Is ketamine an appropriate alternative to ECT for patients with treatment resistant depression? A systematic review

•Ketamine is being studied as an alternative to ECT in patients with depression.•There are indications for faster but less durable antidepressant effects with ketamine.•Ketamine shows a more favourable short term neurocognitive side effect profile than ECT.•There is an urgent need for well-designed randomized controlled trials comparing ketamine to ECT in patients with depression.