Six months later, the quality of life scores of the two groups were similar.
One limitation of the study was that the number of ECT treatments may not have been enough because the treatment period was only three weeks, said Dr. Daniel F. Maixner, ECT program director. to Michigan Medicine at the University of Michigan, which was not affiliated with the study.
Study subjects began their ECT course by receiving electrical currents to one side of the brain, which may take 10 or 12 sessions, as opposed to the nine used in the study, he added. .
“If there’s more improvement to be had, you keep going,” Dr. Maixner said.
Patients who start bilaterally, stimulating both sides at the same time, often need fewer sessions. If patients had had more ECT sessions, a greater proportion of them might have responded to treatment, Dr. Anand said, but it also likely would have caused more side effects.
A small number of patients in both groups – less than 33% – went into remission, meaning they had only mild depressive symptoms. This suggests that additional treatments would be needed for patients to maintain relief.
However, continuing treatment carries additional risks. With ketamine, for example, longer treatment “increases the likelihood of both addiction and cognitive adverse effects, including dissociation, paranoia, and other psychotic symptoms,” wrote Professor Dr. Robert Freedman. of Psychiatry at the University of Colorado, in an editorial. published with the study.
Previous evidence suggests that remission rates from ECT can be much higher – often at least 60% – but these studies may have included a higher percentage of hospitalized patients as well as patients with psychotic depression, for which ECT appears to be particularly effective.
Researchers and clinicians use off-label intravenous ketamine because it has not been approved by the Food and Drug Administration for the treatment of mood disorders, unlike its cousin esketamine, also known as Spravato. , which is administered nasally. Among clinicians, intravenous ketamine is widely considered to be as effective or more effective than esketamine for treatment-resistant depression, Dr. Anand said.