Phase III double-blind, randomised, placebo-controlled trial (n=30) testing IV ketamine 0.5 mg/kg given during ECT sessions 2, 4 and 6 in hospitalised adults with treatment-resistant MDD.
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.
Standard ECT plus intravenous ketamine (subanesthetic) given during ECT sessions 2, 4 and 6.
0.5 mg/kg IV given after induction with Propofol during ECT sessions 2, 4 and 6.
Standard ECT plus IV placebo (saline) administered to mimic ketamine schedule during ECT sessions 2, 4 and 6.
0.9% saline IV administered after induction with Propofol to match ketamine timing.