Ketamine as an Augmentation Strategy for Electroconvulsive Therapy (ECT) in Depression

This double-blind randomised controlled pilot compares therapeutic efficacy and cognitive side effects of ECT performed with ketamine versus methohexital anaesthesia in patients with major depressive episodes (unipolar and bipolar).

Participants receive a standard acute course of bifrontal ECT (3x/week) with ketamine 1–2 mg/kg IV or methohexital 0.5–1 mg/kg IV; MRI (structural and functional) is collected at baseline, <36 hours after first ECT, and after nine ECTs or at remission to assess neurobiological changes.