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Electroconvulsive therapy (ECT) is the most effective treatment for mood disorders, but some sort of maintenance treatment is usually necessary to prevent relapse. Two research groups examined different strategies.
In a pilot study attempting to evaluate ketamine as a maintenance therapy, Finnegan and colleagues recruited 43 patients in Ireland with uncomplicated major depression to receive a course of appropriately dosed ECT and weekly monitoring. Of the 23 responders eligible for the next phase, only 6 agreed to be randomized to 4 weekly intravenous infusions of ketamine or midazolam. All patients left the study after 1 or 2 infusions, most commonly because of distance (average, 30 miles) from the infusion center.
Hausman and colleagues con…