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2025 0 citations Research paper

Comparing the Cognitive Effects of Repeated Intravenous Ketamine and Electroconvulsive Therapy in Patients With Treatment-Resistant Depression

Kristina T. Kumpf, Samuel T. Wilkinson, Bo Hu, Ruoying Chen, Kamini Krishnan, Shinjon Chakrabarti,

Summary & key facts

This secondary analysis of a multisite randomized trial compared cognitive effects of repeated IV ketamine (six treatments) and electroconvulsive therapy (nine sessions) in 365 people with treatment-resistant depression. After the 3-week treatment course, the ECT group did worse than the ketamine group on four objective cognitive tests (P < .001). Among people who met responder criteria (≥50% symptom reduction), there were no cognitive differences between the two groups at 1-, 3-, and 6-month follow-ups. Subjective memory ratings were mixed: both groups improved on one memory questionnaire with greater gains after ketamine, while global self-rated memory improved with ketamine and declined w

Key facts:
  • The trial compared 6 intravenous ketamine treatments versus 9 electroconvulsive therapy (ECT) sessions.
  • The intent-to-treat sample included 365 participants (N = 365).
  • At the end of the 3-week treatment course, ECT recipients performed significantly worse than ketamine recipients on all four objective cognitive tasks (P < .001).
  • Responders were defined as people who had a ≥50% reduction in depressive symptoms. Among responders, there were no significant cognitive differences between ketamine and ECT at 1-, 3-, and 6-month follow-ups.
  • On the Squire Memory Complaint Questionnaire (SMCQ), scores improved for both treatment groups, with greater functional gains reported by the ketamine group.
  • On the Global Self-Evaluation of Memory (GSE-My), ketamine-treated patients reported improved scores while ECT-treated patients reported a decline.
  • Within the ketamine group, measures of executive functioning and cognitive flexibility improved, and these improvements remained after adjusting for changes in depression, suggesting partial independence from mood effects.
  • The study was a secondary analysis of the ELEKT-D randomized trial conducted across multiple sites between April 2017 and November 2022 and is registered at ClinicalTrials.gov (NCT03113968).

Abstract

Trial Registration: ClinicalTrials.gov identifier: NCT03113968.

Topics

Electroconvulsive Therapy Studies Perfectionism, Procrastination, Anxiety Studies Treatment of Major Depression

Categories

Health Sciences Medicine Pharmacology

Tags

Anesthesia Cognition Depression (economics) Economics Electroconvulsive therapy Ketamine Macroeconomics Major depressive disorder Medicine Psychiatry Psychology Psychotherapist Treatment-resistant depression

Substances

Ketamine
Summaries and links are for general information and education only. They are not a substitute for reading the original publication or for professional medical, legal, or other advice. Always refer to the linked source for the full study.

Referencing articles

Altered Healing
The Promise of Ketamine Therapy: A Hope for Treatment-Resistant Depression

Ketamine therapy offers rapid relief for treatment-resistant depression, with effects in hours instead of weeks.

Written by: Clara Bennett