Ketamine augmentation of ECT to improve outcomes in depression

Randomised, placebo-controlled, parallel-group trial (n=180) comparing intravenous ketamine (Ketalar) versus saline administered as a bolus during ECT in adults with depressive episodes; primary aims relate to cognitive outcomes and depression severity.

Primary cognitive endpoints include HVLT-R, AMI-SF and COWAT measured between baseline and end of ECT course; secondary outcomes include depression scales (MADRS, QIDS-SR), number of ECT treatments to remission, and mechanistic neuroimaging measures (fNIRS, fMRI, MRS, ASL).