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Ketamine and electroconvulsive therapy are frequently compared as clinical interventions for treatment-resistant depression, as evidenced by multiple comparative studies such as the ELEKT-D study [1], the 2023 NEJM study [2], and the KetECT trial [3]. Furthermore, the Montreal model clinical team explicitly contrasts the psychological dynamics and treatment protocols of ketamine with those of electroconvulsive therapy {fact:1, fact:2, fact:7}.
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The Montreal model: an integrative biomedical-psychedelic ... frontiersin.org 7 facts
referenceAnand et al. compared the efficacy of ketamine versus electroconvulsive therapy (ECT) for nonpsychotic treatment-resistant major depression in a study published in the New England Journal of Medicine in 2023.
claimThe authors of the Montreal model report that a brief course of ketamine evokes psychological dynamics that resemble an accelerated short-term psychotherapy more closely than a course of electroconvulsive therapy (ECT).
referenceMathew et al. (2019) published the ELEKT-D study protocol in Contemporary Clinical Trials, which compares electroconvulsive therapy (ECT) to ketamine for patients with treatment-resistant depression.
referenceEkstrand et al. (2021) conducted a randomized, open-label, non-inferiority trial (KetECT) comparing racemic ketamine to electroconvulsive therapy for the treatment of unipolar depression.
claimThe Montreal model clinical team observed that ketamine treatment differs from electroconvulsive therapy (ECT) because termination of treatment is a critical consideration in psychotherapy, whereas it is generally only a subject of interest in psychiatry.
accountAt the outset of the clinic, the Montreal model clinical team proposed a protocol of three ketamine infusions for appropriate patients, with subsequent treatments decided based on clinical response, similar to the protocol used for electroconvulsive therapy (ECT).
referencePhillips et al. (2020) published a study protocol in BMC Psychiatry for a randomized, crossover comparison of ketamine and electroconvulsive therapy for the treatment of major depressive episodes, conducted by the Canadian Biomarker Integration Network in Depression (CAN-BIND).