Shams Alizadeh 2015.

Study characteristics
Methods	Randomised, double‐blind trial
Participants	Diagnosis: DSM‐IV‐TR major depressive disorder N: 44 Age: ketamine 0.3 mg/kg group M = 34.27 (SD =10.66); placebo saline 5 mL group M = 35.1 (SD=12.44) Sex: ketamine 0.3mg/kg group 72.7% female; placebo saline 5 mL group 65% female Baseline depression severity: ketamine 0.3 mg/kg group HRSD score M = 35.4 (SD=6.7); placebo saline 5 mL group HRSD score M = 36.44 (SD=7.17)
Interventions	The intervention group received 0.3 mg/kg of ketamine hydrochloride intravenously which was diluted with 5mL of saline. In the control group, ketamine was replaced with 5mL of Normal saline. After 30 seconds, both groups received 0.5 mg of atropine IV, prior to ECT. Ketamine group (N = 22) Control group (N = 22) Concomitant treatments:aAll participants received ECT. Yes, no changes were made in the type and doses of the already prescribed drugs.
Outcomes	HRSD Cognitive Performance Recovery Time
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	No further information beyond, "The patients were allocated randomly using the block randomization method."
Allocation concealment (selection bias)	Unclear risk	No information given on allocation concealment.
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	No further information beyond, "The patients were also blind to the received medication"
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Quote: "The HRSD scores, vital signs, and duration of reorientation were collected by an author who was blind to group assignment".
Incomplete outcome data (attrition bias) All outcomes	Low risk	Numbers of withdrawn participants and reasons for withdrawal reported.
Selective reporting (reporting bias)	Unclear risk	Protocol unavailable
Other bias	Low risk	No other potential sources of bias identified