Comparative efficacy and safety of ketamine anesthesia for ECT in major depressive disorder; a systematic review and meta-analysis

Abstract

Major Depressive Disorder (MDD) poses a significant global health challenge, affecting 5 to 17 percent of individuals worldwide. Treatment-resistant depression (TRD), observed in 20-30% of cases, amplifies the burden on public health. Electroconvulsive therapy (ECT), deemed the gold standard for severe TRD, exhibits efficacy but is associated with cognitive impairment. Ketamine, an N-methyl-D-aspartate antagonist, has gained attention due to its rapid and sustained antidepressant effects. This meta-analysis aims to assess whether ketamine, as an anesthetic or adjunctive to ECT, provides superior outcomes for MDD compared to other anesthetics, considering efficacy and cognitive effects.

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