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Methodologicals and logistics issues.
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The purpose of this study is to determine whether combination of ketamine plus electroconvulsive therapy improves depressive symptoms decreasing cognitive side effects.
This study will compare the clinical response to brief pulse ECT with infusion of ketamine 0.5 mg/kg versus brief pulse electroconvulsive therapy with infusion of placebo (saline) in major depression. We also will compare levels of cognitive impairment among these groups, compare levels of quality of life among these groups, compare levels of BDNF among these groups. We also will study if levels of 25-hydroxyvitamin D are associated with cognitive impairment in subjects undergoing ECT.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ECT + saline | Placebo Comparator | Brief pulse ECT with saline as placebo in each session | |
| ECT + Ketamine | Experimental | Brief pulse ECT with 0.05 mg/kg ketamine infusion in each session |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ECT + Ketamine | Drug | Brief pulse ECT with 0.05 mg/kg ketamine infusion in each session |
|
| Measure | Description | Time Frame |
|---|---|---|
| Hamilton Depression Scale (HAM-D) 17 change | Baseline, week 1, week 2, week 3, week 4, and at the end of hospital stay, an expected average of 5 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Mini Mental Status Exam change | Baseline and at the end of hospital stay, an expected average of 5 weeks | |
| Autobiographical Memory Test change | Baseline and at the end of hospital stay, an expected average of 5 weeks |
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Inclusion criteria
- Patients with unipolar and bipolar depression from The Psychiatric Unit of Hospital de Clinicas de Porto Alegre (diagnosis will be established by the Structured Clinical Interview for DSM-IV Axis I)
Exclusion criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Federal University of Rio Grande do Sul / Hospital de ClÃnicas de Porto Alegre (HCPA) | Porto Alegre | Rio Grande do Sul | 90035-003 | Brazil |
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| ID | Term |
|---|---|
| D003863 | Depression |
| ID | Term |
|---|---|
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
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| ID | Term |
|---|---|
| D004565 | Electroconvulsive Therapy |
| D007649 | Ketamine |
| ID | Term |
|---|---|
| D003295 | Convulsive Therapy |
| D013000 | Psychiatric Somatic Therapies |
| D004191 | Behavioral Disciplines and Activities |
| D004597 | Electroshock |
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| Rey Auditory Verbal Learning Test change | Baseline and at the end of hospital stay, an expected average of 5 weeks |
| WAIS Digit Span change | Baseline and at the end of hospital stay, an expected average of 5 weeks |
| FAS verbal fluency change | Baseline and at the end of hospital stay, an expected average of 5 weeks |
| Stroop Test change | Baseline and at the end of hospital stay, an expected average of 5 weeks |
| Trial Making Test change | Baseline and at the end of hospital stay, an expected average of 5 weeks |
| WAIS Vocabulary | Baseline |
| Montgomery and Asberg Depression Rating Scale change | Baseline, week 1, week 2, week 3, week 4, and at the end of hospital stay, an expected average of 5 weeks |
| Brief Psychiatry Rating Scale change | Baseline, week 1, week 2, week 3, week 4, and at the end of hospital stay, an expected average of 5 weeks |
| Clinical Global Impression-Severity change | Baseline, week 1, week 2, week 3, week 4, and at the end of hospital stay, an expected average of 5 weeks |
| D011580 | Psychological Techniques |
| D003510 | Cyclohexanes |
| D003516 | Cycloparaffins |
| D006840 | Hydrocarbons, Alicyclic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |