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Major Depressive EpisodeRAFT-ECTNCT05402657

The RAFT ECT Study

A study testing Frontoparietal Ultrabrief Right Unilateral (UBRUL-FP) electroconvulsive therapy and Temporoparietal Ultrabrief Right Unilateral (UBRUL-TP) electroconvulsive therapy in people with Major Depressive Episode, run by The George Institute at 7 sites in 2 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Severe depression is devastating for those affected and is often associated with significant risk of suicide. Electroconvulsive therapy (ECT) is a highly effective acute treatment for severe depression, but its use and acceptability are limited by cognitive side effects. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Major Depressive Episode
What is being tested?
Frontoparietal Ultrabrief Right Unilateral (UBRUL-FP) electroconvulsive therapy and Temporoparietal Ultrabrief Right Unilateral (UBRUL-TP) electroconvulsive therapy
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
156 participants
Where
7 sitesin 2 countries
Study dates
22 Mar 2023to 13 Feb 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • DSM-5 diagnosis* of major depressive episode (unipolar or bipolar)
  • HRSD-17 score ≥ 17 at Screening
  • At least 18 years old
  • Able to tolerate washout of prohibited medications and restriction on benzodiazepine dosage, as determined by patient's own treating psychiatrist.
  • ECT indicated for treatment of depression, as determined by own treating referring psychiatrist and confirmed by research evaluations (e.g., diagnosis of depression)
  • Willing and able to participate in research and comply with study requirements
  • Sufficient proficiency in spoken English to ensure validity of neuropsychological testing (e.g., worked or studied in an English-speaking context or equivalent)

Who cannot join

  • History of schizophrenia, schizoaffective disorder, other [non-mood disorder] psychosis, or rapid cycling bipolar disorder (DSM-5 diagnoses*)
  • Current manic episode, hypomanic episode, or major depressive episode with mixed features (DSM-5 diagnoses*)
  • Alcohol or substance use disorder (other than caffeine or nicotine) present in the past month, or is likely to be present during the 24-week study period as determined by study physician evaluation
  • Diagnosis of amnestic disorder, dementia, delirium, or epilepsy, as determined by study physician evaluation and medical history
  • Central nervous system disease or brain injury that has resulted in significant cognitive impact, as determined by study physician evaluation and medical history
  • Serious or unstable medical condition, as determined by study physician evaluation and medical history
Show all 14Show fewer
  • If female of childbearing potential: a) pregnancy as determined by pregnancy urine screen
  • Completed an acute course of ECT during the past 2 months, as determined by treatment history
  • Received any ECT during the past 2 weeks
  • Failed an adequate course of ECT (i.e., 8 ECT treatments ) in the current depressive episode
  • Patients who are prisoners, and those who lack capacity to make medical decisions (as judged by their own treating psychiatrist)
  • Currently enrolled in another interventional clinical trial
  • Currently using another investigational device or product
  • DSM-5 psychiatric diagnoses will be assessed and confirmed using the Mini International Neuropsychiatric Interview (MINI; Sheehan et al., 1998) Version 7.0.2 for DSM-5, administered by research team members.

Trial locations and contacts

7 sites in 2 countries.

7 sites in 2 countries

Australia4 sites
  • Gold Coast University Hospital (GCUH)

    Gold Coast, Queensland, 4215

  • Ramsay Clinic Albert Road

    Melbourne, Victoria, 3004

  • Ramsay Clinic Northside

    Sydney, New South Wales, 2065

  • Ramsay Clinic Lakeside

    Warners Bay, New South Wales, 2282

Other trials in Australia

United States3 sites
  • Emory University

    Atlanta, Georgia, 30322

  • Medical College of Georgia, Augusta University

    Augusta, Georgia, 30912

  • Medical University of South Carolina

    Charleston, South Carolina, 29425

Other trials in United States

About this study

Official title: The Randomised Controlled Trial of Frontoparietal and Temporoparietal Electroconvulsive Therapy (ECT) for Severe Depression: The RAFT ECT Study

Severe depression is devastating for those affected and is often associated with significant risk of suicide. Electroconvulsive therapy (ECT) is a highly effective acute treatment for severe depression, but its use and acceptability are limited by cognitive side effects. Of these, retrograde memory loss is most concerning, and can be long-term. The introduction of ultrabrief right unilateral (UBRUL) ECT into clinical practice has been an important step in reducing the risk of memory impairment, but significant deficits still occur.

A new form of UBRUL ECT which utilises a Frontoparietal electrode placement represents a further development. Preliminary data suggest that Frontoparietal UBRUL has good efficacy and less cognitive side effects than UBRUL given using the conventional Temporoparietal electrode placement. Designed as a pivotal trial, this protocol will be the first RCT comparing these two forms of ECT, producing the rigorous efficacy and safety data required to change clinical practice/policy.

This is a multicentre, parallel group RCT with 1:1 allocation ratio between Frontoparietal (intervention) and Temporoparietal (comparator) forms of UBRUL ECT. Participation will involve receiving randomised acute ECT under blinded conditions during the randomised acute treatment period (typically around 4 weeks), then completion of a 24-week follow-up period which commences after the cessation of all acute ECT. The study protocol aims to provide 12 randomised acute ECT treatments, though the number of treatments (and hence the length of the randomised acute treatment period) can be adjusted by the participant's own treating/admitting psychiatrist according to their clinical judgement.

Being tested
Frontoparietal Ultrabrief Right Unilateral (UBRUL-FP) electroconvulsive therapy, Temporoparietal Ultrabrief Right Unilateral (UBRUL-TP) electroconvulsive therapy
Keywords
Severe depression, Depressive Disorder, Treatment-Resistant, Depressive Disorder, Major, Memory, Electroconvulsive therapy, Randomised clinical trial
Medical subject headings
Depression, Depressive Disorder, Treatment-Resistant, Depressive Disorder, Major

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Frontoparietal Ultrabrief Right Unilateral (UBRUL-FP) electroconvulsive therapyProcedure or surgery

    UBRUL-FP involves ultrabrief right unilateral ECT delivered using a novel frontoparietal montage, where the anterior electrode is shifted frontally to a position above the midpoint of the right eye to avoid temporal lobe stimulation (and reduce memory side effects). UBRUL-FP will be delivered using standard ECT devices.

  • Temporoparietal Ultrabrief Right Unilateral (UBRUL-TP) electroconvulsive therapyProcedure or surgery

    UBRUL-TP is the standard form of ultrabrief right unilateral ECT, using the conventional temporoparietal (d'Elia) electrode placement, where the anterior electrode is placed over the right temporal lobe. UBRUL-TP will be delivered using standard ECT devices.

Study groups in NCT05402657
Study groupRoleWhat they receive
Frontoparietal ECT GroupExperimentalParticipants will receive ultrabrief right unilateral ECT with a frontoparietal placement of ECT electrodes.
Receives: Procedure: Frontoparietal Ultrabrief Right Unilateral (UBRUL-FP) electroconvulsive therapy
Temporoparietal ECT GroupActive comparatorParticipants will receive ultrabrief right unilateral ECT with the conventional temporoparietal placement of ECT electrodes.
Receives: Procedure: Temporoparietal Ultrabrief Right Unilateral (UBRUL-TP) electroconvulsive therapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Depressive Symptoms as Assessed by Hamilton Rating Scale for Depression-17

    The Hamilton Rating Scale for Depression-17 has a range of 0-52. Lower scores represent mild depression to no depression at all.

    Measured: From baseline to end of randomized acute treatment (typically 4 weeks)

Secondary outcomes (13)
  1. Change in Depressive Symptoms as Assessed by Hamilton Rating Scale for Depression-17

    The Hamilton Rating Scale for Depression-17 has a range of 0-52. Lower scores represent mild depression to no depression at all.

    Measured: From end of acute ECT treatment up to 24-week follow-up

  2. Autobiographical Memory Interview-Short Form (AMI-SF) Consistency Scores

    In the Autobiographical Memory Interview-Short Form, participants are graded on the consistency of their answers between baseline and subsequent time-points. The maximum consistency score is 100 percent, with lower percentages representing increasing inconsistency in retrospective autobiographical memory function.

    Measured: From Baseline to end of randomized acute treatment (typically 4 weeks)

  3. Clinical Global Impression-Severity (CGI-S)

    The Clinical Global Impression-Severity measure is a 7-point scale where a clinician rates the severity of a patient's illness in comparison to the clinician's experience with patients who have the same diagnosis. The ratings range from 1 indicating normal, not at all ill to 7 suggesting they are among the most extremely ill patients.

    Measured: From baseline to end of randomized acute treatment (typically 4 weeks)

  4. Clinical Global Impression-Improvement (CGI-I)

    The Clinical Global Impression-Improvement is a measure where a clinician assesses how much the patient's illness has improved or worsened in comparison to baseline. The "improved" version being used in this trial (Kadouri, Corruble \& Falissard, 2007) is a 13-point scale with ratings which range from 6 ('ideal improvement') to -6 (maximum deterioration).

    Measured: Through the randomized acute ECT treatment period (typically 4 weeks)

  5. Suicidality score

    Assessed by examining scores on item 3 (suicidality) of the Hamilton Rating Scale for Depression (which range from 0 to 4, where higher scores indicate more severe and/or persistent suicidality) and scores on the suicidal ideation subscale of the Columbia

    Measured: From baseline to end of randomized acute treatment (typically 4 weeks)

  6. Post ECT reorientation time

    Post ECT reorientation time is the time taken to recover orientation immediately after ECT in randomised treatment phase.

    Measured: After ECT sessions 3 and 6, which typically occur at the end of week 1 and week 2 in the randomised acute treatment phase.

  7. Change in mean neuropsychological function

    Assessed by a cognitive test battery.

    Measured: From baseline to end of randomized acute treatment (typically 4 weeks)

  8. Mental Health Questionnaire-14 (MHQ-14)

    The Mental Health Questionnaire-14 is a self-report quality of life instrument consisting of the mental health component of the Medical Outcomes Study questionnaire. This patient self-report measure contains 14 items in total, addressing symptoms of fatigue, anxiety and depression, and the impact of these symptoms on functioning. Scores on this measure range from 0 to 100, where higher scores indicate better quality of life.

    Measured: From baseline to end of randomized acute treatment (typically 4 weeks)

  9. Number of responders

    Response is defined as a 50 percent reduction in depression severity from baseline, assessed using the Hamilton Rating Scale for Depression-17

    Measured: From baseline to End of Randomized Acute Treatment (typically 4 weeks)

  10. Number of remitters

    Remission is defined as a score of ≤ 7 on the Hamilton Rating Scale for Depression-17.

    Measured: From baseline to end of randomized acute treatment (typically 4 weeks)

  11. Number of participants switched from randomized treatment to another form of acute ECT

    Number of participants switched from randomized treatment to another form of acute ECT after receiving at least 8 randomized ECT.

    Measured: After at least 8 randomized ECT treatments (typically after 3 weeks).

  12. Number of randomized ECT treatments given over the Acute Study Treatment Phase (RCT)

    Number of randomized acute ECT treatments received by participants during the Acute Study Treatment Phase (RCT), compared between the groups.

    Measured: From baseline to End of Randomized Acute Treatment (typically 4 weeks)

  13. Occurrence of adverse events and serious adverse events

    Occurrence of adverse events (AEs) and serious adverse events (SAEs) compared between the groups, based on treating them as binary outcomes (no/yes, e.g., whether participants experienced any given side effect/adverse event at least once) and as count outcomes (number of occurrences).

    Measured: From baseline and up to 24-week follow-up

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Jun 2022
  2. Study start22 Mar 2023
  3. Primary completion19 Aug 2025
  4. Study completion13 Feb 2026

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
156 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05402657
Sponsor's protocol ID
X22-0018
Other IDs
APP1159769, RG180233
Acronym
RAFT-ECT
Status last verified
Mar 2026
First submitted
5 May 2022
Last updated
13 Mar 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: De-identified individual participant data will be shared upon request to the data custodian, subject to approval from the Trial Steering Committee and signing of data transfer agreements.

Publications

  • Loo C, Barreiros AR, Martin D, Dong V, George MS, McCall WV, Sarma S, Hopwood M, Weiss A, Bull M, Tuneu CM, Alonzo A, Hadzi-Pavlovic D, Rodgers A, Sahlem GL, Harvey AJ, Haldane K, Brettell L, Fitzgerald PB, Dokos S, Sackeim H. A Randomized Controlled Trial of Ultrabrief Right Unilateral ECT With Frontoparietal Versus Temporoparietal Electrode Placement for Severe Depression-The RAFT ECT Trial. J ECT. 2024 Dec 1;40(4):229-231. doi: 10.1097/YCT.0000000000001018. Epub 2024 Jul 5. No abstract available.

    PubMed 38968425

Questions about this trial

What is this clinical trial studying?

A study testing Frontoparietal Ultrabrief Right Unilateral (UBRUL-FP) electroconvulsive therapy and Temporoparietal Ultrabrief Right Unilateral (UBRUL-TP) electroconvulsive therapy in people with Major Depressive Episode, run by The George Institute at 7 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 13 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 7 sites in Australia, United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Depressive Symptoms as Assessed by Hamilton Rating Scale for Depression-17 (time frame: From baseline to end of randomized acute treatment (typically 4 weeks)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05402657, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Mar 2026.

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