Single-blinded, randomised, crossover trial (n=17) in treatment-resistant depression comparing etomidate- vs ketamine-general anaesthesia with ECT and ketamine alone; ketamine ~2 mg/kg IV across six treatment sessions per participant.
This study characterises recovery of brain activity and cognitive function following electroconvulsive therapy (ECT) and general anaesthesia using ketamine or etomidate in patients with treatment-resistant depression.
Design: single-blinded, randomised crossover. After a titration ECT session with etomidate, participants undergo six treatment sessions (three per week for two weeks) comprising etomidate+ECT, ketamine+ECT, and ketamine alone in randomized order; ketamine dosing is ~2 mg/kg.
Outcomes include cognitive assessments and EEG measures of recovery after seizure and anaesthesia to compare cognitive reconstitution and electrophysiological patterns across anaesthetic strategies.
General anaesthesia induced with etomidate (~0.2 mg/kg) followed by ECT at therapeutic charge.
Etomidate general anaesthesia ~0.2 mg/kg; ECT charge determined at titration (procedure: ECT).
Procedure: Electroconvulsive Therapy; charge determined during titration.
General anaesthesia induced with ketamine (~2 mg/kg) followed by ECT at therapeutic charge.
Ketamine general anaesthesia ~2 mg/kg (1–2.5 mg/kg range described).
Procedure: Electroconvulsive Therapy; charge determined during titration.
Ketamine general anaesthesia without subsequent ECT charge (sham comparator).
Ketamine general anaesthesia ~2 mg/kg; no ECT charge administered.