Jagtiani 2014.

Study characteristics
Methods	Randomised, double‐blind, controlled trial
Participants	Diagnosis: DSM‐IV‐TR major depressive episode N: 60 Age: MECT and thiopentone 2.5mg/kg = 34.97 (SD = 8.17); MECT and ketamine 1mg/kg = 35.37 (SD = 8.97) Sex: MECT and thiopentone 2.5mg/kg group 43.3% female; MECT and ketamine 1mg/kg group 56.7% female Baseline depression severity: MECT and thiopentone 2.5mg/kg group HAMD17 = 32.00 (SD = 7.60); MECT and ketamine 1mg/kg group HAMD17 = 29.53 (SD = 4.56)
Interventions	MECT was given three times a week: MECT and thiopentone 2.5 mg/kg (N = 30) MECT and ketamine 1 mg/kg (N = 30) Concomitant treatment: yes, succinylcholine (0.5 mg/kg) was given intravenously as muscle relaxant after induction of anaesthesia. The participants in both groups received antidepressant medications randomly as decided by the treating psychiatrists who were not concerned with the study.
Outcomes	HAMD17 BDI MMSE Side effects
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "The patient’s group was decided by picking up a chit randomly from the container by the nurse on ECT duty."
Allocation concealment (selection bias)	Low risk	Quote: "Each patient was allotted randomly to either group ‘A’ or ‘B’ by the nursing assistant, who was not involved in the study, for deciding the choice of anaesthetic drug"
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Quote: "The researchers (AJ and HK), and the patients were blind to the choice anaesthetic drug done by anaesthetist (NM)."
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Quote: "The researchers (AJ and HK) and the patients were blind to the choice anesthetic drug done by anesthetist (NM). The choice of anesthetic drug was revealed only after the data analysis was complete."
Incomplete outcome data (attrition bias) All outcomes	Low risk	Study reports dropouts (zero) “None of the patients withdrew from the study” Participant flow diagram provided for numbers enrolled, excluded and refused to participate. [Figure 1].
Selective reporting (reporting bias)	Unclear risk	Protocol unavailable No protocol found – trial registration number not in paper.
Other bias	Low risk	No other potential sources of bias identified.