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Electroconvulsive therapy (ECT) is so effective that ketamine anesthesia does not improve its benefit. To determine whether adjunctive use might alter clinical outcomes, researchers in China randomized 132 patients to bitemporal ECT thrice weekly with propofol anesthesia plus a subtherapeutic dose of ketamine (0.3 mg/kg) or saline (mean ages, 41 and 37, respectively).
The groups did not differ in overall rate of response (50% decrease in depression rating-scale score). However, the adjunctive ketamine group demonstrated a quicker response (median, 4 treatments vs. 7 in the saline group). Remission (approximately 25% of baseline depression score) was noted after a median of 8 treatments with ketamine versus 9 with placebo. Overall, 44 patient…