Subanesthetic Dose of Ketamine Administered Before Each Electroconvulsive Therapy Session Improves Antidepressant and Sleep Quality Outcomes

Abstract

ObjectivesThe main purpose of this trial is to explore the effects of subanesthetic dose of ketamine on sleep quality and symptoms in patients with major depressive disorder undergoing bitemporal electroconvulsive therapy (ECT).MethodsSeventy-one patients with major depressive disorder and sleep disturbance were randomly divided into 2 groups, namely, the ECT without ketamine group (group ES), receiving routine ECT and saline (3 mL) at each ECT session, and the ECT-assisted ketamine group (group KS), which received ECT and ketamine (3 mL) at each ECT session. The 24 Hamilton Depression Rating Scale was used to assess depressive symptoms and the Chinese Pittsburgh Sleep Quality Index was used to evaluate sleep quality.ResultsThe patients in group KS required shorter ECT treatment sessions. Patients in group ES had lower sleep efficiency, longer sleep latency, and required more sleep medication than patients in group KS at the end of the ECT course.ConclusionsSubanesthetic dose of ketamine improved sleep quality and enhanced ECT therapeutic effects in patients with sleep disturbance.

Editor's Roundup for Issue #4 of 2023

“…Le Droguene et al 5 note that psychomotor signs were among the first to improve in older patients with depression and may indicate eventual full response by the end of a treatment course. Finally, another twist appeared in the “ECT and ketamine” story as Dong et al 6 found that subanesthetic doses of ketamine given before ECT led to better self-reported sleep outcomes—a finding that is also seen with intranasal esketamine 7 …”