ECT with Ketamine Anesthesia Vs High Intensity Ketamine with ECT Rescue for Treatment-Resistant Depression

This study is comparing two treatments for people with severe, treatment-resistant depression: electroconvulsive therapy (ECT, a procedure that uses brief electrical pulses to the brain) combined with standard anesthesia versus a high-intensity ketamine infusion regimen (with ECT available as a backup if needed). **You may be eligible if...** - You have severe depression (a high score on a standard depression scale) and are already scheduled to receive ECT - You have tried at least two different antidepressant medications that have not worked well enough **You may NOT be eligible if...** - You are unable to provide informed consent - You have a pacemaker, defibrillator, or other electronic implanted device - You have schizoaffective disorder - You are pregnant or refuse a pregnancy screening test - You have a known allergy to any of the study drugs - You have a serious heart, lung, brain, or blood pressure condition that makes ECT too risky Talk to your doctor to see if this trial is right for you.