title: Clinically favourable effects of ketamine as an anaesthetic for electroconvulsive therapy: a retrospective study.
abstract: In a retrospective chart review, we examined the effects of ketamine, an N-methyl-d-aspartate (NMDA) receptor antagonist, as electroconvulsive therapy (ECT) anaesthetic in patients suffering from therapy-resistant depression. We included 42 patients who received ECT treatment with either ketamine (n = 16) or the barbiturate thiopental (n = 26). We analysed the number of sessions until completion of ECT treatment (used as a surrogate parameter for outcome), psychopathology as assessed by pre- and post-ECT Mini-Mental State Examination (MMSE) and Hamilton Rating Scale for Depression (HAM-D) scores as well as ECT and seizure parameters (stimulation dose, seizure duration and concordance, urapidil dosage for post-seizure blood pressure management). The ketamine group needed significantly fewer ECT sessions and had significantly lower HAM-D and higher MMSE scores afterwards. As expected, the ketamine group needed more urapidil for blood pressure control. Taking into account the limits inherent in a retrospective study design and the rather small sample size, our results nonetheless point towards synergistic effects of ECT and ketamine anaesthesia, less cognitive side effects and good tolerability of ketamine.
authors.affiliation: Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Ruprecht-Karls-University Heidelberg, J5, 68159 Mannheim, Germany.
authors.forename: Laura
authors.initials: L
authors.lastname: Kranaster
authors.forename: Jutta
authors.initials: J
authors.lastname: Kammerer-Ciernioch
authors.forename: Carolin
authors.initials: C
authors.lastname: Hoyer
authors.forename: Alexander
authors.initials: A
authors.lastname: Sartorius
mesh_terms: D000368:Aged; D000778:Anesthetics, Dissociative / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000009:adverse effects; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003072:Cognition Disorders / Q000209:etiology; D003865:Major Depressive Disorder / Q000628:therapy; D061218:Depressive Disorder, Treatment-Resistant; D004565:Electroconvulsive Therapy / Q000009:adverse effects / Q000379:methods*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007297:Inpatients; D007649:Ketamine / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010879:Piperazines / Q000627:therapeutic use; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D013874:Thiopental / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D000959:Antihypertensive Agents; D010879:Piperazines; D007649:Ketamine; C015568:urapidil; D013874:Thiopental