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Electroconvulsive therapy (ECT) is the gold standard for patients with treatment-resistant depression; however, ketamine infusion can confer rapid improvement (within hours to days). Repeat ketamine infusions often will sustain improvement for at least 1 month. In this meta-analysis, researchers examined 6 studies in which ketamine infusion (3/week for 2 weeks) was compared with ECT (3/week for 4 weeks).
At 1 month, ECT was moderately but significantly more effective than ketamine, with remission rates of 63% versus 43% in the largest study. Effects of ECT and ketamine were similar for reducing suicidal thinking; ECT was associated with more cognitive side effects and ketamine was associated with more depersonalization, vertigo, and visual d…