Antidepressant effects of dexmedetomidine compared with ECT in patients with treatment-resistant depression

• Published in: Journal of affective disorders Vol. 347; pp. 437 - 444
• Main Authors: Liu, Yusi, Hu, Qiyun, Xu, Sen, Li, Wanwen, Liu, Junyun, Han, Liang, Mao, Hui, Cai, Fang, Liu, Qiaoyan, Zhu, Renlai, Fang, Caiyun, Lou, Yifei, Wang, Zhenhua, Yang, Huiling, Wang, Wenyuan
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.02.2024
• Subjects: Antidepressant response; Dexmedetomidine; Electroconvulsive therapy; Treatment-resistant depression; Electroconvulsive therapy; Antidepressant response; Dexmedetomidine; Treatment-resistant depression
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2023.11.077

This pilot study was designed to investigate the antidepressant effects of dexmedetomidine (DEX), a selective α2-adrenergic receptor agonist, in patients with treatment-resistant depression (TRD). The antidepressant effects of dexmedetomidine was compared with ECT, which is widely used in clinical practice for treatment of patients with TRD. Seventy six patients with TRD were randomly assigned to receive 10 sessions of DEX infusions or electroconvulsive therapy (ECT) treatment. The primary outcome was the changes of depression severity determined by the improvement of 24-item Hamilton Depression Rating Scale (HDRS-24). The second outcomes were the rates of therapeutic response (reduction in HDRS-24 ≥ 50 %) and remission (HDRS-24 ≤ 10 and reduction in HDRS-24 ≥ 60 %) at posttreatment and after 3 months of follow-up visits. We found that 10 sessions of DEX infusions or ECT treatments significantly improved HDRS-24 scores at posttreatment and after 3 months of follow-up visits compared with the baseline. In addition, there was no significant difference between DEX infusions and ECT treatments regarding HDRS-24 at these evaluating points. Furthermore, the depression severity dropped to mild after 2 sessions of DEX infusion. In contrast, at least 6 sessions of ECT treatment were needed to achieve a same level. Finally, the rates of therapeutic response and remission were comparable between the two groups. No serious adverse events were observed. Based on current published evidence, we conclude that DEX exhibits rapid and durable antidepressant properties similar to ECT but with fewer side effects. •Ten sessions of DEX infusions or ECT treatments significantly improved HDRS-24 scores.•DEX infusion displays a fast onset of action in antidepressant and anxiolytic effects.•The rates of therapeutic response and remission are similar between the two groups.•The TRD patients receiving 10 sessions of DEX treatment are safety and well tolerable.