Ketodex for Electroconvulsive Therapy in Patients with Psychotic Disorders: A Case Series

Abstract

Before the introduction of antipsychotic medications, Electroconvulsive Therapy (ECT) was considered one of the first-line treatments for psychotic disorders. Although ECT is still recommended for certain patients with psychosis, the widespread use of antipsychotic drugs has made it less commonly utilised. However, the combination of ketamine and dexmedetomidine (Ketodex) may prove beneficial in controlling the haemodynamic response and preventing emergent confusion due to their opposing drug actions. Nonetheless, the use of Ketodex in patients with psychosis undergoing ECT has not been thoroughly explored. This series presents cases of five patients (22 years female, 25 years female, 28 years male, 19 years female and 25 years female patients) who underwent 25 sessions of ECT with the ketamine-dexmedetomidine combination. All patients demonstrated good cardiovascular stability without experiencing emergent confusion. Based on these findings, the study concludes that the combination of ketamine and dexmedetomidine is both effective and safe for patients with psychosis undergoing ECT.