UMCG investigates the effect of esketamine compared to ECT in severe depression

Under the leadership of Professor of Psychiatry Robert Schoevers of the UMCG, five Dutch hospitals and mental health institutions have started a study that could offer an alternative to electroconvulsive therapy (ECT) as a last resort in the treatment of severe depression. This can lead to a big improvement for people with very severe depression. This study has received a subsidy of € 3.2 million from the National Health Care Institute and ZonMw.

One in three patients with depression does not recover or does not recover sufficiently

three patients with depression does not recover or recovers insufficiently as a result of treatment with medication or psychological treatments. For these patients, ECT is the last remaining treatment option. Electroconvulsive therapy is a radical treatment that often involves a long hospital stay, repeated anesthesia and side effects that can sometimes lead to permanent damage, including impairment of memory. Treatment with esketamine in the form of a drink may offer a good alternative to ECT.

Esketamine may be more effective in the long run

The number of patients who have a relapse in the first year after treatment with ECT is quite high, around 60 percent. Based on data from a pilot with a small group of patients, it is expected that the group receiving esketamine will have better results.

More patient-friendly and cheaper alternative

172 patients will participate in this study. One group is treated with ECT, while the other group receives a dose of oral esketamine twice a week for eight weeks. Both groups are then monitored for a year, with the group receiving esketamine gradually tapering off the treatment. If the patient has not recovered, the patient can still receive the treatment for which he/she did not draw lots.

The study will last a total of four years. If it can be demonstrated that oral esketamine works equally well in severe non-psychotic treatment-resistant depression, then this is a more patient-friendly, but also a cheaper alternative to ECT. The results of the study will be used to determine whether oral esketamine can be reimbursed via the basic insurance in the future.

Who can participate in this research?

Patients suffering with depression from 18 years of age who are eligible for ECT treatment. Patients with a bipolar disorder or psychotic complaints cannot participate in this study. There are other additional eligibility requirements that are discussed in a screening with interested patients.

Participating parties in the study

In addition to the UMCG, participants can also be treated at the LUMC, Amsterdam UMC, Pro Persona and PsyQ/Parnassia Group The Hague. Patient organisation the Depression Association and MIND, the umbrella organisation of client organisations in mental health care, are also collaborating with this study.

Anyone who would like to receive more information about participating in this study can contact: [email protected]