Randomised, quadruple-blind, factorial trial (n=150) comparing S-ketamine 0.25 mg/kg and ketamine 0.5 mg/kg versus propofol+saline during ECT in adults with depressive disorders to evaluate short-term efficacy and safety.
This randomised, quadruple-blind, factorial study (n=150) evaluates whether adjunctive intravenous S-ketamine (0.25 mg/kg) or ketamine (0.5 mg/kg), given with propofol anaesthesia, improves short-term antidepressant outcomes and safety during routine ECT for adults with depressive disorders.
Primary outcomes focus on short-term efficacy and safety; secondary assessments include cognitive effects, adverse events, and measures relevant to suicide risk and relapse.
Interventions compare three arms: propofol+saline (placebo comparator), propofol+ketamine (0.5 mg/kg), and propofol+S-ketamine (0.25 mg/kg), administered as IV bolus infusions prior to ECT sessions.
Propofol 1 mg/kg plus saline bolus infusion before ECT (placebo comparator arm).
Propofol 1 mg/kg IV bolus + saline bolus infusion before ECT
Saline bolus infusion (placebo)
Propofol 1 mg/kg plus ketamine 0.5 mg/kg bolus infusion before ECT (active comparator).
Ketamine 0.5 mg/kg IV bolus before ECT
Propofol 1 mg/kg IV bolus (co-administered)
Propofol 1 mg/kg plus S-ketamine 0.25 mg/kg bolus infusion before ECT (experimental).
S-ketamine (esketamine) 0.25 mg/kg IV bolus before ECT
Propofol 1 mg/kg IV bolus (co-administered)