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Vagus Nerve Stimulation As an Adjunctive Neurostimulation Tool in Treatment-resistant Depression
Published on: January 7, 2019
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Ketamine for refractory depression: Save the best for last?
Kabir Nigam1, Franklin King2, Fernando Espi Forcen3
1Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.
Journal of Psychopharmacology (Oxford, England)
|September 20, 2024
Summary
Ketamine shows efficacy comparable to electroconvulsive therapy (ECT) for depression. Its low side-effect profile suggests evaluating ketamine as a second-line treatment for refractory depression.
Area of Science:
- Psychiatry
- Pharmacology
- Clinical Medicine
Background:
- Electroconvulsive therapy (ECT) is a highly effective treatment for depression.
- Ketamine demonstrates non-inferior efficacy to ECT for depression.
- Ketamine is currently considered a third-line option for treatment-refractory depression.
Purpose of the Study:
- To evaluate ketamine as a second-line augmentation strategy for refractory depression.
- To compare the efficacy and side-effect profile of ketamine with existing depression treatments.
Main Methods:
- Review of available data on ketamine's efficacy and tolerability.
- Comparison of ketamine's side-effect burden with second-line augmentation strategies.
- Consideration of treatment outcomes in relation to the duration of untreated illness.
Main Results:
- Ketamine is non-inferior to ECT in treating depression.
- Ketamine has a lower side-effect burden compared to many second-line depression treatments.
- Ketamine is better tolerated than several augmentation strategies.
Conclusions:
- Ketamine's high efficacy and low side-effect burden warrant its consideration as a second-line treatment.
- Re-evaluating ketamine's position from third-line to second-line agent is in patients' best interest.
- Further research should explore ketamine's role in optimizing depression treatment outcomes.
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