Ketamine as the anaesthetic for electroconvulsive therapy

the KANECT randomised controlled trial

Gordon Fernie (Lead / Corresponding author), James Currie, Jennifer S. Perrin, Caroline A. Stewart, Virginica Anderson, Daniel M. Bennett, Steven Hay, Ian C. Reid

    Research output: Contribution to journalArticle

    13 Citations (Scopus)
    27 Downloads (Pure)

    Abstract

    Background: Ketamine has recently become an agent of interest as an acute treatment for severe depression and as the anaesthetic for electroconvulsive therapy (ECT). Subanaesthetic doses result in an acute reduction in depression severity while evidence is equivocal for this antidepressant effect with anaesthetic or adjuvant doses. Recent systematic reviews call for high-quality evidence from further randomised controlled trials (RCTs).

    Aims: To establish if ketamine as the anaesthetic for ECT results in fewer ECT treatments, improvements in depression severity ratings and less memory impairment than the standard anaesthetic.

    Method: Double-blind, parallel-design, RCT of intravenous ketamine (up to 2 mg/kg) with an active comparator, intravenous propofol (up to 2.5 mg/kg), as the anaesthetic for ECT in patients receiving ECT for major depression on an informal basis. (Trial registration: European Clinical Trials Database (EudraCT): 2011-000396-14 and clinicalTrials.gov: NCT01306760)

    Results: No significant differences were found on any outcome measure during, at the end of or 1 month following the ECT course.

    Conclusions: Ketamine as an anaesthetic does not enhance the efficacy of ECT.

    Original languageEnglish
    Pages (from-to)422-428
    Number of pages7
    JournalBritish Journal of Psychiatry
    Volume210
    Issue number6
    Early online date2 Mar 2017
    DOIs
    Publication statusPublished - 1 Jun 2017

    Fingerprint

    Electroconvulsive Therapy
    Ketamine
    Anesthetics
    Randomized Controlled Trials
    Depression
    Anesthesia Adjuvants
    Propofol
    Double-Blind Method
    Antidepressive Agents
    Outcome Assessment (Health Care)
    Clinical Trials
    Databases
    Therapeutics

    Cite this

    Fernie, G., Currie, J., Perrin, J. S., Stewart, C. A., Anderson, V., Bennett, D. M., ... Reid, I. C. (2017). Ketamine as the anaesthetic for electroconvulsive therapy: the KANECT randomised controlled trial. British Journal of Psychiatry, 210(6), 422-428. https://doi.org/10.1192/bjp.bp.116.189134
    Fernie, Gordon ; Currie, James ; Perrin, Jennifer S. ; Stewart, Caroline A. ; Anderson, Virginica ; Bennett, Daniel M. ; Hay, Steven ; Reid, Ian C. / Ketamine as the anaesthetic for electroconvulsive therapy : the KANECT randomised controlled trial. In: British Journal of Psychiatry. 2017 ; Vol. 210, No. 6. pp. 422-428.
    @article{c74eec0a2ab24bc1a256a84a869d62a0,
    title = "Ketamine as the anaesthetic for electroconvulsive therapy: the KANECT randomised controlled trial",
    abstract = "Background: Ketamine has recently become an agent of interest as an acute treatment for severe depression and as the anaesthetic for electroconvulsive therapy (ECT). Subanaesthetic doses result in an acute reduction in depression severity while evidence is equivocal for this antidepressant effect with anaesthetic or adjuvant doses. Recent systematic reviews call for high-quality evidence from further randomised controlled trials (RCTs).Aims: To establish if ketamine as the anaesthetic for ECT results in fewer ECT treatments, improvements in depression severity ratings and less memory impairment than the standard anaesthetic.Method: Double-blind, parallel-design, RCT of intravenous ketamine (up to 2 mg/kg) with an active comparator, intravenous propofol (up to 2.5 mg/kg), as the anaesthetic for ECT in patients receiving ECT for major depression on an informal basis. (Trial registration: European Clinical Trials Database (EudraCT): 2011-000396-14 and clinicalTrials.gov: NCT01306760)Results: No significant differences were found on any outcome measure during, at the end of or 1 month following the ECT course.Conclusions: Ketamine as an anaesthetic does not enhance the efficacy of ECT.",
    author = "Gordon Fernie and James Currie and Perrin, {Jennifer S.} and Stewart, {Caroline A.} and Virginica Anderson and Bennett, {Daniel M.} and Steven Hay and Reid, {Ian C.}",
    note = "The Chief Scientists Office (CSO) of Scotland funded this research C.AS. reports grants from Vifor Pharma, outside the submitted work. I.C.R. (deceased) declared personal fees from AstraZeneca, Sanofi Aventis and Sunovion, and non-financial support from Lundbeck, between 2009 and 2014 and all outside the submitted work.",
    year = "2017",
    month = "6",
    day = "1",
    doi = "10.1192/bjp.bp.116.189134",
    language = "English",
    volume = "210",
    pages = "422--428",
    journal = "British Journal of Psychiatry",
    issn = "0007-1250",
    publisher = "Royal College of Psychiatrists",
    number = "6",

    }

    Fernie, G, Currie, J, Perrin, JS, Stewart, CA, Anderson, V, Bennett, DM, Hay, S & Reid, IC 2017, 'Ketamine as the anaesthetic for electroconvulsive therapy: the KANECT randomised controlled trial', British Journal of Psychiatry, vol. 210, no. 6, pp. 422-428. https://doi.org/10.1192/bjp.bp.116.189134

    Ketamine as the anaesthetic for electroconvulsive therapy : the KANECT randomised controlled trial. / Fernie, Gordon (Lead / Corresponding author); Currie, James; Perrin, Jennifer S.; Stewart, Caroline A.; Anderson, Virginica; Bennett, Daniel M.; Hay, Steven; Reid, Ian C.

    In: British Journal of Psychiatry, Vol. 210, No. 6, 01.06.2017, p. 422-428.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Ketamine as the anaesthetic for electroconvulsive therapy

    T2 - the KANECT randomised controlled trial

    AU - Fernie, Gordon

    AU - Currie, James

    AU - Perrin, Jennifer S.

    AU - Stewart, Caroline A.

    AU - Anderson, Virginica

    AU - Bennett, Daniel M.

    AU - Hay, Steven

    AU - Reid, Ian C.

    N1 - The Chief Scientists Office (CSO) of Scotland funded this research C.AS. reports grants from Vifor Pharma, outside the submitted work. I.C.R. (deceased) declared personal fees from AstraZeneca, Sanofi Aventis and Sunovion, and non-financial support from Lundbeck, between 2009 and 2014 and all outside the submitted work.

    PY - 2017/6/1

    Y1 - 2017/6/1

    N2 - Background: Ketamine has recently become an agent of interest as an acute treatment for severe depression and as the anaesthetic for electroconvulsive therapy (ECT). Subanaesthetic doses result in an acute reduction in depression severity while evidence is equivocal for this antidepressant effect with anaesthetic or adjuvant doses. Recent systematic reviews call for high-quality evidence from further randomised controlled trials (RCTs).Aims: To establish if ketamine as the anaesthetic for ECT results in fewer ECT treatments, improvements in depression severity ratings and less memory impairment than the standard anaesthetic.Method: Double-blind, parallel-design, RCT of intravenous ketamine (up to 2 mg/kg) with an active comparator, intravenous propofol (up to 2.5 mg/kg), as the anaesthetic for ECT in patients receiving ECT for major depression on an informal basis. (Trial registration: European Clinical Trials Database (EudraCT): 2011-000396-14 and clinicalTrials.gov: NCT01306760)Results: No significant differences were found on any outcome measure during, at the end of or 1 month following the ECT course.Conclusions: Ketamine as an anaesthetic does not enhance the efficacy of ECT.

    AB - Background: Ketamine has recently become an agent of interest as an acute treatment for severe depression and as the anaesthetic for electroconvulsive therapy (ECT). Subanaesthetic doses result in an acute reduction in depression severity while evidence is equivocal for this antidepressant effect with anaesthetic or adjuvant doses. Recent systematic reviews call for high-quality evidence from further randomised controlled trials (RCTs).Aims: To establish if ketamine as the anaesthetic for ECT results in fewer ECT treatments, improvements in depression severity ratings and less memory impairment than the standard anaesthetic.Method: Double-blind, parallel-design, RCT of intravenous ketamine (up to 2 mg/kg) with an active comparator, intravenous propofol (up to 2.5 mg/kg), as the anaesthetic for ECT in patients receiving ECT for major depression on an informal basis. (Trial registration: European Clinical Trials Database (EudraCT): 2011-000396-14 and clinicalTrials.gov: NCT01306760)Results: No significant differences were found on any outcome measure during, at the end of or 1 month following the ECT course.Conclusions: Ketamine as an anaesthetic does not enhance the efficacy of ECT.

    U2 - 10.1192/bjp.bp.116.189134

    DO - 10.1192/bjp.bp.116.189134

    M3 - Article

    VL - 210

    SP - 422

    EP - 428

    JO - British Journal of Psychiatry

    JF - British Journal of Psychiatry

    SN - 0007-1250

    IS - 6

    ER -