compared to other anesthetic agents, ketamine alone does not appear to improve the efficacy of ECT. However, ketamine+other anesthetic combinations may confer a short-term advantage in improving depressive symptom at the early stages of ECT.
KeywordAnaesthesia Depression ECT Ketamine Meta-analysis
DOI10.1016/j.jad.2019.02.044
URLView the original
Language英语
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Cited Times [WOS]:12   [WOS Record]     [Related Records in WOS]
Document TypeJournal article
CollectionUniversity of Macau
Corresponding AuthorWang,Gang
Affiliation1.The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital),Guangzhou,China
2.The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & The Advanced Innovation Center for Human Brain Protection,Capital Medical University,School of Mental Health,Beijing,China
3.Suzhou Guangji Hospital,The Affiliated Guangji Hospital of Soochow University,Suzhou,China
4.Shenzhen Traditional Chinese Medicine Hospital,Shenzhen,China
5.The University of Notre Dame Australia,Fremantle,Australia
6.Division of Psychiatry,School of Medicine,Perth,Australia
7.Department of Psychiatry,University of Melbourne,Melbourne,Australia
8.Department of Psychological Medicine,Beijing Chao-Yang Hospital,Capital Medical University,Beijing,China
9.University of California,Davis,United States
10.Unit of Psychiatry,Institute of Translational Medicine,Faculty of Health Sciences,University of Macau,Taipa,Avenida da Universidade, 3/F, Building E12,China
Recommended Citation
GB/T 7714
Zheng,Wei,Li,Xiao Hong,Zhu,Xiao Min,et al. Adjunctive ketamine and electroconvulsive therapy for major depressive disorder: A meta-analysis of randomized controlled trials[J]. Journal of Affective Disorders,2019,250:123-131.
APA Zheng,Wei,Li,Xiao Hong,Zhu,Xiao Min,Cai,Dong Bin,Yang,Xin Hu,Ungvari,Gabor S.,Ng,Chee H.,Ning,Yu Ping,Hu,Yong Dong,He,Shu Hua,Wang,Gang,&Xiang,Yu Tao.(2019).Adjunctive ketamine and electroconvulsive therapy for major depressive disorder: A meta-analysis of randomized controlled trials.Journal of Affective Disorders,250,123-131.
MLA Zheng,Wei,et al."Adjunctive ketamine and electroconvulsive therapy for major depressive disorder: A meta-analysis of randomized controlled trials".Journal of Affective Disorders 250(2019):123-131.
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