Evidence map›Paper›PMID 35020871›Full record

Trial reportThe international journal of neuropsychopharmacology2022

Racemic Ketamine as an Alternative to Electroconvulsive Therapy for Unipolar Depression: A Randomized, Open-Label, Non-Inferiority Trial (KetECT).

Joakim Ekstrand, Christian Fattah, Marcus Persson, Tony Cheng, Pia Nordanskog, Jonas Åkeson, Anders Tingström, Mats B Lindström, Axel Nordenskjöld, Pouya Movahed Rad

Open access · goldAbstract readRandomized Controlled TrialEquivalence Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The international journal of neuropsychopharmacology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 8 pooled it
9.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 8 syntheses or guidelines pooled it, 106 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Joakim EkstrandDepartment of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
Christian FattahDepartment of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
Marcus PerssonDepartment of Clinical Sciences, Faculty of Medicine, Lund University, Helsingborg, Sweden.
Tony ChengDepartment of Clinical Sciences, Faculty of Medicine, Lund University, Malmö, Sweden.
Pia NordanskogDepartment of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Jonas ÅkesonDepartment of Clinical Sciences, Faculty of Medicine, Lund University, Malmö, Sweden.
Anders TingströmDepartment of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
Mats B LindströmDepartment of Clinical Sciences, Faculty of Medicine, Lund University, Malmö, Sweden.
Axel NordenskjöldFaculty of Medicine and Health, Örebro University, Örebro, Sweden.ORCID 0000-0001-7454-3065
Pouya Movahed RadDepartment of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.ORCID 0000-0003-2041-3550
Lund University · SELinköping University · SEÖrebro University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundKetamine has emerged as a fast-acting and powerful antidepressant, but no head to head trial has been performed, Here, ketamine is compared with electroconvulsive therapy (ECT), the most effective therapy for depression.

methodsHospitalized patients with unipolar depression were randomized (1:1) to thrice-weekly racemic ketamine (0.5 mg/kg) infusions or ECT in a parallel, open-label, non-inferiority study. The primary outcome was remission (Montgomery Åsberg Depression Rating Scale score ≤10). Secondary outcomes included adverse events (AEs), time to remission, and relapse. Treatment sessions (maximum of 12) were administered until remission or maximal effect was achieved. Remitters were followed for 12 months after the final treatment session.

resultsIn total 186 inpatients were included and received treatment. Among patients receiving ECT, 63% remitted compared with 46% receiving ketamine infusions (P = .026; difference 95% CI 2%, 30%). Both ketamine and ECT required a median of 6 treatment sessions to induce remission. Distinct AEs were associated with each treatment. Serious and long-lasting AEs, including cases of persisting amnesia, were more common with ECT, while treatment-emergent AEs led to more dropouts in the ketamine group. Among remitters, 70% and 63%, with 57 and 61 median days in remission, relapsed within 12 months in the ketamine and ECT groups, respectively (P = .52).

conclusionRemission and cumulative symptom reduction following multiple racemic ketamine infusions in severely ill patients (age 18-85 years) in an authentic clinical setting suggest that ketamine, despite being inferior to ECT, can be a safe and valuable tool in treating unipolar depression.

Indexed as

Depressive Disorder, Treatment-ResistantElectroconvulsive TherapyKetamineMajor Depressive DisorderAdolescentAdultAgedAged, 80 and overAntidepressive AgentsHumansMiddle AgedTreatment OutcomeYoung AdultAntidepressive AgentsKetamineElectroconvulsive therapyketamine infusionmajor depressive disorderpsychotic depressionracemic ketamine

Identifiers

PMID35020871
PMCPMC9154276
OpenAlexW4206656872

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.