Section - Quick Takes

02. Efficacy and Safety of Ketamine vs Electroconvulsive Therapy Among Patients With Major Depressive Episode: A Systematic Review and Meta-analysis

Published on February 1, 2023 Certification expiration date: February 1, 2029

James Phelps, M.D.

Research Editor - Psychopharmacology Institute

Key Points

For the treatment of major depression, electroconvulsive therapy (ECT) is markedly more effective than ketamine, per this meta-analysis of 6 randomized head-to-head comparison studies, at the end of 3–4 weeks of treatment.
In 2 of these studies that measured longer-term outcomes (i.e., 2 and 10 months after treatment, respectively), no difference was found in ketamine vs ECT.

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In the 1970 movie Five Easy Pieces, Jack Nicholson’s character orders bacon in a diner. He’s told, “No, sorry, we’re not serving breakfast anymore; it’s lunchtime.” But he notices there’s a bacon, lettuce, and tomato sandwich on the lunch menu, so he says, “I just want the bacon.” “Sorry,” the waitress says, “you can’t have just bacon.” “Okay,” he says, “I’ll have the bacon, lettuce, and tomato sandwich; hold the mayo, hold the bread, hold the lettuce, hold the tomato.” For depression then, how about, “Oh, I’ll have ECT please; just use ketamine as the anesthetic, and hold the electricity.” How well does ketamine work compared with ECT? Wouldn’t it be interesting to see a head-to-head study of the 2? Better yet, not just 1 study, how about 6?

Hi! Jim Phelps here for the Psychopharmacology Institute. Here’s a meta-analysis of those 6 head-to-head studies by Dr. Taeho Rhee and

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03. Bridging Knowledge Gaps in the Diagnosis and Management of Neuropsychiatric Sequelae of COVID-19

Learning Objectives:

Examine evidence in favor of and against the use of N-acetylcysteine in treatment-resistant schizophrenia.
Compare outcomes of ketamine and ECT in the short-term treatment of major depressive disorder.
Examine 5 mechanisms by which acute COVID-19 infection might lead to long-term neuropsychiatric sequelae.
Examine the results of a randomized trial for sublingual dexmedetomidine for the treatment of acute agitation in patients with a diagnosis of schizophrenia or schizoaffective disorder.
Compare the efficacy of a basic behavioral therapy and naltrexone–bupropion combination for the treatment of binge-eating disorder.

Original Release Date: February 1, 2023

Review and Re-release Date: February 1, 2026

Expiration Date: February 1, 2029

Expert: James Phelps, M.D.

Medical Editor: Melissa Mariano, M.D.

Relevant Financial Disclosures:

James R Phelps declares the following interests:

– McGraw-Hill: Royalties

– W.W. Norton & Co.: Royalties

All of the relevant financial relationships listed above have been mitigated by Medical Academy and the Psychopharmacology Institute.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

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Participants must complete the activity online during the valid credit period that is noted above.

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Complete the Post Activity Evaluation for providing the necessary feedback for continuing accreditation purposes and for the development of future activities. NOTE: Completing the Post Activity Evaluation after the quiz is required to receive the earned credit.
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Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.