This randomised, open-label, parallel-group trial (n=70) will evaluate the efficacy, safety and tolerability of bitemporal electroconvulsive therapy (ECT) versus intravenous ketamine in adults with treatment-resistant major depressive disorder (TRD). The study will recruit adults aged 18-75 years with major depressive disorder who have not responded to at least two adequate antidepressant trials in the current episode and have a Montgomery-Åsberg Depression Rating Scale (MADRS) score of at least 20. Participants will receive either bitemporal ECT twice weekly for 4 weeks or intravenous ketamine 0.5 mg/kg infused over 40 minutes twice weekly for 4 weeks. The primary outcome is change in MADRS score 3 weeks post-procedure. Exclusion criteria include psychotic or bipolar disorder, current substance use disorder, significant neurological disease or traumatic brain injury, uncontrolled hypertension, recent cardiovascular disease, and pregnancy or breastfeeding.
This study aimed to compare the efficacy, safety, and tolerability of electroconvulsive therapy (ECT) versus intravenous (IV) ketamine in adults with treatment-resistant major depressive disorder (TRD).
Patients received Bitemporal electroconvulsive Therapy (ECT) (2x/week for 4 weeks).
Unmatched intervention: Electroconvulsive Therapy
Patients received intravenous (IV) ketamine 0.5 mg/kg IV infusion over 40 mins (2x/week for 4 weeks).