Ketamine vs. ECT

For many patients, yes. A 2024 Massachusetts General Hospital trial directly compared ketamine and ECT for treatment-resistant depression and found comparable response rates — both were superior to conventional medications. Ketamine has advantages: no anesthesia required, no memory loss, no muscle relaxation, shorter recovery time.

Electroconvulsive therapy (ECT) involves passing an electric current through the brain under general anesthesia and muscle paralysis to trigger a controlled seizure. Despite its portrayal in media, modern ECT is safe and effective for severe depression — but it requires hospital admission, general anesthesia, and can cause transient memory impairment.

The evidence is mixed. A 2024 randomized controlled trial (published in NEJM) found ketamine and ECT had similar response rates (~55-70%) for treatment-resistant depression. Some studies favor ECT for psychotic depression; others favor ketamine for its convenience, cognitive safety, and acceptability to patients.

ECT can cause both retrograde amnesia (difficulty remembering events before treatment) and anterograde amnesia (difficulty forming new memories) — particularly with bilateral electrode placement. These effects are usually transient but can last weeks or months for some patients. Ketamine has no documented memory-impairing effects at clinical doses.

No general anesthesia is required (ketamine infusions are done in our clinic with monitoring, not in a hospital OR). No muscle paralysis or seizure induction. No memory loss — in fact, many patients report improved memory. Faster recovery time, with most patients leaving the clinic within about 90 minutes.

Yes — and many patients have. Some patients respond to both; others respond to one but not the other. Having tried ECT doesn't reduce your likelihood of responding to ketamine. We evaluate your full treatment history during your consultation.