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Subject Area

General Surgery

Article Type

Original Study

Abstract

Objective The aim was to investigate the efficacy of ketamine vs electroconvulsive therapy (ECT) in hospitalized patients suffering from treatment-resistant major depressive disorder (MDD). Background Both propofol and ketamine are the commonly used anesthetic agents, but recent clinical studies have suggested that ketamine has rapid-acting antidepressant properties, itself, at subanesthetic doses. Patients and methods A clinical comparative randomized cross-sectional study was conducted on 20 patients suffering from treatment-resistant MDD, and receiving ketamine only (group 1) and 20 patients suffering from treatment-resistant MDD receiving ECT only (group 2), who were recruited from inpatients wards of Neuropsychiatry Department, Menoufia University and Met-Khalaf Hospital for Psychiatric Health from December 1, 2018 until March 14, 2019. All participates were subjected to full detailed general medical, neurological, and psychiatric history and examination. Results There was a statistically insignificant differences between the studied patients regarding the types of depression (P = 0.61). Bipolar depression and MDDs were represented in 57 and 54% in the ECT group and 43 and 46% in the Ketamine group, respectively. Also, catatonic depression, melancholic subtype, and seasonal affective disorder were represented by 80, 66.7, and 100% in the Ketamine group vs 20, 33.3, and 0.00% in ECT group, respectively. Conclusion There was statistically significant difference between the ketamine group and ECT, regarding the efficacy of both ketamine and ECT in favor of the ketamine group as ketamine has a more rapid effect in improving depressive symptoms in MDD patients and have more rapid antidepressant effects compared with ECT.

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