Understanding Treatments for Severe Depression and Suicidality: Ketamine, Electroconvulsive Therapy (ECT), Transcranial Magnetic Stimulation (TMS) and Specialized Psychotherapy

 

 

REaKT Study Information 

In the United States every 10 minutes a person dies by their own hand. It is estimated that 1.5 million make a suicide attempt and 10 million Americans seriously think of suicide every year. The situation is only worsening and has now become a public health crisis. There has been a 35% increase in suicide rates in the last twenty years with an alarming increase in the younger population age 18 – 34 yrs. in whom suicide is currently the second leading cause of death.. A vast majority of suicides and suicide attempts are associated with clinical depression. Acute suicidal depression (ASD) is a life-threatening illness where there is an intent of imminent suicide or an actual attempt has already been made.

A number of psychotherapies and measures such as suicide hotlines have helped in decreasing suicide attempts in the community, but once ASD has set in it requires rapid reversal. This can be done only with medical treatments such as electroconvulsive therapy (ECT) and subanesthetic intravenous ketamine (KET) with known efficacy in ASD. ECT has been available for nearly 80 years and though its administration requires brief anesthesia and it can cause short-term memory deficits, it is the most effective treatment for ASD and is recommended by all treatment guidelines.

KET has been available for the last 20 years as a treatment of ASD and has been shown to have a specific anti-suicidal effect. However, there is a brewing crisis in the treatment of ASD treatment in the current health system. 

Researchers are inviting 1500 patients at a dozen sites to study the effectiveness of ECT or KET treatment.

For more information, please click on the Study link.

Study Details | NCT06034821 | Comparative Effectiveness of ECT vs. KETAMINE Over the Lifespan | ClinicalTrials.gov

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person’s general health condition or prior treatments.

Eligibility Criteria

Description

Inclusion Criteria:

1. You must be an adult 18-90 years of age who is considered by a clinician as appropriate for referral to treatment services for rapid reversal of acute suicidal depression

Exclusion Criteria: You are not eligible to participate if you have the following conditions.

1. Are pregnant or suffer from uncontrolled medical illness or Ketamine allergies
2. Meet DSM-5 criteria for schizophrenia, schizophreniform disorder, schizoaffective disorder.
3. Are not able to give informed consent to receive ECT or KET treatment or give informed consent to participate in the study.
4. Meet exclusion criteria for ECT treatment as described in guidelines.
5. Meet exclusion criteria for KET treatment
6. Have an intellectual disability and unable to provide consent or follow study procedures.