This unregistered trial (n=45) was a randomised, open-label pilot study of intramuscular or oral ketamine versus electroconvulsive therapy for major depressive disorder with suicidal ideation in adults, which found ketamine to be as effective as ECT with higher patient preference.
This synthetic trial has been added to our database because a psychedelic paper (about a clinical trial) references this trial, but no (live) registration can be found.
The study compared the antidepressant and antisuicidal effects of three different treatment modalities: intramuscular (IM) racemic ketamine at 0.5 mg/kg, oral R-ketamine at 1 mg/kg, and electroconvulsive therapy (ECT) consisting of 6 to 9 sessions over three weeks. The participants were 45 adults aged 18 to 70 years diagnosed with major depressive disorder (MDD) who were considered suitable candidates for ECT due to the severity of their symptoms or suicidal ideation.
Results indicated that all three interventions significantly improved depression and suicidal ideation scores compared to baseline, with no significant differences in efficacy between the groups. However, the ketamine groups experienced only transient dissociative symptoms, whereas some patients in the ECT group experienced memory loss for up to one month. Ultimately, patients reported higher satisfaction and preference for the ketamine-based treatments.
Electroconvulsive therapy (ECT) consisting of 6 to 9 sessions during 3 weeks.
Electrical stimulus titrated based on duration of induced seizure; electrodes placed bifrontotemporal.
0.5 mg/kg of intramuscular (IM) racemic ketamine repeated for 6 to 9 injections during 3 weeks.
Racemic ketamine (R-ketamine) administered in gluteus medius site.
1 mg/kg of oral R-ketamine every 2 to 3 days up to 6 to 9 sessions during 3 weeks.
R-ketamine administered with flavors and sweeteners to eliminate bitter taste.