Oral Aspirin + Ketamine as Adjunct to Oral Antidepressant Therapy for Depression

Inclusion Criteria: Adult patients with Treatment Resistant Depression with Montgomery-Asberg Depression Rating Scale score >22 upon presentation to the clinic Treatment Resistant Depression is defined as Major Depressive Disorder that does not cease after at least 6 week trial of another class of antidepressants Unipolar Depression Exclusion Criteria: Adult patients with recent or current suicidal ideation with an intent to act, homicidal ideations with an intent to act History of Bipolar Disorder, Obsessive Compulsive Disorder, antisocial personality disorder, borderline personality disorder, and congestive cardiac failure Uncontrolled hypertension (BP >140 mm Hg systolic and/or >90 mm Hg diastolic on two separate readings at the time of screening) or on 2 medications for hypertension Patients with unstable vital signs (systolic blood pressure <90 or>160 mm Hg, pulse rate <50 or >150 beats/min, and respiration rate <10 or >30 breaths/min), History of Gastrointestinal hemorrhage, renal and hepatic insufficiency Allergy to Ketamine or Aspirin Active Substance Abuse Disorder Active psychosis Active Peptic Ulcer Disease Lithium Therapy Swallowing difficulty Consumption of Aspirin or NSAID's within 6 hours of arrival to the site Previous participation in this study; a patient may not re-enroll in another study while in this study Pregnant or breastfeeding