Ketamine is almost as effective as a treatment for depression as electroconvulsive therapy (ECT), according to a new study.
Scientists in India compared the efficacy of the dissociative drug with ECT, which is routinely used in the treatment of psychiatric illnesses.
ECT involves sending a powerful electric current through the brain, but can cause adverse side effects such as nausea, headaches and memory loss.
Researchers analysed data from five randomised clinical trials that included 278 participants.
They concluded that, while ECT was "superior to ketamine for improving depressive symptoms", the advantage was "small".
"For many patients, especially those who want to be protected against cognitive risks, a trial of ketamine may be worth considering before a trial of ECT."
Ketamine, commonly used as a club drug, is a Class B substance and possession in the UK carries a five-year prison sentence.
Professor David Nutt, Head of the Centre for Neuropsychopharmacology at Imperial College London, said of the study: “This is a fair analysis of the current evidence we have on ECT and ketamine in treating major depressive episodes... It would be ideal if all NHS trusts could offer both options to give patients some choice in their treatment options.”
Dr Rupert McShane, Associate Professor at the Department of Psychiatry, University of Oxford, said: “ECT and ketamine are both potent treatments for depression. This meta-analysis shows that they are, broadly speaking, equally as good as each other with perhaps a slight advantage for ECT.
“Whether or not there is a difference depends on exactly how you define it and how you cut the data. Despite the slight advantage for ECT in this analysis, the authors support using ketamine before ECT, especially in patients who are worried about the cognitive risks of ECT. This seems sensible.“
Separate UK trials are exploring the potential of drugs such as magic mushrooms and MDMA to treat depression, bipolar disorder and anorexia nervosa.
Australia recently approved the use of MDMA and psilocybin in the treatment of post-traumatic stress disorder and psilocybin for treatment-resistant depression.
The study is published today in the US journal JAMA Psychiatry.
