Carspecken CW, et al. - Researchers assessed the antidepressive impacts of ketamine when used as a primary anesthetic in electroconvulsive therapy (ECT). They also investigated its tolerability relative to standard anesthesia and whether plasma brain-derived neurotrophic factor (BDNF) is needed for treatment response was also investigated in this dual-arm double-blinded randomized clinical trial. Either methohexital (1 to 2 mg/kg) or ketamine (1 to 2 mg/kg) anesthesia was administered to adults meeting criteria for treatment-resistant depression undergoing index course ECT. Findings showed that the use of ketamine vs methohexital as a single induction agent for ECT did not result in any significant improvements in depression. Additionally, ketamine increased serum BDNF and did not increase rates of post-ECT agitation. For some patients that were not captured via standard depression assessment questionnaires alone, ketamine use in ECT could offer some benefits.