Efficacy and safety of repeated oral ketamine in treatment resistant depression

50 patients of depression fulfilling inclusion and exclusion criteria will be recruited from Psychiatry OPD after making the diagnosis of treatment resistant depression by Consultant Psychiatrist at JNMCH, Aliagrh. They will be assessed on a semi structured proforma which includes socio-demographic details, brief clinical history, mental status examination and physical examination. The severity of Depression will be assessed using Hamilton Depression Rating Scale. After assessment patients will be randomised into 2 groups (Group 1 and Group 2) using computer generated randomisation. Group1 will be given high dose oral ketamine (3mg/kg of body weight in 50 ml of water to gulp over 3-5 minutes) and Group2 will be given low dose oral ketamine (1mg/kg of body weight in 50 ml water to gulp over 3-5 minutes).During the procedure their vitals and any other adverse effect will be monitored for 4 hours. Ketamine will be given thrice a week for 3 weeks, then the patients will be assessed again on HAM-D at 1,3 weeks and will be followed up to 3 months. This study aims to evaluate the efficacy of repeated oral ketamine as an add on treatment in treatment resistant depression with secondary objectives of comparing the efficacy of oral Ketamine at different doses and comparing the safety and adherence to repeated oral ketamine treatment.