Ketamine Frequency Treatment for Major Depressive Disorder

NCT ID: NCT00646087

Last Updated: 2011-06-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

PHASE4

Study Classification

INTERVENTIONAL

Study Start Date

2008-03-31

Brief Summary

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Depression is a wide spread illness. Depression contributes most significantly to national health care costs. While the number and types of treatments used for depression have expanded over the years, even with an increased range of options, the response rate, defined as the number of subjects who have a 50% reduction in depressive symptoms, is estimated to be around 65%.

This randomized clinical trial will examine the frequency of treatment with ketamine in patients with treatment-resistant depression TRD without psychosis. It will compare two modes of the ketamine treatment; every other day ketamine, versus two active and four placebo treatments over the period of 12 days.

Detailed Description

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Conditions

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Treatment Resistant Depression

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Ketamine (6K)

6K: 6 ketamine injections (0.5 mg/kg of ketamine) every other day for 12 days

Group Type EXPERIMENTAL

Ketamine

Intervention Type DRUG

0.5 mg/kg of ketamine every other day for 12 days (days 1, 3, 5, 7, 9, 11)

Ketamine/Placebo (2K4P)

2K4P = two active ketamine injections(2K) and four placebo (saline) injections over 12 days.

Group Type ACTIVE_COMPARATOR

Ketamine/Saline

Intervention Type DRUG

0.5 mg/kg of ketamine on days 1 and 7, placebo (saline) on days 3, 5, 9, 11

Interventions

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Ketamine

0.5 mg/kg of ketamine every other day for 12 days (days 1, 3, 5, 7, 9, 11)

Intervention Type DRUG

Ketamine/Saline

0.5 mg/kg of ketamine on days 1 and 7, placebo (saline) on days 3, 5, 9, 11

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age 30 to 65
* Major depressive disorder without psychotic features confirmed by a structured clinical diagnostic interview, SCID.
* Treatment resistant depression defined using the Antidepressant Treatment History Form (ATHF)
* HDRS 21 score \> 18
* Female participants of childbearing potential must be using a medically accepted means of contraception (birth control pills, spermicidal barrier)
* Ability to concur with medication standardization regiment (section as an outpatient
* Physically healthy (no chronic diseases; normal CBC, BMP, AST, ALT, and UA)
* Competent to give informed consent to all required tests and examinations and sign a consent document

Exclusion Criteria

* Bipolar disorder
* Psychosis or any other psychotic disorder as defined by DSM-IV criteria
* Serious or imminent threat for suicide
* Pregnant or nursing female
* Presence of serious unstable medical illnesses including hepatic, renal, gastrointestinal, respiratory, cardiovascular, endocrinologic, neurologic, immunologic, or hematologic disease, or abnormal laboratory tests (CBC, BMP, AST, ALT, and UA)
* Uncontrolled hypertension
* History of CVA
* Treatment with St. Johns wort, tramadol, phentolamine, naloxone, or anticholinergic medications
* Alcohol or illicit drug abuse for 6 months (evidence from UDS)
* Currently involved in a clinical trial or used an experimental medication within the last 30 days
* Hypersensitivity to ketamine products
Minimum Eligible Age

30 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Essentia Health

OTHER

Sponsor Role lead

Responsible Party

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St. Mary's Duluth Clinic Health System

Principal Investigators

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Micheal Messer, MD

Role: PRINCIPAL_INVESTIGATOR

Essentia Health

Locations

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St. Mary's Duluth Clinic Health System

Duluth, Minnesota, United States

Site Status

Countries

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United States

References

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Pincus HA, Pettit AR. The societal costs of chronic major depression. J Clin Psychiatry. 2001;62 Suppl 6:5-9.

Reference Type BACKGROUND
PMID: 11310818 (View on PubMed)

Holtzheimer PE 3rd, Nemeroff CB. Advances in the treatment of depression. NeuroRx. 2006 Jan;3(1):42-56. doi: 10.1016/j.nurx.2005.12.007.

Reference Type BACKGROUND
PMID: 16490412 (View on PubMed)

Nierenberg AA, Amsterdam JD. Treatment-resistant depression: definition and treatment approaches. J Clin Psychiatry. 1990 Jun;51 Suppl:39-47; discussion 48-50.

Reference Type BACKGROUND
PMID: 2112132 (View on PubMed)

Burrows GD, Norman TR, Judd FK. Definition and differential diagnosis of treatment-resistant depression. Int Clin Psychopharmacol. 1994 Jun;9 Suppl 2:5-10. doi: 10.1097/00004850-199406002-00002.

Reference Type BACKGROUND
PMID: 7930496 (View on PubMed)

Crown WH, Finkelstein S, Berndt ER, Ling D, Poret AW, Rush AJ, Russell JM. The impact of treatment-resistant depression on health care utilization and costs. J Clin Psychiatry. 2002 Nov;63(11):963-71. doi: 10.4088/jcp.v63n1102.

Reference Type BACKGROUND
PMID: 12444808 (View on PubMed)

Berman RM, Cappiello A, Anand A, Oren DA, Heninger GR, Charney DS, Krystal JH. Antidepressant effects of ketamine in depressed patients. Biol Psychiatry. 2000 Feb 15;47(4):351-4. doi: 10.1016/s0006-3223(99)00230-9.

Reference Type BACKGROUND
PMID: 10686270 (View on PubMed)

Correll GE, Futter GE. Two case studies of patients with major depressive disorder given low-dose (subanesthetic) ketamine infusions. Pain Med. 2006 Jan-Feb;7(1):92-5. doi: 10.1111/j.1526-4637.2006.00101.x. No abstract available.

Reference Type BACKGROUND
PMID: 16533209 (View on PubMed)

Kudoh A, Takahira Y, Katagai H, Takazawa T. Small-dose ketamine improves the postoperative state of depressed patients. Anesth Analg. 2002 Jul;95(1):114-8, table of contents. doi: 10.1097/00000539-200207000-00020.

Reference Type BACKGROUND
PMID: 12088953 (View on PubMed)

Zarate CA Jr, Singh JB, Carlson PJ, Brutsche NE, Ameli R, Luckenbaugh DA, Charney DS, Manji HK. A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression. Arch Gen Psychiatry. 2006 Aug;63(8):856-64. doi: 10.1001/archpsyc.63.8.856.

Reference Type BACKGROUND
PMID: 16894061 (View on PubMed)

Hirota K, Lambert DG. Ketamine: its mechanism(s) of action and unusual clinical uses. Br J Anaesth. 1996 Oct;77(4):441-4. doi: 10.1093/bja/77.4.441. No abstract available.

Reference Type BACKGROUND
PMID: 8942324 (View on PubMed)

Paul IA, Skolnick P. Glutamate and depression: clinical and preclinical studies. Ann N Y Acad Sci. 2003 Nov;1003:250-72. doi: 10.1196/annals.1300.016.

Reference Type BACKGROUND
PMID: 14684451 (View on PubMed)

Annetta MG, Iemma D, Garisto C, Tafani C, Proietti R. Ketamine: new indications for an old drug. Curr Drug Targets. 2005 Nov;6(7):789-94. doi: 10.2174/138945005774574533.

Reference Type BACKGROUND
PMID: 16305457 (View on PubMed)

Stewart CE. Ketamine as a street drug. Emerg Med Serv. 2001 Nov;30(11):30, 32, 34 passim.

Reference Type BACKGROUND
PMID: 11759641 (View on PubMed)

Correll GE, Maleki J, Gracely EJ, Muir JJ, Harbut RE. Subanesthetic ketamine infusion therapy: a retrospective analysis of a novel therapeutic approach to complex regional pain syndrome. Pain Med. 2004 Sep;5(3):263-75. doi: 10.1111/j.1526-4637.2004.04043.x.

Reference Type BACKGROUND
PMID: 15367304 (View on PubMed)

Leonard B. Clinical implications of mechaniszms of action of antidepresants. Advan Psychiatr Treat. 2000;6:178-186.

Reference Type BACKGROUND

Beck AT, Beamesderfer A. Assessment of depression: the depression inventory. Mod Probl Pharmacopsychiatry. 1974;7(0):151-69. doi: 10.1159/000395074. No abstract available.

Reference Type BACKGROUND
PMID: 4412100 (View on PubMed)

Beck AT, Steer RA, Garbin MG. Psycometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clin Psychol Rev. 1988;8:77-100.

Reference Type BACKGROUND

Overall J, Gorham D. The brief psychiatric rating scale. Psycol Rep. 1962;10:799-812.

Reference Type BACKGROUND

Bremner JD, Krystal JH, Putnam FW, Southwick SM, Marmar C, Charney DS, Mazure CM. Measurement of dissociative states with the Clinician-Administered Dissociative States Scale (CADSS). J Trauma Stress. 1998 Jan;11(1):125-36. doi: 10.1023/A:1024465317902.

Reference Type BACKGROUND
PMID: 9479681 (View on PubMed)

HAMILTON M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960 Feb;23(1):56-62. doi: 10.1136/jnnp.23.1.56. No abstract available.

Reference Type BACKGROUND
PMID: 14399272 (View on PubMed)

First MB, Spitzer RL, Miriam G, Williams JBW. Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition. (SCID-I/P). New York: Biometrics Research, New York State Psychiatric Institute; 2002

Reference Type BACKGROUND

Other Identifiers

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04-07-04

Identifier Type: -

Identifier Source: org_study_id

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