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Comparative efficacy and tolerability of different anesthetics in electroconvulsive therapy for major depressive disorder: A systematic review and network meta-analysis.
Ren, Li; Yu, Jian; Zeng, Jie; Wei, Ke; Li, Ping; Luo, Jie; Shen, Yiwei; Lv, Feng; Min, Su.
Afiliación
  • Ren L; Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
  • Yu J; Department of Psychiatry, Shanghai Tenth People's Hospital, Anesthesia and Brain Research Institute, Tongji University, Shanghai, China.
  • Zeng J; Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China.
  • Wei K; Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
  • Li P; Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
  • Luo J; Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
  • Shen Y; Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
  • Lv F; Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. Electronic address: lvfengmazui@sina.cn.
  • Min S; Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. Electronic address: 459910606@qq.com.
J Psychiatr Res ; 171: 116-125, 2024 03.
Article en En | MEDLINE | ID: mdl-38271762
ABSTRACT
Electroconvulsive therapy (ECT) is one of the most effective treatments for major depressive disorder. Modern ECT is conducted with anesthesia, however, the optimal anesthetic agent for ECT is yet to be understood. This study is aimed to compare the effects of different anesthetic agents on antidepressant efficacy and tolerability in depressed individuals undergoing ECT. We searched MEDLINE, EMBASE, the CENTRAL and PsycINFO for randomized controlled trials from database inception until Nov 13, 2022 (PROSPERO CRD42022375407). Global and local inconsistencies, heterogeneity and publication bias were assessed. Rankings were calculated with the surface under the cumulative ranking curve. A total of 33 studies involving 1898 patients were enrolled. Remission rates were higher for ketamine anesthesia as compared to adjunctive ketamine and propofol. In terms of ranking, ketamine was found to be first in terms of response/remission rates and depressive scores after the 1st, 3rd and 6th ECT and at the end of ECT session, while a higher incidence of adverse events was also observed. No significant advantage of any anesthetic was revealed for the cognitive function after ECT. In summary, based on current evidence, no specific anesthetic is recommended for ECT anesthesia. However, despite more side effects, ketamine monoanesthesia seems to reveal a potential benefit in improving antidepressant efficacy of ECT, and further studies are needed to investigate the relationship between anesthetic agents and the therapeutic effect of ECT.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastorno Depresivo Mayor / Terapia Electroconvulsiva / Metaanálisis en Red / Ketamina Tipo de estudio: Clinical_trials / Systematic_reviews Límite: Humans Idioma: En Revista: J Psychiatr Res Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastorno Depresivo Mayor / Terapia Electroconvulsiva / Metaanálisis en Red / Ketamina Tipo de estudio: Clinical_trials / Systematic_reviews Límite: Humans Idioma: En Revista: J Psychiatr Res Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido