title: Antidepressant Effect of Combined Ketamine and Electroconvulsive Therapy on Patients With Major Depressive Disorder: A Randomized Trial.
abstract: 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.
  
  
  OBJECTIVE
  We aimed to determine the effect of Ketamine as a synergistic antidepressant and anesthetic agent on MDD in electroconvulsive therapy (ECT).
  
  
  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.
authors.affiliation: Kurdistan Research Center for Social Determinants of Health, Department of Psychiatry, Qods Hospital, Kurdistan University of Medical Sciences, Sanandaj, IR Iran.
authors.forename: Narges
authors.initials: N
authors.lastname: Shams Alizadeh
authors.affiliation: Department of Psychiatry, Qods Hospital, Kurdistan University of Medical Sciences, Sanandaj, IR Iran.
authors.forename: Azad
authors.initials: A
authors.lastname: Maroufi
authors.affiliation: Departments of Anesthesia and Intensive Care, Kurdistan University of Medical Sciences, Sanandaj, IR Iran.
authors.forename: Karim
authors.initials: K
authors.lastname: Nasseri
authors.affiliation: Department of Psychiatry, Qods Hospital, Kurdistan University of Medical Sciences, Sanandaj, IR Iran.
authors.forename: Seyed Hosein
authors.initials: SH
authors.lastname: Sadeghi Najafabadi
authors.affiliation: Department of Psychiatry, Qods Hospital, Kurdistan University of Medical Sciences, Sanandaj, IR Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Mousavi Taghiabad
authors.affiliation: Deputyship of Research, Kurdistan University of Medical Sciences, Sanandaj, IR Iran.
authors.forename: Fardin
authors.initials: F
authors.lastname: Gharibi
authors.affiliation: Department of Psychiatry, Qods Hospital, Kurdistan University of Medical Sciences, Sanandaj, IR Iran.
authors.forename: Gholam Reza
authors.initials: GR
authors.lastname: Esfandiari
keywords: Antidepressants; Electroconvulsive Therapy; Ketamine