Evidence map›Paper›PMID 34076068›Full record

Trial reportRevista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)

Low-dose ketamine does not improve the speed of recovery from depression in electroconvulsive therapy: a randomized controlled trial.

Adrianna J Woolsey, Jalal A Nanji, Chantal Moreau, Sudhakar Sivapalan, Stephane L Bourque, Alfonso Ceccherini-Nelli, Ferrante S Gragasin

Registry-linked trialOpen access · diamondAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999). The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02579642 (Effects of Low-dose Ketamine as an Adjunct to Propofol-based Anesthesia for Electroconvulsive Therapy), which is not on this map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 21% 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.

NCT02579642 phase4completednot on this map

Effects of Low-dose Ketamine as an Adjunct to Propofol-based Anesthesia for Electroconvulsive Therapy

TypeinterventionalSponsorUniversity of AlbertaRan2015 to 2019Enrolled48ConditionsDepressive DisorderArmsKetamine, Placebo
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
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

7 authors at 1 institution in 2 countries.

Adrianna J WoolseyDepartment of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada.ORCID http://orcid.org/0000-0001-6262-4159
Jalal A NanjiDepartment of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada.
Chantal MoreauDepartment of Psychiatry, University of Alberta, Edmonton, Alberta, Canada.
Sudhakar SivapalanDepartment of Psychiatry, University of Alberta, Edmonton, Alberta, Canada.
Stephane L BourqueDepartment of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada.
Alfonso Ceccherini-NelliDepartment of Psychiatry, University of Alberta, Edmonton, Alberta, Canada.
Ferrante S GragasinDepartment of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada.
University of Alberta · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveElectroconvulsive therapy (ECT) is a well-established therapeutic intervention for major depressive disorder. Recent literature has shown that the anesthetic agent ketamine has some antidepressant properties at low doses and may be an alternative therapy for treatment-resistant major depressive disorder. We hypothesized that the use of low-dose ketamine as an anesthetic adjunct in ECT would more rapidly improve depression while maintaining hemodynamic stability than ECT with propofol alone.

methodsInstitutional ethics approval was obtained, and the use of ketamine in this study was approved by Health Canada. This is a randomized, double-blinded, placebo-controlled trial that involved ketamine administration at 0.5 mg/kg IV in addition to propofol anesthesia for ECT. The primary outcome was the number of ECT treatments required to achieve a 50% reduction in the Montgomery-Asberg Depression Rating Scale (MADRS). Secondary outcomes included the number of ECT treatments required to achieve a 25% reduction in MADRS score, as well as any differences in the Clinical Global Impression Scale for Severity, hemodynamic variables, and seizure duration. Adverse events were recorded for safety assessment.

resultsA total of 45 patients completed the study. No difference was found between groups with respect to the primary or secondary outcomes. The ketamine group showed a trend towards a decreased dose of propofol required to achieve adequate anesthesia. No adverse events were reported.

conclusionLow-dose ketamine does not improve psychiatric outcomes in the setting of propofol-based anesthesia for ECT. Specifically, ketamine did not reduce the number of ECT sessions necessary to achieve a 50 or 25% reduction in MADRS scores. Reassuringly, the fact that no differences in hemodynamic variables or unexpected adverse events occurred suggests that low-dose ketamine may be safely used in this setting should clinical indications warrant its use. CLINICAL

trial registrationClinicalTrials.gov, NCT02579642.

Indexed as

Electroconvulsive TherapyKetamineMajor Depressive DisorderAnesthetics, DissociativeAnesthetics, IntravenousDepressionHumansPsychiatric Status Rating ScalesTreatment OutcomeAnesthetics, DissociativeAnesthetics, IntravenousKetamine

Identifiers

PMID34076068
PMCPMC8827368
OpenAlexW3165188554

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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 Socratic graph.