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Clinically favourable effects of ketamine as an anaesthetic for electroconvulsive therapy: a retrospective study

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Abstract

In a retrospective chart review, we examined the effects of ketamine, an N-methyl-d-aspartate (NMDA) receptor antagonist, as electroconvulsive therapy (ECT) anaesthetic in patients suffering from therapy-resistant depression. We included 42 patients who received ECT treatment with either ketamine (n = 16) or the barbiturate thiopental (n = 26). We analysed the number of sessions until completion of ECT treatment (used as a surrogate parameter for outcome), psychopathology as assessed by pre- and post-ECT Mini-Mental State Examination (MMSE) and Hamilton Rating Scale for Depression (HAM-D) scores as well as ECT and seizure parameters (stimulation dose, seizure duration and concordance, urapidil dosage for post-seizure blood pressure management). The ketamine group needed significantly fewer ECT sessions and had significantly lower HAM-D and higher MMSE scores afterwards. As expected, the ketamine group needed more urapidil for blood pressure control. Taking into account the limits inherent in a retrospective study design and the rather small sample size, our results nonetheless point towards synergistic effects of ECT and ketamine anaesthesia, less cognitive side effects and good tolerability of ketamine.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Ruprecht-Karls-University Heidelberg, J5, 68159, Mannheim, Germany

    Laura Kranaster, Carolin Hoyer & Alexander Sartorius

  2. Department of General Psychiatry and Psychotherapy, Psychiatric Centre Nordbaden, Wiesloch, Germany

    Jutta Kammerer-Ciernioch

Authors
  1. Laura Kranaster
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  2. Jutta Kammerer-Ciernioch
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  3. Carolin Hoyer
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  4. Alexander Sartorius
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Correspondence to Alexander Sartorius.

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The authors Laura Kranaster and Jutta Kammerer-Ciernioch contributed equally.

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Kranaster, L., Kammerer-Ciernioch, J., Hoyer, C. et al. Clinically favourable effects of ketamine as an anaesthetic for electroconvulsive therapy: a retrospective study. Eur Arch Psychiatry Clin Neurosci 261, 575–582 (2011). https://doi.org/10.1007/s00406-011-0205-7

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  • DOI: https://doi.org/10.1007/s00406-011-0205-7

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