Double-Blind, Placebo-Controlled Trial of Ketamine Therapy in Treatment-Resistant Depression (TRD)

This study is not yet open for participant recruitment. (see Contacts and Locations)
Verified May 2014 by Massachusetts General Hospital
Sponsor:
Collaborators:
Baylor College of Medicine
Mount Sinai School of Medicine
Stanford University
University of Texas
Yale University
Information provided by (Responsible Party):
Maurizio Fava, MD, Massachusetts General Hospital
ClinicalTrials.gov Identifier:
NCT01920555
First received: August 8, 2013
Last updated: May 29, 2014
Last verified: May 2014
  Purpose

This study is looking at the efficacy, durability, safety, and tolerability of multiple single doses of Ketamine for treating patients with treatment resistant depression who are taking an antidepressant that is not working for them.


Condition Intervention Phase
Treatment Resistant Depression
Drug: Ketamine
Drug: Placebo Midazolam
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Double-Blind, Placebo-Controlled Trial of Ketamine Therapy in Treatment-Resistant Depression (TRD)

Resource links provided by NLM:


Further study details as provided by Massachusetts General Hospital:

Primary Outcome Measures:
  • Hamilton Rating Scale for Depression - 6 items [ Time Frame: Past 48 hours ] [ Designated as safety issue: No ]
    This instrument is completed with a structured interview guide by the clinician based on his/her assessment of the patient's symptoms. This structured interview has been validated for use with time frames shorter than one week. The time frame for this scale is the past 48 hours.


Estimated Enrollment: 100
Study Start Date: July 2014
Estimated Study Completion Date: February 2015
Estimated Primary Completion Date: January 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Ketamine 0.1mg
Patients in this arm will receive 0.1 mg/kg of Ketamine per day for 3 days
Drug: Ketamine
Dose of Ketamine will be 0.1 mg/kg per day for 3 days
Active Comparator: Ketamine 0.2mg
Patients in this arm will receive 0.2 mg/kg of Ketamine per day for 3 days
Drug: Ketamine
Dose of Ketamine will be 0.2 mg/kg per day for 3 days
Active Comparator: Ketamine 0.5mg
Patients in this arm will receive 0.5 mg/kg of Ketamine per day for 3 days
Drug: Ketamine
Dose of Ketamine will be 0.5 mg/kg per day for 3 days
Active Comparator: Ketamine 1.0mg
Patients in this arm will receive 1.0 mg/kg of Ketamine per day for 3 days
Drug: Ketamine
Dose of Ketamine will be 1.0 mg/kg per day for 3 days
Placebo Comparator: Midazolam (Active Placebo)
Patients in this arm will receive 0.045 mg/kg of midazolam per day for 3 days
Drug: Placebo Midazolam
Dose of Midazolam (active placebo) will be 0.045 mg/kg per day for 3 days

  Eligibility

Ages Eligible for Study:   18 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Male or female, 18-65 years old.
  • Able to read, understand, and provide written, dated informed consent prior to screening.
  • Diagnosed with Major Depressive Disorder (MDD), single or recurrent, and currently experiencing a Major Depressive Episode (MDE) of at least eight weeks in duration, prior to screening.
  • Has a history of TRD during the current MDE.
  • Meet the threshold on the total MADRS score of greater than or equal to 20 at both screening and baseline visits (Day -5/-14 and Day 0), as confirmed by the remote centralized MGH CTNI rater between the screen visit and the baseline visit.
  • In good general health
  • For female participants, status of non-childbearing potential or use of an acceptable form of birth control
  • Body mass index between 18-35 kg/m2
  • Concurrent psychotherapy will be allowed if the type and frequency of the therapy has been stable for at least three months prior to screening and is expected to remain stable during participation in the study
  • Concurrent hypnotic therapy will be allowed if the therapy has been stable for at least 4 weeks prior to screening and if it is expected to remain stable during the course of the subject's participation in the study.

Exclusion Criteria:

  • Female of childbearing potential who is not willing to use one of the specified forms of birth control during the study
  • Female that is pregnant or breastfeeding
  • Female with a positive pregnancy test at screening or baseline
  • History during the current MDE of failure to achieve a satisfactory response to >7 treatment courses of a therapeutic dose of an antidepressant therapy of at least 8 weeks duration during the current episode
  • Total MADRS score of <20 at the screen or baseline visits, or as assessed by the remote, independent MGH CTNI rater and reported to the site
  • Current diagnosis of a Substance Use Disorder (Abuse or Dependence) with the exception of nicotine dependence, at screening or within 6 months prior to screening
  • Current diagnosis of Axis I disorders other than dysthymic disorder, generalized anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, or specific phobia (unless one of these is comorbid and clinically unstable, and/or the focus of the participant's treatment for the past 6 months or more)
  • History of bipolar disorder, schizophrenia or schizoaffective disorders, or any history of psychotic symptoms in the current or previous depressive episodes
  • History of eating disorders within five years of screening
  • Any Axis I or Axis II Disorder, which at screening is clinically predominant to their MDD or has been predominant at any time within 6 months prior to screening
  • Subject is considered at significant risk for suicidal behavior during the course of their participation in the study
  • Has failed to respond to electroconvulsive therapy during the current depressive episode
  • Has received vagus nerve stimulation (VNS) at any time prior to screening
  • Dementia, delirium, amnestic, or any other cognitive disorder
  • Has a clinically significant abnormality on the screening physical examination
  • Participation in any clinical trial with an investigational drug or device within the past month or concurrent to study participation
  • Known history or current episode of: hypertension, Recent myocardial infarction (within one year) or a history of myocardial infarction, Syncopal event within the past year, Congestive heart failure, Angina pectoris, heart rate <50 or >105 beats per minute at screening or randomization, or QTcF greater than or equal to 450 msec at screening or randomization.
  • Chronic lung disease
  • Lifetime history of surgical procedures involving the brain or meninges, encephalitis, meningitis, degenerative central nervous system disorder, epilepsy, mental retardation, or any other disease/procedure/accident/intervention associated with significant injury to or malfunction of the central nervous system, or a history of significant head trauma within the past 2 years
  • Presents with a history of Thyroid stimulating hormone outside of the normal limits and clinically significant as determined by the investigator
  • Patients with diabetes mellitus fulfilling any of the following criteria:

    1. Unstable diabetes mellitus defined as glycosylated hemoglobin (HbA1c) >8.5% at screening
    2. Admitted to hospital for treatment of diabetes mellitus or diabetes mellitus related illness in the past 12 weeks
    3. Not under physician care for diabetes mellitus
    4. Has not been on the same dose of oral hypoglycaemic drug(s) and/or diet for the 4 weeks prior to screening. For thiazolidinediones (glitazones) this period should not be less than 8 weeks.
    5. Any other clinically significant abnormal laboratory result (as determined after evaluation by study investigator and MGH CTNI medical monitor) at the time of the screening exam.
  • History of hypothyroidism and has been on a stable dosage of thyroid replacement medication for less than 6 months prior to screening. (Subjects on a stable dosage of thyroid replacement medication for at least 6 months or more prior to screening are eligible for enrollment.)
  • History of hyperthyroidism which was treated (medically or surgically) less than six months prior to screening
  • Any current or past history of any physical condition which in the investigator's opinion might put the subject at risk or interfere with study results interpretation
  • History of positive screening urine test for drugs of abuse
  • Patients with exclusionary laboratory values, or requiring treatment with exclusionary concomitant medications
  • Patients who have participated in studies of ketamine or AZD6765 for depression
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01920555

Locations
United States, California
Stanford University Not yet recruiting
Palo Alto, California, United States, 94304
Principal Investigator: Charles DeBattista, MD         
United States, Connecticut
Yale University Not yet recruiting
New Haven, Connecticut, United States, 06520
Principal Investigator: Gerard Sanacora, MD, PhD         
United States, Massachusetts
Massachusetts General Hospital Not yet recruiting
Boston, Massachusetts, United States, 02114
Principal Investigator: Cristina Cusin, MD         
United States, New York
Mount Sinai School of Medicine Not yet recruiting
New York, New York, United States, 10029
Principal Investigator: Dan V Iosifescu, MD         
United States, Texas
University of Texas Southwestern Not yet recruiting
Dallas, Texas, United States, 75390
Baylor College of Medicine Not yet recruiting
Houston, Texas, United States, 77030
Principal Investigator: Sanjay J Mathew, MD         
Sponsors and Collaborators
Massachusetts General Hospital
Baylor College of Medicine
Mount Sinai School of Medicine
Stanford University
University of Texas
Yale University
  More Information

No publications provided

Responsible Party: Maurizio Fava, MD, Overall Principal Investigator, Massachusetts General Hospital
ClinicalTrials.gov Identifier: NCT01920555     History of Changes
Other Study ID Numbers: RAP-002
Study First Received: August 8, 2013
Last Updated: May 29, 2014
Health Authority: United States: Food and Drug Administration

Keywords provided by Massachusetts General Hospital:
Depression
Treatment Resistant Depression
Ketamine

Additional relevant MeSH terms:
Depression
Depressive Disorder
Depressive Disorder, Treatment-Resistant
Behavioral Symptoms
Mood Disorders
Mental Disorders
Ketamine
Midazolam
Analgesics
Sensory System Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Pharmacologic Actions
Central Nervous System Agents
Therapeutic Uses
Anesthetics, Dissociative
Anesthetics, Intravenous
Anesthetics, General
Anesthetics
Central Nervous System Depressants
Excitatory Amino Acid Antagonists
Excitatory Amino Acid Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Adjuvants, Anesthesia
Hypnotics and Sedatives
Anti-Anxiety Agents
Tranquilizing Agents
Psychotropic Drugs
GABA Modulators

ClinicalTrials.gov processed this record on October 01, 2014