antidepressant effect of combined ketamine and electroconvulsive therapy on patients with major depressive disorder: a randomized trial

Background: one of the shortcomings of the available treatments for major depressive disorder (mdd) is the time delay between starting the treatment and achieving an antidepressant response. objectives: we aimed to determine the effect of ketamine as a synergistic antidepressant and anesthetic agent on mdd in electroconvulsive therapy (ect). patients and methods: twenty-two patients with mdd received ketamine and propofol as anesthetic agents compared with 20 patients as the control group who received propofol in a double-blind randomized clinical trial. the hamilton rating scale for depression was used to determine the changes in symptoms severity during ect and a 2-week follow-up. results: both groups showed a reduction in depression severity, but there was no significant difference between the groups in the recovery process (p = 0.92). however, the cognitive performance recovery time in the ketamine group was lower than that in the control group (p = 0.042). conclusions: this study could not show the effect of ketamine on depression recovery in a 2-week follow-up period. nevertheless, ketamine may provide a better cognitive performance in patients under ect.