title: A randomized comparison of ketamine versus methohexital anesthesia in electroconvulsive therapy.
abstract: To assess the clinical utility of ketamine as an anesthetic agent for electroconvulsive therapy (ECT), based upon recent findings that ketamine may have antidepressant properties. Depressed ECT patients were randomly assigned to receive anesthesia with either ketamine or methohexital. Outcome measures included assessments of depressive severity, cognition, post-anesthesia side effects, and hemodynamics. Twenty one patients were treated with ketamine and 17 with methohexital. There were no significant differences in depression or cognitive outcomes between the two drugs. Additionally, there were no measures of post-anesthesia tolerability or hemodynamics which favored ketamine. Ketamine anesthesia does not accelerate the antidepressant effect of ECT or diminish the cognitive side effects, at least as measured in this study. Furthermore, there is no apparent benefit of ketamine for speed or quality of post-ECT recovery, and it is associated with higher systolic blood pressures after the treatments. Ketamine is associated with longer motor seizure duration than methohexital.
authors.affiliation: Mayo Clinic Departments of Psychiatry and Psychology, Rochester, MN 55905, USA. Electronic address: rasmussen.keith@mayo.edu.
authors.forename: Keith G
authors.initials: KG
authors.lastname: Rasmussen
authors.affiliation: Mayo Clinic Departments of Psychiatry and Psychology, Rochester, MN 55905, USA.
authors.forename: Simon
authors.initials: S
authors.lastname: Kung
authors.affiliation: Mayo Clinic Departments of Psychiatry and Psychology, Rochester, MN 55905, USA.
authors.forename: Maria I
authors.initials: MI
authors.lastname: Lapid
authors.affiliation: Mayo Clinic Departments of Psychiatry and Psychology, Rochester, MN 55905, USA.
authors.forename: Tyler S
authors.initials: TS
authors.lastname: Oesterle
authors.affiliation: Mayo Clinic Departments of Psychiatry and Biostatistics, Rochester, MN, USA.
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Geske
authors.affiliation: Mayo Clinic Departments of Psychiatry and Anesthesiology, Rochester, MN, USA.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Nuttall
authors.affiliation: Mayo Clinic Departments of Psychiatry and Anesthesiology, Rochester, MN, USA.
authors.forename: William C
authors.initials: WC
authors.lastname: Oliver
authors.affiliation: Mayo Clinic Departments of Psychiatry and Anesthesiology, Rochester, MN, USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Abenstein
mesh_terms: D000328:Adult; D000777:Anesthetics / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D003071:Cognition / Q000187:drug effects; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007649:Ketamine / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008723:Methohexital / Q000494:pharmacology / Q000627:therapeutic use*; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000777:Anesthetics; D007649:Ketamine; D008723:Methohexital
keywords: Anesthesia; Cognition; Hemodynamics; Major depression; Mood disorder