SynthesisTranslational psychiatry2026
Time matters for metas: a systematic review and meta-analysis of ect vs ketamine for depression incorporating time.
Synthesis in Translational psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
importanceComparing treatments for severe and medication-resistant depression is essential for guiding clinical decision-making.
objectiveIn this meta-analysis, we investigate the efficacy of electroconvulsive therapy (ECT) compared to ketamine for the treatment of major depressive disorder (MDD) and address the discrepant results of prior meta-analyses. DATA SOURCES: We systematically searched PubMED (MEDLINE), Embase, and Cochrane Library databases for studies published up to 31 November 2024. STUDY SELECTION: Eligible studies met the following criteria: (1) participants diagnosed with major depression, (2) ECT and ketamine (administered via parenteral routes) treatment arms with comparable treatment durations and assessment periods, and (3) efficacy measured by standardized depression scales at a minimum of two time points. DATA EXTRACTION AND SYNTHESIS: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two independent reviewers assessed study eligibility, evaluated risk of bias (Cochrane Risk of Bias 2 tool), and extracted data from all available time points. A mixed-effects meta-regression analysis incorporated time as a fixed effect - minimising issues arising from temporal discrepancies between studies - and study as a random effect. MAIN OUTCOMES AND MEASURES: Efficacy was assessed by change in depression symptoms from baseline on a standardised measurement tool.
resultsSeven studies (731 participants) out of 1220 identified articles were eligible for analysis. Depression scores were significantly lower at baseline in the ketamine group compared to ECT (SMD = -0·28; p = 0·018; 95% CI -0·51-·05). Meta-regression analysis, adjusted for baseline scores, revealed a significant effect of time for standardised mean differences (β = 0·018; p < 0·0001; 95% CI 0·009-0·026), indicating that ECT led to a faster rate of improvement of approximately 0·02 SMD per day, amounting to a predicted SMD = 0·59 (95% CI -0·26-1·43) over four weeks. CONCLUSIONS AND RELEVANCE: ECT resulted in a more rapid reduction of depressive symptoms, with a projected moderate efficacy advantage over ketamine by the end of a four-week course, within the established range for a clinically meaningful benefit.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.