LTEs in NEJM Re Ketamine-ECT Non-Inferiority Trial


Out on PubMed, from international authors, are these LTEs in the NEJM:







The pdf is here.
The link is here:
https://www.nejm.org/doi/full/10.1056/NEJMc2308757




Here are three letters critiquing the recent NEJM PCORI-funded multi-center trial comparing IV ketamine to ECT in non-psychotic
patients (mostly outpatients). 
To summarize, the trial seemed destined by design to provide a very favorable view of ketamine and a damning-with-faint-praise view of ECT. The extremely poor ECT results (anomalous by any standard)  made ketamine look good in comparison. The poor ECT results, in turn, were the result of suboptimal ECT technique and a patient population not typical of ECT cohorts.
I will leave it to you to review all the details, also covered previously in blog posts on June 1 and June 12, 2023.

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