Clinical efficacy of adjunctive esketamine anesthesia in electroconvulsive therapy for major depressive disorders: A pragmatic, randomized, controlled trial

作者全名：Ren, Li; Chen, Qibin; Gao, Jin; Liu, Yuanyuan; Li, Xiao; Luo, Qinghua; Lv, Feng; Min, Su; Tao, Yi

作者地址：[Ren, Li; Chen, Qibin; Gao, Jin; Liu, Yuanyuan; Lv, Feng; Min, Su; Tao, Yi] Chongqing Med Univ, Dept Anesthesiol, Affiliated Hosp 1, 1 Youyi Rd, Chongqing 400016, Peoples R China; [Li, Xiao; Luo, Qinghua] Chongqing Med Univ, Dept Phase 1, Affiliated Hosp 1, Clin Trial Ward, Chongqing, Peoples R China

通信作者：Lv, F; Min, S (通讯作者)，Chongqing Med Univ, Dept Anesthesiol, Affiliated Hosp 1, 1 Youyi Rd, Chongqing 400016, Peoples R China.

来源：PSYCHIATRY RESEARCH

ESI学科分类：PSYCHIATRY/PSYCHOLOGY

WOS号：WOS:001207406100001

JCR分区：Q1

影响因子：4.2

年份：2024

卷号：335

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：Depression; Electroconvulsive therapy; Esketamine; Treatment efficacy

摘要：Electroconvulsive therapy (ECT) is an effective treatment for depression, and esketamine has been shown to have antidepressant effects. However, it is currently unclear whether adjunctive esketamine can enhance the clinical efficacy of ECT in real-world clinical practice. In this pragmatic clinical trial, patients with major depression were randomly assigned into two groups: patients received 0.25 mg/kg esketamine plus propofol (esketamine group) or the same volume of saline (control group) plus propofol. Results indicated that there was no difference in response and remission rates between the two groups. However, patients receiving esketamine had a higher remission rate of SI and lower psychotic scores. Patients receiving esketamine also required a lower electric dose, but the seizure duration and cognitive function were comparable between the two groups. Diastolic blood pressure increased after esketamine injection, but there was no increased risk of hypertension. Furthermore, incidence of delirium and confusion were comparable between the groups. Conclusively, adjunctive esketamine anesthesia does not provide any advantage in improving the response and remission rates of ECT. However, it can improve remission of SI and alleviate accompanying psychotic symptoms in depressive patients. With adjunctive usage, the adverse cardiovascular and neuropsychiatric events associated with esketamine appear to be tolerable.

基金机构：Medical Research Project of Chongqing Municipal Health Commission [2022WSJK034]

基金资助正文：<BOLD> This work was supported by the Medical Research Project of Chongqing Municipal Health Commission (grant number: 2022WSJK034) . </BOLD> Li Ren was contributed to the conceptualization, data curation, funding acquisition, project administration, data analysis and original draft. Qibin Chen, Jin Gao, Xiao Li, Qinghua Luo and Yuanyuan Liu were contributed to project administration. Yi Tao was contributed to the data analysis. Feng Lv was contributed to the data curation, data analysis and writing editing. Su Min was contributed to the project supervision and writing review.