title: Neuropsychological and mood effects of ketamine in electroconvulsive therapy: a randomised controlled trial.
abstract: BACKGROUND
  Preliminary evidence suggests that the use of ketamine during electroconvulsive therapy (ECT) may be neuroprotective against cognitive impairment and have synergistic antidepressant effects. This study tested whether the addition of ketamine reduced cognitive impairment and enhanced efficacy over a course of ECT, in a randomised, placebo-controlled, double-blind study.
  
  
  METHODS
  Fifty-one depressed patients treated with ultrabrief pulse-width right unilateral ECT were randomised to receive either ketamine (0.5mg/kg) or placebo (saline) in addition to thiopentone during anaesthesia for ECT. Neuropsychological outcomes (measured before ECT, after six treatments, and after the final ECT treatment) and mood outcomes (measured before ECT, and weekly after every three ECT treatments) were measured by a rater blinded to treatment condition.
  
  
  RESULTS
  Neuropsychological outcomes did not differ between groups. The ECT-ketamine group had a slightly greater improvement in depressive symptoms over the first week of treatment and at one-week follow up, though there was no overall difference in efficacy at the end of the ECT course. No psychomimetic effects were detected.
  
  
  CONCLUSIONS
  The study was conducted in a clinical setting, so not all aspects of ECT treatment were fully controlled. Thiopentone doses differed slightly between groups, in order to accommodate the addition of ketamine to the anaesthetic.
  
  
  CONCLUSIONS
  The addition of ketamine did not decrease cognitive impairment in patients having ultrabrief pulse-width right unilateral ECT, but was safe and slightly improved efficacy in the first week of treatment and at one-week follow up.
  
  
  BACKGROUND
  Clinicaltrials.gov ID: NCT00680433. Ketamine as an anaesthetic agent in electroconvulsive therapy (ECT). www.clinicaltrials.gov.
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, NSW 2031, Australia. colleen.loo@unsw.edu.au
authors.forename: Colleen K
authors.initials: CK
authors.lastname: Loo
authors.forename: Natalie
authors.initials: N
authors.lastname: Katalinic
authors.forename: Joshua B B
authors.initials: JB
authors.lastname: Garfield
authors.forename: Kirby
authors.initials: K
authors.lastname: Sainsbury
authors.forename: Dusan
authors.initials: D
authors.lastname: Hadzi-Pavlovic
authors.forename: Ross
authors.initials: R
authors.lastname: Mac-Pherson
mesh_terms: D000328:Adult; D000339:Affect / Q000187:drug effects*; D001714:Bipolar Disorder / Q000150:complications; D003071:Cognition / Q000187:drug effects; D003072:Cognition Disorders / Q000209:etiology* / Q000517:prevention & control*; D003865:Major Depressive Disorder / Q000150:complications / Q000628:therapy*; D004311:Double-Blind Method; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007649:Ketamine / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000209:etiology / Q000517:prevention & control; D018696:Neuroprotective Agents / Q000494:pharmacology*; D009483:Neuropsychological Tests; D013874:Thiopental; D016896:Treatment Outcome
chemical_list: D018696:Neuroprotective Agents; D007649:Ketamine; D013874:Thiopental