Randomized, parallel-group study (n=154 actual) testing intravenous subanesthetic ketamine with or without adjunctive computer-based cognitive training for treatment-resistant depression; mechanistic outcomes (fMRI, IAT, cognitive flexibility) and clinical outcomes (MADRS acute; QIDS over 12-month follow-up).
This randomized, quadruple-masked, parallel-group trial examines whether pairing subanesthetic intravenous ketamine with computer-based cognitive training extends antidepressant effects compared with ketamine with sham training and saline with training.
Aim 1 focuses on mechanistic outcomes (fMRI functional connectivity, Implicit Association Test, cognitive flexibility), and Aim 2 assesses clinical efficacy with MADRS during the acute 30-day phase and QIDS across a 12-month naturalistic follow-up.
IV ketamine (0.5 mg/kg over 40 minutes) plus active computer-based automated self-association training (ASAT), delivered twice daily for 4 days starting 24 hours after infusion.
Subanesthetic intravenous ketamine infusion over 40 minutes.
Active automated self-association training (ASAT), up to 20 minutes per session.
IV ketamine (0.5 mg/kg over 40 minutes) plus sham computer-based training, delivered twice daily for 4 days starting 24 hours after infusion.
Subanesthetic intravenous ketamine infusion over 40 minutes.
Sham computer-based training with no positive or self-referential stimuli.
IV saline placebo (50 mL 0.9% sodium chloride over 40 minutes) plus active computer-based ASAT, delivered twice daily for 4 days starting 24 hours after infusion.
Intravenous saline placebo over 40 minutes.
Active automated self-association training (ASAT), up to 20 minutes per session.
This secondary analysis of a randomised clinical trial examines whether automated self‑association training prolongs the antidepressant effect of a single intravenous ketamine infusion in patients with treatment‑resistant depression, reporting outcomes over a one‑year follow‑up.