Ketamine Augmentation of ECT in Treatment-Resistant Depression (Ketamina)

Randomised, double-blind, placebo-controlled Phase III trial assessing whether adjunctive IV ketamine enhances antidepressant response to ECT in treatment‑resistant major depressive disorder. Thirty participants will receive ketamine or saline during ECT sessions 2, 4 and 6.

Primary outcome is change in MADRS at 4 weeks; secondary outcomes include cognitive side effects and safety measures. Ketamine is given at a subanesthetic dose (0.5 mg/kg IV) after induction with Propofol to evaluate additive antidepressant and potential cognitive‑protective effects.