concept

Electroconvulsive therapy

Also known as: ECT

Facts (10)

Sources

The Montreal model: an integrative biomedical-psychedelic ... frontiersin.org Frontiers in Psychiatry 10 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.

claimElectroconvulsive therapy (ECT) is considered the most evidence-based treatment option for treatment-resistant depression, though it is associated with stigma, inconsistent availability, and side effects such as amnesia due to the requirement for general anesthesia.

referenceLemasson et al. analyzed health administrative data from 1996 to 2013 to study electroconvulsive therapy practice in the province of Quebec, published in the Canadian Journal of Psychiatry in 2018.

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.

accountThe Montreal team established an intravenous (IV) ketamine service for Treatment-Resistant Depression (TRD) that utilized an electroconvulsive therapy (ECT)-like model of care and standard dosing protocols.

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).