{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T17:21:18Z","timestamp":1789924878384,"version":"4.0.1"},"reference-count":19,"publisher":"Royal College of Psychiatrists","issue":"6","license":[{"start":{"date-parts":[[2018,1,2]],"date-time":"2018-01-02T00:00:00Z","timestamp":1514851200000},"content-version":"unspecified","delay-in-days":215,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Ketamine has emerged as a novel therapeutic agent for major depressive episodes, spurring interest in its potential to augment electroconvulsive therapy (ECT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>We sought to update our preliminary systematic review and meta-analysis, focusing on randomised controlled trials (RCTs) involving an index course of ECT, and testing the hypothesis that lack of efficacy is due to barbiturate anaesthetic co-administration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We searched EMBASE, CENTRAL and Medline to identify RCTs examining the efficacy of ketamine during a course of ECT. Data were synthesised from ten trials (ketamine group <jats:italic>n<\/jats:italic> = 333, comparator group <jats:italic>n<\/jats:italic> = 269) using pooled random effects models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Electroconvulsive therapy with ketamine was not associated with greater improvements in depressive symptoms or higher rates of clinical response or remission, nor did it result in pro-cognitive effects. This held true when limiting analysis to trials without barbiturate anaesthetic co-administration. Increased rates of confusion were reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Overall, our analyses do not support using ketamine over other induction agents in ECT.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjp.bp.116.195826","type":"journal-article","created":{"date-parts":[[2017,4,6]],"date-time":"2017-04-06T22:15:04Z","timestamp":1491516904000},"page":"403-407","source":"Crossref","is-referenced-by-count":62,"title":["Adjunctive ketamine in electroconvulsive therapy: Updated systematic review and meta-analysis"],"prefix":"10.1192","volume":"210","author":[{"given":"Alexander","family":"McGirr","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo T.","family":"Berlim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Bond","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Y.","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakshmi N.","family":"Yatham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond W.","family":"Lam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2018,1,2]]},"reference":[{"key":"S0007125000281658_ref16","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e3182a4b4c6"},{"key":"S0007125000281658_ref11","article-title":"Effect of ketamine, thiopental and ketamine-thiopental combination during electroconvulsive therapy for depression","volume":"43","author":"Kuscu","year":"2015","journal-title":"Turk J Anaesthesiol Reanim"},{"key":"S0007125000281658_ref10","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e318283b7e9"},{"key":"S0007125000281658_ref8","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.2213-07.2007"},{"key":"S0007125000281658_ref5","doi-asserted-by":"publisher","DOI":"10.1111\/acps.12572"},{"key":"S0007125000281658_ref3","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291714001603"},{"key":"S0007125000281658_ref2","doi-asserted-by":"publisher","DOI":"10.1038\/nature17998"},{"key":"S0007125000281658_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2015.01.003"},{"key":"S0007125000281658_ref14","article-title":"Impact comparison of ketamine and sodium thiopental on anesthesia during electroconvulsive therapy in major depression patients with drug-resistant; a double-blind randomized clinical trial","volume":"18","author":"Salehi","year":"2015","journal-title":"Ann Card Anaesth"},{"key":"S0007125000281658_ref4","doi-asserted-by":"publisher","DOI":"10.1093\/ijnp\/pyv124"},{"key":"S0007125000281658_ref1","doi-asserted-by":"publisher","DOI":"10.1038\/nature10130"},{"key":"S0007125000281658_ref9","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e31824f8296"},{"key":"S0007125000281658_ref13","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0000000000000317"},{"key":"S0007125000281658_ref15","doi-asserted-by":"publisher","DOI":"10.17795\/ijpbs-1578"},{"key":"S0007125000281658_ref6","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0141564"},{"key":"S0007125000281658_ref18","unstructured":"Anderson IM , Blamire A , Branton T , Brigadoi S , Clark R , Downey D , et al. Randomised-controlled trial of ketamine augmentation of ECT on neuropsychological and clinical outcomes in depression (Ketamine-ECT Study). Efficacy and Mechanism Evaluation, in press."},{"key":"S0007125000281658_ref19","article-title":"Resistance to antidepressant medications and short-term clinical response to ECT","volume":"153","author":"Prudic","year":"1996","journal-title":"Am J Psychiatry"},{"key":"S0007125000281658_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2016.05.011"},{"key":"S0007125000281658_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2012.04.032"}],"container-title":["British Journal of Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0007125000281658","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,17]],"date-time":"2019-04-17T18:04:26Z","timestamp":1555524266000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0007125000281658\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6]]},"references-count":19,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2017,6]]}},"alternative-id":["S0007125000281658"],"URL":"https:\/\/doi.org\/10.1192\/bjp.bp.116.195826","relation":{},"ISSN":["0007-1250","1472-1465"],"issn-type":[{"value":"0007-1250","type":"print"},{"value":"1472-1465","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,6]]}}}