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Intranasal Ketamine in Treatment-Resistant Depression

This study has been completed.
Information provided by (Responsible Party):
James Murrough, Icahn School of Medicine at Mount Sinai Identifier:
First received: February 23, 2011
Last updated: December 16, 2016
Last verified: December 2016
The objective of the current study is to investigate the safety and efficacy of a single dose of intranasal (IN) ketamine in treatment-resistant depression (TRD).

Condition Intervention
Major Depressive Disorder Drug: Ketamine Drug: placebo

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Intranasal (IN) Ketamine in Treatment-Resistant Depression (TRD)

Resource links provided by NLM:

Further study details as provided by James Murrough, Icahn School of Medicine at Mount Sinai:

Primary Outcome Measures:
  • Montgomery-Asberg Depression Rating Scale (MADRS) [ Time Frame: 24 hours ]

    Number of patients meeting response criteria of >=50% decrease in MADRS score from baseline , ie, difference in depressive symptoms using MADRS instrument, 24 hours following drug administration

    10-item instrument used for the evaluation of depressive symptoms in adults and for the assessment of any changes to those symptoms. Each of the 10 items is rated on a scale of 0 to 6, with differing descriptors for each item. These individual item scores are added together to form a total score, which can range between 0 and 60 points.

Secondary Outcome Measures:
  • Systematic Assessment for Treatment Emergent Effects (SAFTEE) [ Time Frame: 2 weeks ]
    This is a self-report measure for systematically assessing 48 possible adverse events. It documents their severity, relationship to study drug, and the action taken.

Enrollment: 20
Study Start Date: October 2011
Study Completion Date: October 2014
Primary Completion Date: October 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Ketamine
Subjects randomized to this arm will receive the active study medication, intranasal ketamine.
Drug: Ketamine
A single dose of intranasal ketamine up to 50 mg
Placebo Comparator: Placebo
Subjects randomized to this arm will receive intranasal saline.
Drug: placebo
Single dose of saline intranasal


Ages Eligible for Study:   21 Years to 65 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Male or female patients, 21-65 years;
  2. Women of childbearing potential must agree to use a medically accepted means of contraception for the duration of the study;
  3. Primary diagnosis of major depressive disorder as assessed by the SCID-P;
  4. Current depressive episode;
  5. History of a failure to respond to at least one (1) adequate pharmacotherapy trials in the current major depressive episode;
  6. Subjects must have scored ≥ 30 on the IDS-C30 at Screening ≥ 24 at Treatment Day #1 and #2;
  7. Each subject must have a level of understanding sufficient to agree to all tests and examinations required by the protocol and must sign an informed consent document;
  8. Subjects must be able to identify a family member, physician, or friend who will participate in the Treatment Contract and serve as an emergency contact.

Exclusion Criteria:

  1. Women who plan to become pregnant, are pregnant or are breast-feeding;
  2. Any unstable medical illness including hepatic, renal, gastroenterologic, respiratory, cardiovascular, endocrinologic, neurologic, immunologic, or hematologic disease;
  3. Clinically significant abnormal findings of laboratory parameters, physical examination, or ECG;
  4. Lifetime history of schizophrenia, schizoaffective disorder, bipolar disorder, OCD, mental retardation, pervasive developmental disorders, or Tourette's syndrome;
  5. Drug or alcohol abuse or dependence within the preceding 6 months;
  6. Lifetime abuse or dependence on ketamine or phencyclidine;
  7. Patients judged by study investigator to be at high risk for suicide.
  8. Previous participation in a ketamine study at Mount Sinai
  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 identifier: NCT01304147

United States, New York
Icahn School of Medicine at Mount Sinai
New York City, New York, United States, 10029
Sponsors and Collaborators
James Murrough
Principal Investigator: James W Murrough, MD Icahn School of Medicine at Mount Sinai
  More Information

Additional Information:
Responsible Party: James Murrough, Principal Investigator, Icahn School of Medicine at Mount Sinai Identifier: NCT01304147     History of Changes
Other Study ID Numbers: GCO 11-0492
Study First Received: February 23, 2011
Results First Received: April 18, 2016
Last Updated: December 16, 2016

Keywords provided by James Murrough, Icahn School of Medicine at Mount Sinai:
treatment resistance
intranasal, antidepressant
NMDA receptor

Additional relevant MeSH terms:
Depressive Disorder
Depressive Disorder, Major
Depressive Disorder, Treatment-Resistant
Behavioral Symptoms
Mood Disorders
Mental Disorders
Sensory System Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Anesthetics, Dissociative
Anesthetics, Intravenous
Anesthetics, General
Central Nervous System Depressants
Excitatory Amino Acid Antagonists
Excitatory Amino Acid Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action processed this record on September 21, 2017