Montgomery-Asberg Depression Rating Scale

The Montgomery-Asberg Depression Rating Scale (MADRS) is a ten-item diagnostic questionnaire used to measure the severity of depressive symptoms in patients with mood disorders. Each item in the scale yields a score of 0-6, with the overall score ranging from 0-60. Higher scores indicate more severe depression with scores >34 the most severe.

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Find out more about Montgomery-Asberg Depression Rating Scale

Alternative name
MADRS

Active? Yes

First used: 01 January 1970

Related Topic

Depression
Depression impacts over 260 million people. It is the most extensively studied disorder in the world of psychedelics with psilocybin, ketamine and DMT all showing promise.

Related Papers

Cognitive Function Mediates the Anti-suicide Effect of Repeated Intravenous Ketamine in Adult Patients With Suicidal Ideation
This study (n=86) assessed the effects of six infusions of ketamine (35mg/70kg) over 2 weeks on suicidality in patients with depression. Next to the Beck Scale for Suicide Ideation (SSI) and the Montgomery-Asberg Depression Rating Scale (MADRS), the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery was also used. MADRS total score and processing speed (but not other cognitive domains) were significant partial mediators of the association between ketamine treatment and improvements in suicidal ideation.

International pooled patient-level meta-analysis of ketamine infusion for depression: In search of clinical moderators
This meta-analysis (n=809, s=17) finds robust effects of ketamine for relieving depression (at 24 hours and seven days). Moderators of this effect were the level of treatment resistance (i.e. more failed SSRIs) and studies that used a cross-over design (smaller placebo effect). Other moderators were found, but all were modest and clinically irrelevant (i.e. age or sex doesn't moderate treatment effect).

Dose-related effects of ketamine for antidepressant-resistant symptoms of posttraumatic stress disorder in veterans and active-duty military: a double-blind, randomized, placebo-controlled multi-centre clinical trial
This double-blind RCT (n=158) assessed 8 repeated doses of intravenous ketamine administered twice weekly at a low dose (0.2 mg/kg; n = 53), standard dose (0.5 mg/kg; n = 51) ketamine or placebo (n=54) in veterans and service members with PTSD. It was found that the standard dose of ketamine reduced MADRS scores significantly more than placebo. However, the trial failed to find a significant dose-related effect of ketamine on PTSD symptoms measured using the CAPS-5.

The relationship between dissociation and antidepressant effects of esketamine nasal spray in patients with treatment-resistant depression
This posthoc analysis further analyzes the results of the TRANSFORM studies using esketamine for patients with treatment-resistant depression. In TRANSFORM-2 the percentage of responders (>50% reduction in MADRS) at day-2 and day-28 did not differ significantly between patients who did versus did not manifest significant dissociation. The mean peak dissociation (CADSS) scores significantly decreased across consecutive doses and fewer patients experienced significant dissociation after the last esketamine dose compared to the first.

Comparative effectiveness of repeated ketamine infusions in treating anhedonia in bipolar and unipolar depression
This open-label study investigated the effects of six intravenous ketamine infusions (0.5 mg/kg) on anhedonia (the inability to feel pleasure) in patients with major depressive disorder (MDD) (n=77) or bipolar depression (BD) (n=20). A significant reduction in the MADRS anhedonia subscale score was observed at 4hrs after the first infusion and was maintained with repeated infusions. Reductions were similar in both MDD and BD groups.

Efficacy and safety of esketamine nasal spray by sex in patients with treatment-resistant depression: findings from short-term randomized, controlled trials
This post hoc analysis of three RCTs using esketamine in patients with treatment-resistant depression (TRD) (n=721) found no sex differences when using esketamine for TRD. Across the three trials, it was found that the efficacy and overall safety of esketamine in patients with TRD were similar for both men and women. The most common adverse events in esketamine-treated patients were nausea, dissociation, dizziness, and vertigo, each reported at a rate higher in women than men.

Efficacy, Safety, and Durability of Repeated Ketamine Infusions for Comorbid Posttraumatic Stress Disorder and Treatment-Resistant Depression
This is the first open-label study (2018) to assess the effects of repeated ketamine infusions in the treatment of comorbid PTSD and treatment-resistant depression (TRD) (n=15). Participants received six IV ketamine infusions (0.5 mg/kg) on a Monday-Wednesday-Friday schedule over a 12-day period. Ketamine significantly reduced measures of symptoms change for both disorders (MADRS & PTSD Checklist for DSM-V) and the remission rate for PTSD and TRD were 80% and 93.3%, respectively.

Relationships between reduction in symptoms and restoration of function and wellbeing: Outcomes of the Oral Ketamine Trial on Suicidality (OKTOS)
In this open-label study (n=30) participants received six oral sub-anaesthetic doses of ketamine, one dose a week over six weeks. The initial dose was 35mg/70kg which increased to a max of 210mg/70kg by week six. Although restoration of function and wellbeing did improve, these effect sizes were smaller than for suicidality and depression outcomes suggesting that reduction in these outcomes may not be necessary for full restoration of function and wellbeing.

Ketamine improves short-term plasticity in depression by enhancing sensitivity to prediction errors
This EEG study (n=30) in patients with depression shows that prediction error sensitivity (a possible proxy for brain plasticity, lacking in this population) is improved by ketamine (30.8mg/70kg).

Related Trials

Psilocybin Versus Ketamine in Treatment-Resistant Depression (PSIKET_001)
e main goal is to compare the antidepressant effects of psilocybin and ketamine in patients with TRD versus the antidepressant inactive substance midazolam.

An Open-Label, Phase 2, Feasibility Study of Manualized MDMA-Assisted Psychotherapy in Subjects with Major Depressive Disorder
The primary objective is to evaluate the effect of MDMA-assisted psychotherapy for MDD in clinician-rated depression scores, as measured by the mean change in MADRS scores from Visit 4 (Baseline) to Visit 13 (approximately 12 weeks post Baseline).

The Safety and Efficacy of Psilocybin in Patients With Treatment-resistant Depression and Chronic Suicidal Ideation
This study aims to explore the safety and tolerability of a single dose of psilocybin (25mg) administered under supportive conditions to adult participants with TRD and chronic suicidal ideation.

MDMA-assisted Psychotherapy for Anxiety Associated With a Life-threatening Illness
This Phase 2 pilot study is a randomized, double-blind, placebo-controlled study in 18 participants comparing the effects of MDMA-assisted therapy vs. placebo with therapy.

University of Iowa Interventional Psychiatry Service Patient Registry
The purpose of this study is to examine the effects of interventional/procedural therapies for treatment-resistant depression (TRD). These treatments include electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), racemic ketamine infusion and intranasal esketamine insufflation.

Use of Transmucosal Ketamine in Post Stroke Depression
Studies have shown that ketamine is very effective and has a quick onset in the treatment of depression. Most of these studies used intravenous ketamine in an inpatient setting and there are no large trials examining its use in Post Stroke Depression (PSD).

Psilocybin and Depression
The main aim of the study is to investigate the possible long-term therapeutic effects of psilocybin on the symptoms of severe depression, as well as the brain mechanisms underlying these changes

Proof of Concept Study Evaluating the Efficacy and Safety of MIJ821 in Patients With Treatment-resistant Depression
This study evaluated the efficacy and safety of the compound MIJ821 compared to placebo in patients aged from 18 to 65 years diagnosed with treatment-resistant depression. The study was conducted in the US and in Europe (Spain). The MIJ821 was administered via infusion on a weekly or bi-weekly basis. The efficacy was measured after 24 hours using a specific golden standard scale, the Montgomery-Asberg Depression Rating Scale. The study duration was 6 weeks of treatment plus 1 month of follow up period.

Optimization of IV Ketamine for Treatment Resistant Depression
In this study we are investigating whether ketamine can have an antidepressant effect compared to midazolam. Midazolam has similar anesthetic effects compared to ketamine but has not been shown to be an antidepressant, and is therefore acting as an active control in this study.

Open Label Ketamine Treatment for Major Depressive Disorder in Veterans
Medically healthy Veterans ages 21-75 that have been diagnosed with Depression will get up to 6 treatments of Ketamine infusions, weekly. After treatment is completed, follow up will occur at 1 month, 3 months, and 6 months after completion of infusions to evaluate the longer term effects of ketamine.

NRX-101 for Maintenance of Remission From Severe Bipolar Depression in Patients With Suicidal Ideation
The SevereBD study will test the hypothesis that NRX-101 is superior to lurasidone alone in maintaining remission from symptoms of depression (primary endpoint), clinical relapse (declared secondary endpoint), and suicidal ideation or behavior (declared secondary endpoint) over a six week period of twice-daily oral dosing.

Naltrexone Plus Ketamine for the Rapid Treatment of Major Depressive Disorder and Alcohol Use Disorder
To evaluate if naltrexone plus ketamine is effective in reducing depression and alcohol consumption.

Music as an Intervention to Improve Hemodynamic Tolerability of Ketamine in Depression
The purpose of this study is to assess the impact of music on patients receiving a course of intravenous (IV) ketamine for treatment-resistant depression (TRD), both unipolar and bipolar. The primary outcome is changes in in systolic blood pressure throughout each 40-minute infusion. Secondary outcomes include repeated measures of mood, anxiety, suicidality, and psychological/physical pain. Aspects of the treatment experience, with and without music, will also be explored.

miRNAs, Suicide, and Ketamine - Plasma Exosomal microRNAs as Novel Biomarkers for Suicidality and Treatment Outcome
The purpose of this study is to examine whether neural-derived exosomal miRNAs are differentially expressed that are specific to suicidal ideation or behavior, and which by affecting specific miRNA targets and pathways, are associated with suicidal behavior and response to ketamine.

Trial of the Rapid Antisuicidal Effects of Intranasal Ketamine in Comorbid Depression and Alcohol Abuse
This project aims to evaluate the potential rapid and sustained antisuicidal and antidepressant effects of a single intranasal dose of ketamine in inpatients during a mood episode in Major Depressive Disorder (MDD) or Bipolar Disorder (BD) with or without comorbid recent abuse of alcohol.

Low Dose Intravenous Ketamine in Treatment Resistant Depression Patients
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Long Term Follow Up Study to COMP 001 And COMP 003 Trials (P-TRD LTFU)
The primary objective of this study is to assess the long-term efficacy of psilocybin with respect to use of new antidepressant treatment, hospitalisations for depression, suicidality, and depressive severity rated using the Montgomery and Asberg Depression Rating Scale (MADRS) over a total of 52 weeks (compared across the 1 mg, 10 mg and 25 mg psilocybin groups from COMP 001).

Ketamine Versus Electroconvulsive Therapy in Depression
The aim of this study is to show that compared to ECT, ketamine treatment produces faster results, has less side effects, requires less or shorter hospitalizations, and is less expensive. The measures collected throughout the study (clinician scales, self-reports, blood samples, and neuroimaging) may help with predicting if future patients will respond to ECT or ketamine. This could lead to faster, more effective treatment for patient with depression.

Ketamine Trial for the Treatment of Depression
This study is a Randomized Controlled Trial, investigating the safety and efficacy of administration of ketamine as a potential treatment for depression.

Ketamine Plus Lithium in Treatment-Resistant Depression
The purpose of this study is to test the antidepressant effect of ketamine when given repeatedly over a period of 1 week, as well as the use of Lithium as a relapse-prevention strategy for patients with treatment-resistant depression (TRD) who respond to an initial series of ketamine infusions.

Ketamine IV Classic Protocol : Five Years Follow up
Patients who suffer from MDD received ketamine (2014-15) in open study will be addressed and there depression mood will be evaluated using the rating scale that were used in the original research. In addition time of relapse and questions about their medications and drug use will be performed.

Ketamine Interleaved With Electroconvulsive Therapy for Depression
Pragmatic, randomised, controlled, parallel group, pilot clinical trial of ketamine vs. midazolam interleaved with electroconvulsive therapy (ECT) as an adjunctive treatment for a major depressive episode. The main purpose of the pilot study is to assess trial processes to help inform a future definitive trial.

Ketamine Infusions for PTSD and Treatment-Resistant Depression
The purpose of this study is to see whether ketamine, when given as repeated infusions, can produce quick and sustained improvement in depression and PTSD symptoms for individuals who have not had their symptoms effectively treated by current treatments.

Ketamine Infusions for Major Depression Disorder
The investigators believe that the data presented above allows us to provide ketamine treatment here in the Sheba Medical Center for TRD patients.

Study Where Pharmaco Magnetic Resonance Imaging (MRI) Effects of AZD6765 Will be Compared to Placebo in Depressive Male and Female Subjects
The purpose of this study is to determine the effect of a single dose infusion of AZD 6765 compared with placebo and ketamine on the blood oxygen level dependent signal using fMRI (functional Magnetic Resonance Imaging) in depressed subjects.

Frontline Clinician Psilocybin Study
We aim to investigate the effects of a single dose of psilocybin, delivered in the context of pre- and post-dose psychotherapy, on symptoms of depression and burnout suffered by healthcare clinicians as a result of frontline work in the coronavirus disease of 2019 (COVID) pandemic.

Psilocybin Therapy for Depression in Bipolar II Disorder (BAP)
The purpose of this study is to determine the safety, tolerability, and feasibility of psilocybin therapy in people with Bipolar II Disorder.

The Safety and Efficacy of Psilocybin in Participants With Type 2 Bipolar Disorder (BP-II) Depression.
The primary objective of this study is to evaluate the efficacy of 25 mg of psilocybin under supportive conditions to adult participants with BP-II, current episode depressed, in improving depressive symptoms.

The Safety and Efficacy of Psilocybin in Participants With Treatment Resistant Depression
The Safety and Efficacy of Psilocybin in Participants with Treatment Resistant Depression - a dose-ranging study.

The Safety and Efficacy of Psilocybin in Cancer Patients With Major Depressive Disorder
This is a Phase II, single-center, fixed dose, open label trial to explore the safety, tolerability and efficacy of a 25mg dose of psilocybin in cancer patients with MDD.

The Effect of S-ketamine for Patients Undergoing Electroconvulsive Therapy (ECT)
This study will determine the effectiveness and safety of S-Ketamine in depression patients undergoing electroconvulsive therapy.

The Effect of Psilocybin on MDD Symptom Severity and Synaptic Density
The effect of psilocybin on major depressive disorder (MDD) symptom severity and synaptic density - a single dose randomized, double blind, placebo-controlled phase 2b positron emission tomography study.

The Effect of Minocycline on Relapse After Successful Intravenous Ketamine/Minocycline-induced Symptoms Response in Subjects With Depression
The purpose of this study is to assess whether the antidepressant effect from intravenous (IV) ketamine treatment can be maintained by minocycline compared to placebo after IV ketamine treatment is stopped.

The BIO-K Study: A Single-Arm, Open-Label, Biomarker Development Clinical Trial of Ketamine for Non-Psychotic Unipolar Major Depression and Bipolar I or II Depression.
The purpose of this research study is to find out if the medication known as ketamine can help the symptoms of depression.

Ketamine Infusion for Adolescent Depression and Anxiety
The purpose of this study is to determine the tolerability and short-term efficacy of a single ketamine infusion for the treatment of adolescents with 1) medication-refractory major depressive disorder (MDD) and/or 2) medication-refractory anxiety disorders (social anxiety disorder, panic disorder, generalized anxiety disorder and/or separation anxiety disorder).

Sequential Therapy for the Treatment of Severe Bipolar Depression
This study is conducted as a feasibility study for a pivotal phase 2b/3 clinical trial and the primary outcomes for this phase 2 study were blood levels of NRX-101, in order to confirm pharmaco-kinetics with remission from depression, as measured by BISS-derived MADRS and relapse as secondary outcomes.

Research Study for Major Depressive Disorder: Investigation of Glutamate Medications
This study is examining the safety and effectiveness of two medications, ketamine and riluzole, in treating patients with treatment resistant major depressive disorder.

Repeated Neurocognitive Measurements in Depressed Patients
In this project, we will A) track the functioning of a collection of potential neurobiological targets for depression over time, B) examine how fluctuations in the functioning of those targets relates to real-world functioning, and C) in a subset of the sample, determine how the functioning in those targets is altered by a single dose of ketamine.

Repeated Ketamine Infusions for Comorbid PTSD and MDD in Veterans
The purpose of this study is to use repeated ketamine infusions as a probe to validate a model of PTSD+MDD that focuses on neuroanatomy and executive functioning.

Rapid Antidepressant Effects of Ketamine in Major Depression
This study examines whether ketamine can cause a rapid-next day antidepressant effect in patients with Major Depressive Disorder.

Treatment Resistant Depression (Pilot)
Treatment-resistant depression (TRD) is a major public health problem. Current therapeutic options for this patient population remain limited. With all available treatments, only a subset of those patients who achieve an antidepressant response is likely to achieve treatment-induced remission.

Effect of Lithium Versus Placebo in Adults With Treatment-Resistant Depression Who Are Receiving Ketamine
The purpose of this research study is to compare the antidepressant effect of lithium versus placebo in adults receiving ketamine.

Treatment Study of Bipolar Depression
The purpose of this study is to determine whether a single intravenous administration of an N-methyl-D-aspartate antagonist (ketamine) is safe and effective for the acute treatment of bipolar depression.

Trial of Ketamine and Lithium Therapy in Bipolar Depression
This study is looking at the safety and efficacy of combined ketamine and lithium therapy for treating patients with bipolar depression who are taking a mood stabilizer that is not working for them.

Clinical, Neurocognitive, and Emotional Effects of Psilocybin in Depressed Patients - Proof of Concept
Effects of serotonin 2A/1A receptor stimulation by psilocybin on mood and emotion processing in major depressive disorder: a randomized double-blind placebo-controlled study

Efficacy of Repeated Ketamine Infusions for Treatment-resistant Depression
The investigators propose to study if multiple infusions of ketamine can provide greater and longer antidepressant effects than one infusion. If that is the case, multiple infusions could be an alternative to relieve depressive symptoms that do not respond to multiple antidepressant drugs.

Efficacy of Psilocybin in OCD: a Double-Blind, Placebo-Controlled Study
This study aims to investigate the effects of oral psilocybin on OCD symptomatology and provide the first evidence of the neural mechanism that may mediate psilocybin's purported therapeutic effects on OCD.

Effects of Low-dose Ketamine as an Adjunct to Propofol-based Anesthesia for Electroconvulsive Therapy
This is a proof-of-concept study to elucidate whether the use of low-dose ketamine as an adjunct to propofol-based anesthesia for electroconvulsive therapy has beneficial anti-depressant effects in a population of adults with major depressive disorder presenting for ECT.

Effect of Ketamine vs. Active Placebo on Suicidal Ideation in Depressed Inpatients With Major Depressive Disorder or Bipolar Depression
The purpose of this study is to conduct a pilot trial of IV ketamine + treatment as usual (TAU) vs. midazolam (an active placebo) + TAU to estimate sample size for a full-scale RCT examining these treatments for decreasing suicidal ideation among depressed inpatients with major depressive disorder and bipolar depression.

Double-Blind, Placebo-Controlled Trial of Ketamine Therapy in Treatment-Resistant Depression (TRD)
This study is looking at the efficacy, durability, safety, and tolerability of multiple single doses of Ketamine vs. active placebo for treating patients with treatment resistant depression who are taking an antidepressant that is not working for them.

D-cycloserine for Relapse Prevention Following Intravenous Ketamine in Treatment-resistant Depression
The aim of the study is to determine whether 8 weeks of DCS maintenance therapy will prevent relapse of depressive symptoms following ketamine infusions.

Continuation Ketamine in Major Depression
As of May 21st, 2012, the purpose of this study is to test the antidepressant effect of ketamine when given repeatedly over a period of 1 week, as well as the use of Lithium as a relapse-prevention strategy for patients with treatment-resistant depression (TRD) who respond to an initial series of ketamine infusions.

Comparing Ketamine and Propofol Anesthesia for Electroconvulsive Therapy
To determine the effect of ketamine, compared to propofol, when used an an anesthetic agent for electroconvulsive therapy (ECT) in the treatment of major depressive disorder (MDD).

Cognitive Therapy to Sustain the Antidepressant Effects of Intravenous Ketamine in Treatment-resistant Depression
The goals of this study are: 1) to investigate the efficacy of combining ketamine with intensive cognitive behavioral therapy (CBT) to sustain the antidepressant effects of ketamine; and 2) to determine ketamine's delayed effects on learning and memory, and to explore the relationship between any ketamine-induced changes in learning and memory and duration of antidepressant efficacy, with and without CBT augmentation.

Cognitive Behavioral Therapy in Prolonging the Antidepressant Effects of Intravenous Ketamine
Subjects with depressive episodes will be recruited to undergo a brief 2 week course of IV infusions of ketamine in combination with cognitive behavioral therapy for 8 weeks.

Evaluation of Schemes of Administration of Intravenous Ketamine in Depression
Goals: Provide clinical evidence of responseas well as a neurological basis or biomarker of response to a series of ketamine infusions.

Biomarkers of Response to Ketamine in Depression: MRI and Blood Assays Before and After Open Label Intranasal Ketamine
This pilot study aims to identify predictors of response to intranasal ketamine treatment in patients with treatment-resistant depression.

Antidepressant Effects of Ayahuasca: a Randomized Placebo Controlled Trial in Treatment Resistant Depression
The purpose of the present trial is to test the efficacy of Ayahuasca in treatment-resistant depression.

An Open Label Study of the Safety and Efficacy of Psilocybin in Participants With Treatment-Resistant Depression (P-TRD)
The primary objective of this study is to evaluate the efficacy of psilocybin (25 mg) administered under supportive conditions to adult participants with severe TRD, in improving depressive symptoms.

Administration of Subanesthetic Dose of Ketamine and Electroconvulsive Treatment for Treatment Resistant Depression
In this proof of concept study, the investigators plan to administer iv ketamine interleaved with Electroconvulsion Therapy days.

A Two-Year Observational Follow-up Study of Subjects With Major Depressive Disorder Following a Randomized, Double-Blind Single-Dose of Psilocybin or Niacin-Control
This is a Phase 2 double-blind, long-term observational follow-up study of participants from Study PSIL201.

A Study of SLS-002 (Intranasal Racemic Ketamine) in Adults With Major Depressive Disorder at Imminent Risk of Suicide
The purpose of the study is to evaluate the efficacy, safety, and tolerability of SLS-002 (intranasal racemic ketamine) in addition to standard of care on symptoms of Major Depressive Disorder (MDD) and suicidality.

A Study of Psilocybin for Major Depressive Disorder (MDD)
The purpose of this study is to evaluate the potential efficacy of a single 25 mg oral dose of psilocybin for MDD compared to the active placebo in otherwise medically-healthy participants, assessed as the difference between groups in changes in depressive symptoms from Baseline to Day 43 post-dose.

A Study of Ketamine in Patients With Treatment-resistant Depression
The purpose of this study is to explore the optimal dose frequency of ketamine in patients with treatment-resistant depression (TRD).

A Study of Brexpiprazole Plus Ketamine in Treatment-Resistant Depression (TRD)


Ketamine as a Rapid Treatment for Post-traumatic Stress Disorder (PTSD)
The objective of the proposed study is to test if a single IV dose of ketamine (0.5 mg/kg) decreases symptoms of PTSD.

Ketamine in Adolescents With Treatment-Resistant Depression
This study will test the use of ketamine for treatment of depression in adolescents that have not responded to other treatments. We will also examine neurobiological mechanisms of treatment.

Ketamine for Treatment Resistant Late-Life Depression
The purpose of this study is to examine the effectiveness of a single infusion of ketamine (KET), to determine which dose is optimal 7 days after infusion using Bayesian Adaptive Randomization, and to learn about how ketamine works in the body and brain in persons with late-life treatment resistant depression.

Ketamine for the Rapid Treatment of Major Depressive Disorder and Alcohol Use Disorder
The investigators will compare 3 treatment groups (ketamine plus naltrexone vs. ketamine alone vs. placebo) for treating major depressive disorder (MDD) and alcohol use disorder (AUD) in an 8-week randomized, double-blind, placebo-controlled, between-subjects trial.

Ketamine For Suicidal Ideation
This study will examine the effects of Intravenous (IV) ketamine both in an outpatient population and with subjects on the inpatient unit with suicidal ideation (SI).

Ketamine for Low Mood States in the ER
The investigators hope to see if a commonly used drug such as ketamine could help depressed ER patients feel better and improve their mood quickly.

Ketamine for Depression and Suicide Risk
The purpose of this research study was to find out if the medication known as ketamine could help the symptoms of depression.

Ketamine Associated ACC GABA and Glutamate Change and Depression Remission
This is a feasibility study and the goal of this project is to evaluate whether peak ACC GABA and glutamate, quantified as a CSF-corrected absolute concentration percent change from baseline, is associated with clinical remission, Montgomery Asberg Depression Rating Scale (MADRS) total score of <10, to the anti-glutamatergic antidepressant ketamine. As MRS is expensive, we also aim to study a correlation between change in peripheral metabolites (GABA and glutamate) and central GABA and glutamate levels.

Ketamine as an Alternative Treatment to ECT in Major Depressive Disorder
In this study the investigators evaluate the NMDA-receptor antagonist ketamine as a potentially new antidepressant treatment for severely depressed patients and compare its effectiveness with that of electroconvulsive therapy (ECT).

Ketamine as a Rapidly-Acting Antidepressant in Depressed Emergency Department Patients
This study plans to explore the potential that ketamine's rapid antidepressant action holds for improving outcomes in patients presenting to the Emergency Department with severe depression.

A Naturalistic Study of Ketamine for Treatment Resistant Mood Disorders
This study aims to openly test the long-term safety, tolerability and effectiveness of repeated administration of IV, nasal spray and oral ketamine for treatment-resistant mood disorders.

Ketamine and Nitroprusside for Depression
The study team would like to see if nitroprusside can prevent the reported bad effects of ketamine without blocking the reported good effects. This might make ketamine a better treatment for depression.

Ketamine Alcohol (in Treatment-Resistant Depression)
Based on the prior post hoc results, the investigators seek to prospectively demonstrate that a family history of an alcohol use disorder predicts a more robust antidepressant response to ketamine. The research team will also explore potential biomarkers of ketamine's antidepressant effects in treatment-refractory depressed patients at greater risk of developing an alcohol use disorder, using physiological and neurochemical responses to alcohol.

Intravenous Ketamine Plus Neurocognitive Training for Depression
This study has two aims: 1) to characterize the effects of intravenous ketamine on neurocognitive markers in depressed patients; 2) to test the efficacy of a synergistic intervention for depression combining intravenous ketamine with neurocognitive training.

Intraoperative Ketamine Versus Saline in Depressed Patients Undergoing Anesthesia for Non-cardiac Surgery
This study evaluates whether ketamine, given as part of an anesthetic, improves depression symptoms in depressed patients undergoing total joint replacement surgery. Half of participants will receive a ketamine infusion during surgery, while the other half will receive a placebo (normal saline) during surgery.

Intranasal Ketamine in Treatment-Resistant Depression
The objective of the current study is to investigate the safety and efficacy of a single dose of intranasal (IN) ketamine in treatment-resistant depression (TRD).

Intranasal Esketamine to Maintain the Antidepressant Response to IV Racemic Ketamine
This study aims to assess the efficacy and safety of intranasal esketamine as maintenance antidepressant therapy in patients who have demonstrated clinical improvement with off-label intravenous racemic ketamine for treatment-resistant depression.

Intra-nasal vs. Intra-venous Ketamine Administration
The current study wishes to contribute to the applicability of the use of ketamine in a clinical setting by focusing on the efficacy of intra-nasal administration compared with the IV route.

Examining the Impact of Sirolimus on Ketamine's Antidepressant Effects
The aim of the study is to provide insight into the impact of the immunosuppressant drug sirolimus, on the antidepressant effects of the prototypal rapid-acting antidepressant medication, ketamine.

Evaluation of the Initial Prescription of Ketamine and Milnacipran in Depression in Patients With a Progressive Disease
KetaPal is a placebo-controlled randomized trial designed to demonstrate the antidepressant action of ketamine in palliative care situations. Half of participants will receive Ketamine and Milnacipran in combination, while the other half will receive a Placebo and Milnacipran in combination.

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