Ketamine Versus Electroconvulsive Therapy in Depression
Randomised, multi-centre, crossover trial (n=240) comparing IV ketamine (0.5 mg/kg IV over 40 minutes, thrice weekly initial course) versus electroconvulsive therapy (ECT) in patients referred for ECT for severe depression.
Details
Multi-centre randomised crossover trial enrolling 240 adults referred for ECT to compare efficacy, speed of antidepressant effect, side-effect profile, hospitalisation needs and cost between IV ketamine and ECT.
Participants receive either IV ketamine 0.5 mg/kg infused over 40 minutes thrice weekly for 3–4 weeks (9–12 sessions; upper=12) with a maintenance schedule for responders, or ECT administered per treating physician; responders and non-responders may follow maintenance or crossover pathways as specified.
Outcomes include clinician-rated and self-report measures, neuroimaging, molecular biomarkers and cognitive assessments to evaluate response predictors and comparative effectiveness.