The Comparison of the effect of combining Ketamine-Propofol and Ketamine- Thiopental during Electroconvulsive Therapy in Reducing the Symptoms in Patients with Major Depression Disorder :a clinical trial

The aim of this study was to compare the effect of ketamine-propofol combination with ketamine-thiopental during electroconvulsive therapy(ECT) anesthesia in improving depressive symptoms in patients diagnosed with major depression.

Clinical trial, with parallel groups, not blinded, randomized, phase 3 on 60 patients, used to randomize the quadruple block.

60patients between the ages of 18 and 59 years, with a definite diagnosis of refractory depressive disorder, who have been referred to the psychiatric ward of Kowsar Hospital in Semnan, are admitted to the study after applying the inclusion and exclusion criteria. The patients are divided into two groups. At first, 0.5 mg of atropine is administered. After one minute, thiopental-ketamine is given to the first group and propofol-ketamine to the second group. Grams are prescribed per kilogram of patient weight. After one minute, shock is given as prescribed and the duration of seizures is recorded for each patient. 6 ECT sessions are performed for all samples and before the beginning of the first ECT session and at the end of the third and sixth sessions, Beck depression test is taken from all samples.

Inclusion criteria: diagnosis of moderate to severe depression; age at least 18 years; having informed consent; ECT history in the last 6 months; Exclusion criteria: conscious dissatisfaction; anorexia nervosa; ECT in the last three months; contraindications for ECT; development of psychotic symptoms; or exacerbation of depressive symptoms during the study.

Intervention group: 30 patients under anesthesia with thiopental combination at a dose of 3 mg/kg with ketamine at a dose of 0.5 mg/kg Control group: 30 patients under anesthesia with a combination of propofol at a dose of 1.5 mg/kg with ketamine 0.5 mg/kg

Depression

Block randomization (quadruple blocks) All possible blocks are arranged as follows: block 1: ABAB block 2: AABB block 3: ABBA block 4: BBAA block 5: BABA block 6: BAAB We need 15 blocks to select 60 people. We randomly select these blocks from the numbers 1 to 6.Using R software, we choose a random number between the numbers 1 to 6. For example, number 6 is chosen as the first block and number 2 as the forth block. The people who enter the study are given B-A-A-BA- A-B-B, respectively.Finally, group 1 and group 2 will be identified.