title: Impact comparison of ketamine and sodium thiopental on anesthesia during electroconvulsive therapy in major depression patients with drug-resistant; a double-blind randomized clinical trial.
abstract: BACKGROUND
  Electroconvulsive therapy (ECT) is one of the available and the most effective therapies for the treatment of resistant depression. Considering the crucial role of seizure duration on therapeutic response in patients treated with ECT, this study aimed to compare the effect of ketamine and sodium thiopental anesthesia during ECT for treatment of patients with drug-resistant major depression (DRMD).
  
  
  METHODS
  In a double-blind randomized clinical trial, 160 patients with DRMD were selected consequently and were assigned randomly into two groups including ketamine 0.8 mg/kg and sodium thiopental 1.5 mg/kg. The seizure duration, recovery time, and the side effects of anesthesia were evaluated after 1-h after anesthesia. Data of recovery time and complication collected in 2 nd , 4 th , 6 th , and 8 th ECT. Depression was assessed by Hamilton depression scale.
  
  
  RESULTS
  The results indicated that ketamine and sodium thiopental had a significant effect on the reduction of depression scores in patients with DRMD (P < 0.05). Complications such as a headache, nausea, pain at the injection site, short-term delirium, and long-term delirium were higher in ketamine group (P > 0.05). But ketamine was more effective in improvement of depression score and increasing systolic and diastolic blood pressure (P < 0.05). The mean of seizure duration showed a decreasing trend and was significant between two study groups (P < 0.05).
  
  
  CONCLUSIONS
  Anesthesia induced by ketamine during ECT therapy increased blood pressure and seizure duration. Therefore, due to lower medical complication and attack rate of seizure, ketamine is an appropriate option for anesthesia with ECT in patients with DRMD.
authors.forename: B
authors.initials: B
authors.lastname: Salehi
authors.forename: A
authors.initials: A
authors.lastname: Mohammadbeigi
authors.forename: A R
authors.initials: AR
authors.lastname: Kamali
authors.forename: M R
authors.initials: MR
authors.lastname: Taheri-Nejad
authors.affiliation: Department of Anesthesiology, Arak University of Medical Sciences, Arak, Iran.
authors.forename: I
authors.initials: I
authors.lastname: Moshiri
mesh_terms: D000328:Adult; D000758:Anesthesia / Q000379:methods*; D000778:Anesthetics, Dissociative / Q000494:pharmacology; D003865:Major Depressive Disorder / Q000628:therapy*; D004311:Double-Blind Method; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology; D007649:Ketamine / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D013874:Thiopental / Q000494:pharmacology*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000778:Anesthetics, Dissociative; D006993:Hypnotics and Sedatives; D007649:Ketamine; D013874:Thiopental