ALH and HVC (Grant number: L-023032) is registered at ClinicalTrials.gov (ID: NCT02649231).We would furthermore like to thank Dr. Evgeny Krupitsky for his pioneering research into ketamine as a treatment and his input into the design of the study. This paper is dedicated to the memory of our colleague Dr. David Gilhooly.

In the treatment of depression “in all comparisons it is necessary to bear in mind that electroplexy carries a negligible mortality rate and that there are relatively few physical contraindications to its application” (Shepherd, 1959). Bruce et al. (1960) compared electroplexy and imipramine in 50 consecutive admissions and at one month the former is shown to give better results. Rees et al. (1961), whose cases were suitable for electroplexy, show only 35 per cent. with total remission or marked improvement after three weeks treatment with imipramine—a much lower figure than one would expect with E.C.T.