Ketamine or ECT? What Have We Learned From the KetECT and ELEKT-D Trials?

Joakim Ekstrand, Akihiro Takamiya, Axel Nordenskjold, George Kirov, Pascal Sienaert, Charles H. Kellner, Pouya Movahed Rad

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


1. Two recent clinical trials, KetECT and ELEKT-D, compared the effectiveness of ketamine and electroconvulsive therapy (ECT) for major depressive disorder. Notably, these trials reported marked differences in ECT's clinical outcomes of, with remission rates of 63% for KetECT and a strikingly lower rate of 22% for ELEKT-D, while the remission rates for ketamine were 46% and 38%, respectively. Considering that the primary objective of both trials was to compare the standard treatment (ECT) with an experimental intervention (ketamine), it is crucial to highlight the pronounced disparities in ECT's clinical outcomes. This article offers a comprehensive comparison of these trials while also exploring how patient characteristics, treatment protocols, and study designs may contribute to such pronounced outcome discrepancies. These differences highlight the heterogeneous nature of depression and underscore the need for personalized treatments. These studies also provide valuable insights into identifying the most suitable candidates for ketamine and ECT.

Original languageEnglish
Article numberpyad065
JournalInternational Journal of Neuropsychopharmacology
Issue number1
StatePublished - 1 Jan 2024
Externally publishedYes


  • Major depressive disorder
  • clinical trials
  • electroconvulsive therapy
  • racemic ketamine


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