"The Effects of Propofol With and Without Ketamine on Montreal Cognitive Assessment Test Results in Patients With Mood Disorders Undergoing Electroconvulsive Therapy"

Determining the effect of propofol with or without ketamine on the result of the Montreal test in patients with mood disorders treated with electroshock in Imam Hossein (AS) hospital in 1402

Clinical trial with a control group, with parallel groups, double-blind, randomized, phase one on 88 patients. In both groups, the day before the ECT treatment, one day after the end of the ECT treatment, and one month after the last ECT treatment session, the Montreal cognitive test will be performed, and the effect of ketamine will be compared on cognition

The study population is selected from the Imam Hossein Hospital, diagnosed with any type of mood disorders (unipolar, bipolar, with or without psychosis, and major depressive disorder) based on DSM-5 criteria and identified by a psychiatrist as requiring ECT treatment. After obtaining informed consent, the patients will undergo a comprehensive psychiatric evaluation and physical examination by a psychiatry resident. Patients meeting the inclusion and exclusion criteria will be enrolled in the study. Allocation concealment will be accomplished by placing cards inside opaque, sealed, and sequentially numbered envelopes (Sequence Numbered Sealed Opaque Envelopes - SNOSE)

Persian-speaking 18-70 year old patients diagnosed with mood disorders (bipolar I or II, with/without psychosis, major depression) requiring ECT treatment, with no neurological/cognitive diseases or alcohol use in the past 14 days or opioid/amphetamine use in the past month.

the intervention group, induction of general anesthesia will be performed using Pofol injection and simultaneous injection of intravenous ketamine hydrochloride, and in the control group, induction of general anesthesia will be performed using only Pofol.

Pre and post(1 month after)ECT montreal test

Random distribution of high people after matching with age and education by observing the principle of ignorance by creating a random sequence Random Sequence Generation will be done in the form of simple randomization and through cards shuffling. So that a number of cards will be prepared as the first group and the same number of cards will be prepared for the next group. is taken out and its allocation is recorded and that card is returned to the sum of other cards. Then the cards are dealt again and another card is taken out. This process will continue until reaching a random sequence according to the sample size. Found.

Allocation concealment will be achieved by placing cards containing information about patient assignment to different treatment groups (propofol with ketamine or propofol alone) in sequentially numbered, opaque, sealed envelopes (Sequence Numbered Sealed Opaque Envelopes - SNOSE). For further explanation: The envelopes containing the group assignment cards will be prepared and sequentially numbered by an independent individual not involved in the study conduct or patient evaluation. The envelopes will be opened in the order of patient enrollment, and patients will be assigned to one of the treatment groups based on the contents of the envelope. The physicians and MoCA evaluators will be blinded to the treatment received by the patients. Data analysis will also be performed by a statistician who is unaware of the patient grouping.