Significant treatment effect of add-on ketamine anesthesia in electroconvulsive therapy in depressive patients: A meta-analysis

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• 作者：Dian-Jeng Li^a ; ^b ; Fu-Chiang Wang^b ; Che-Sheng Chu^c ; Tien-Yu Chen^d ; Chia-Hung Tang^e ; Wei-Cheng Yang^f ; Philip Chik-keung Chow^g ; Ching-Kuan Wu^h ; Ping-Tao Tseng^h ; ¹ ; ^{ducktseng@gmail.com} ; Pao-Yen Linⁱ ; ^j ; ¹ ; ^{py1029@adm.cgmh.org.tw}
• 关键词：Psychiatry ; Depression ; Treatment ; NMDA
• 刊名：European Neuropsychopharmacology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：27
• 期：1
• 页码：29-41
• 全文大小：1006 K
• 卷排序：27

文摘

Add-on ketamine anesthesia in electroconvulsive therapy (ECT) has been studied in depressive patients in several clinical trials with inconclusive findings. Two most recent meta-analyses reported insignificant findings with regards to the treatment effect of add-on ketamine anesthesia in ECT in depressive patients. The aim of this study is to update the current evidence and investigate the role of add-on ketamine anesthesia in ECT in depressive patients via a systematic review and meta-analysis. We performed a thorough literature search of the PubMed and ScienceDirect databases, and extracted all relevant clinical variables to compare the antidepressive outcomes between add-on ketamine anesthesia and other anesthetics in ECT. Total 16 articles with 346 patients receiving add-on ketamine anesthesia in ECT and 329 controls were recruited. We found that the antidepressive treatment effect of add-on ketamine anesthesia in ECT in depressive patients was significantly higher than that of other anesthetics (p<0.001). This significance persisted in both short-term (1–2 weeks) and moderate-term (3–4 weeks) treatment courses (all p<0.05). However, the side effect profiles and recovery time profiles were significantly worse in add-on ketamine anesthesia group than in control group. Our meta-analysis highlights the significantly higher antidepressive treatment effect of add-on ketamine in depressive patients receiving ECT compared to other anesthetics. However, clinicians need to take undesirable side effects into consideration when using add-on ketamine anesthesia in ECT in depressive patients.