Use of Ketamine vs Methohexital for Electroconvulsive Therapy (ECT) on Patient Recovery and Re-orientation Time

Inclusion Criteria:

* All patients eligible for ECT with a primary mood disorder (bipolar disorder, major depressive disorder) will be eligible to participate in this study. - Patients must have decisional capacity and must be able to consent for this study.

Exclusion Criteria:

* patients with a primary psychotic disorder (schizophrenia, schizoaffective disorder); patients designated as having an American Society of Anesthesiologist (ASA) Status of greater than 3;
* patients with a known allergic reactions to methohexital , ketamine and succinylcholine;
* patients with current or previous history of aneurysms, intracranial bleeds, or intracranial hypertension;
* patients with uncontrolled severe hypertension.