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Electroconvulsive therapy (ECT) and subanesthetic ketamine infusion both are used commonly to manage patients with treatment-resistant depression. To compare the efficacy of these approaches, researchers randomized 365 patients (mean age, 46) with treatment-resistant depression at 5 U.S. healthcare centers to receive 3-week courses of ECT (thrice weekly) or intravenous ketamine (twice weekly).
After 3 weeks, 55% of ketamine recipients and 41% of ECT recipients had responded (i.e., scores on a standardized depression scale had decreased by ≥50%). ECT was associated with memory impairment that recovered gradually, and ketamine was associated with dissociative symptoms. Patients received postprotocol treatment with various psychotropic medicati…