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Updated: Feb 10, 2026

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Ketamine and electroconvulsive therapy: so happy together?

Kathryn Cobb1, Monika Nanda

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Ketamine may offer short-term benefits when combined with electroconvulsive therapy (ECT) for depression. However, current evidence does not clearly show it is more effective than ECT alone, and more research is needed.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Pharmacology

Background:

  • Anesthetics like thiopental, methohexital, propofol, and ketamine are used for electroconvulsive therapy (ECT).
  • Ketamine has recently shown potential antidepressant effects.
  • The role of ketamine in augmenting ECT's antidepressant efficacy is under investigation.

Purpose of the Study:

  • To review ketamine's side effect profile.
  • To examine literature on ketamine augmenting antidepressant effects of ECT.
  • To evaluate the combined use of ketamine and ECT for depression.

Main Methods:

  • Systematic reviews and meta-analyses of randomized controlled trials (RCTs).
  • Literature search for studies on ketamine and ECT for depression.
  • Analysis of existing evidence on efficacy and side effects.

Main Results:

  • Systematic reviews have yielded varied conclusions on the benefits of adding ketamine to ECT.
  • There is currently a lack of clear evidence that ketamine combined with ECT is more efficacious than ECT alone.
  • Ketamine's side effect profile may be a concern for certain patient populations.

Conclusions:

  • Large, multicenter RCTs are necessary to further investigate the advantages of adding ketamine to ECT for severe or refractory depression.
  • Ketamine may provide some early benefits for acute depressive disorders when added to ECT.
  • ECT is likely the primary driver of lasting remission; risks and benefits of adding ketamine must be carefully weighed.