Trial Outcomes & Findings for Ketamine For Suicidal Ideation (NCT NCT01507181)

NCT ID: NCT01507181

Last Updated: 2017-02-08

Results Overview

Change in BSI score at 24 hours following treatment as compared to baseline. Beck Scale is a 21-item self or clinician administered instrumentation used to measure the current intensity of patients' specific attitudes, behaviors and plans to commit suicide. Score range 0-42, with higher score indicating higher intensity.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

24 participants

Primary outcome timeframe

baseline and 24 hours post infusion

Results posted on

2017-02-08

Participant Flow

Participants were recruited through the inpatient psychiatric service or through an academic outpatient psychiatric clinic. All study treatments were performed at Mount Sinai Hospital between April 2012 and June 2014.

Participant milestones

Participant milestones
Measure
Ketamine
single dose IV ketamine, .5mg/kg Ketamine: single dose IV ketamine, .5mg/kg infused over 40 minutes
Midazolam
single dose IV midazolam, .45mg/kg Midazolam: single dose IV midazolam, .45mg/kg infused over 40 minutes
Overall Study
STARTED
12
12
Overall Study
COMPLETED
12
12
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Ketamine For Suicidal Ideation

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Ketamine
n=12 Participants
single dose IV ketamine, .5mg/kg
Midazolam
n=12 Participants
single dose IV midazolam, .45mg/kg
Total
n=24 Participants
Total of all reporting groups
Age, Continuous
45.8 years
STANDARD_DEVIATION 15.2 • n=5 Participants
39.1 years
STANDARD_DEVIATION 10.6 • n=7 Participants
42.4 years
STANDARD_DEVIATION 13.3 • n=5 Participants
Gender
Female
8 Participants
n=5 Participants
8 Participants
n=7 Participants
16 Participants
n=5 Participants
Gender
Male
4 Participants
n=5 Participants
4 Participants
n=7 Participants
8 Participants
n=5 Participants
History of suicide attempt
yes
6 participants
n=5 Participants
9 participants
n=7 Participants
15 participants
n=5 Participants
History of suicide attempt
no
6 participants
n=5 Participants
3 participants
n=7 Participants
9 participants
n=5 Participants
BSI score, baseline
17.5 units on a scale
STANDARD_DEVIATION 7.2 • n=5 Participants
17.9 units on a scale
STANDARD_DEVIATION 11.9 • n=7 Participants
17.7 units on a scale
STANDARD_DEVIATION 9.7 • n=5 Participants
MADRS score, baseline
35.2 units on a scale
STANDARD_DEVIATION 6.1 • n=5 Participants
34.3 units on a scale
STANDARD_DEVIATION 4.1 • n=7 Participants
34.8 units on a scale
STANDARD_DEVIATION 5.1 • n=5 Participants
Primary Diagnosis
MDD
6 participants
n=5 Participants
7 participants
n=7 Participants
13 participants
n=5 Participants
Primary Diagnosis
Bipolar disorder
4 participants
n=5 Participants
3 participants
n=7 Participants
7 participants
n=5 Participants
Primary Diagnosis
PTSD
1 participants
n=5 Participants
2 participants
n=7 Participants
3 participants
n=5 Participants
Primary Diagnosis
BPD
1 participants
n=5 Participants
0 participants
n=7 Participants
1 participants
n=5 Participants
Co-occurring disorders
MDD
2 participants
n=5 Participants
2 participants
n=7 Participants
4 participants
n=5 Participants
Co-occurring disorders
PTSD
2 participants
n=5 Participants
1 participants
n=7 Participants
3 participants
n=5 Participants
Co-occurring disorders
BPD
1 participants
n=5 Participants
0 participants
n=7 Participants
1 participants
n=5 Participants
Co-occurring disorders
Panic disorder
3 participants
n=5 Participants
1 participants
n=7 Participants
4 participants
n=5 Participants
Co-occurring disorders
SAD
2 participants
n=5 Participants
4 participants
n=7 Participants
6 participants
n=5 Participants
Co-occurring disorders
OCD
3 participants
n=5 Participants
3 participants
n=7 Participants
6 participants
n=5 Participants
Co-occurring disorders
GAD
5 participants
n=5 Participants
1 participants
n=7 Participants
6 participants
n=5 Participants

PRIMARY outcome

Timeframe: baseline and 24 hours post infusion

Change in BSI score at 24 hours following treatment as compared to baseline. Beck Scale is a 21-item self or clinician administered instrumentation used to measure the current intensity of patients' specific attitudes, behaviors and plans to commit suicide. Score range 0-42, with higher score indicating higher intensity.

Outcome measures

Outcome measures
Measure
Ketamine
n=12 Participants
single dose IV ketamine, .5mg/kg
Midazolam
n=12 Participants
single dose IV midazolam, .045mg/kg
Change in Beck Scale for Suicidal Ideation (BSSI)
10.8 units on a scale
Standard Deviation 8.5
14.0 units on a scale
Standard Deviation 10.2

PRIMARY outcome

Timeframe: baseline and 48 hours post infusion

Change in BSI score at 48 hours following treatment as compared to baseline. Beck Scale is a 21-item self or clinician administered instrumentation used to measure the current intensity of patients' specific attitudes, behaviors and plans to commit suicide. Score range 0-42, with higher score indicating higher intensity.

Outcome measures

Outcome measures
Measure
Ketamine
n=12 Participants
single dose IV ketamine, .5mg/kg
Midazolam
n=12 Participants
single dose IV midazolam, .045mg/kg
Change in Beck Scale for Suicidal Ideation (BSSI)
8.8 units on a scale
Standard Deviation 8.3
15.3 units on a scale
Standard Deviation 10.9

SECONDARY outcome

Timeframe: up to 7 days post infusion

The MADRS is a 10-item instrument used for the evaluation of depressive symptoms in adults and for the assessment of any changes to those symptoms. Higher MADRS score indicates more severe depression, and each item yields a score of 0 to 6. The overall score ranges from 0 to 60.

Outcome measures

Outcome measures
Measure
Ketamine
n=12 Participants
single dose IV ketamine, .5mg/kg
Midazolam
n=12 Participants
single dose IV midazolam, .045mg/kg
Montgomery-Asberg Depression Rating Scale (MADRS)
24 hours
19.0 units on a scale
Standard Deviation 15.5
26.2 units on a scale
Standard Deviation 10.8
Montgomery-Asberg Depression Rating Scale (MADRS)
48 hours
19.3 units on a scale
Standard Deviation 13.5
28 units on a scale
Standard Deviation 12.3
Montgomery-Asberg Depression Rating Scale (MADRS)
72 hours
20.9 units on a scale
Standard Deviation 14.5
24.1 units on a scale
Standard Deviation 12.2
Montgomery-Asberg Depression Rating Scale (MADRS)
7 days
21.7 units on a scale
Standard Deviation 13.1
22.2 units on a scale
Standard Deviation 13.1

SECONDARY outcome

Timeframe: 24 hours post infusion

The MADRS-SI ranges from 0 to 6; a score of 2 corresponds to fleeting, passive SI; a score of 4 indicates that SI is frequent with at least moderate intensity but without specific plans or intention; a score of 6 corresponds to active intention and planning for suicide.

Outcome measures

Outcome measures
Measure
Ketamine
n=12 Participants
single dose IV ketamine, .5mg/kg
Midazolam
n=12 Participants
single dose IV midazolam, .045mg/kg
Suicidality Item of the MADRS (MADRS-SI)
1.8 units on a scale
Standard Deviation 1.9
3.3 units on a scale
Standard Deviation 1.6

SECONDARY outcome

Timeframe: baseline, 40 minutes post infusion, 240 minutes post infusion

An 11-item questionnaire, used to assess manic symptoms based on the patient's subjective report of his or her clinical condition. There are four items that are graded on a 0 to 8 scale (irritability, speech, thought content, and disruptive/aggressive behavior), while the remaining seven items are graded on a 0 to 4 scale. The scores from each question are added together to form a total score ranging from 0 to 60, with higher scores indicating a greater severity of symptoms.

Outcome measures

Outcome measures
Measure
Ketamine
n=12 Participants
single dose IV ketamine, .5mg/kg
Midazolam
n=12 Participants
single dose IV midazolam, .045mg/kg
The Young Mania Rating Scale (YMRS)
baseline
0.0 units on a scale
Standard Deviation 0.0
0.1 units on a scale
Standard Deviation 0.3
The Young Mania Rating Scale (YMRS)
40 minutes post infusion
0.0 units on a scale
Standard Deviation 0.0
0.3 units on a scale
Standard Deviation 0.6
The Young Mania Rating Scale (YMRS)
240 minutes post infusion
0.2 units on a scale
Standard Deviation 0.6
0.2 units on a scale
Standard Deviation 0.6

SECONDARY outcome

Timeframe: baseline, 40 minutes post infusion, and 240 minutes post infusion

The BPRS measures psychomimetic effects with higher scores indicating more severe symptoms (scale range 7 - 49).

Outcome measures

Outcome measures
Measure
Ketamine
n=12 Participants
single dose IV ketamine, .5mg/kg
Midazolam
n=12 Participants
single dose IV midazolam, .045mg/kg
The Brief Psychiatric Rating Scale (BPRS)
baseline
7.7 units on a scale
Standard Deviation 1.12
7.7 units on a scale
Standard Deviation 1.3
The Brief Psychiatric Rating Scale (BPRS)
40 minutes post infusion
9.9 units on a scale
Standard Deviation 3.3
7.9 units on a scale
Standard Deviation 1.8
The Brief Psychiatric Rating Scale (BPRS)
240 minutes post infusion
8.1 units on a scale
Standard Deviation 1.6
7.0 units on a scale
Standard Deviation 0.1

SECONDARY outcome

Timeframe: baseline, 40 minutes post infusion and 240 minutes post infusion

The CADSS measures dissociation with higher scores indicating more severe symptoms (scale range 0 - 92).

Outcome measures

Outcome measures
Measure
Ketamine
n=12 Participants
single dose IV ketamine, .5mg/kg
Midazolam
n=12 Participants
single dose IV midazolam, .045mg/kg
The Clinician-Administered Dissociative States Scale (CADSS)
40 minutes post infusion
17.1 units on a scale
Standard Deviation 19.9
3.3 units on a scale
Standard Deviation 3.1
The Clinician-Administered Dissociative States Scale (CADSS)
240 minutes post infusion
1.2 units on a scale
Standard Deviation 1.9
1.3 units on a scale
Standard Deviation 2.6
The Clinician-Administered Dissociative States Scale (CADSS)
baseline
1.1 units on a scale
Standard Deviation 2.6
4.0 units on a scale
Standard Deviation 7.0

SECONDARY outcome

Timeframe: duration of study

The PRISE assesses the presence of treatment side effects in nine organ/function systems (gastrointestinal, nervous system, heart, eyes/ears, skin, genital/urinary, sleep, sexual functioning, and other). Data reported in in Adverse Events section.

Outcome measures

Outcome measures
Measure
Ketamine
n=12 Participants
single dose IV ketamine, .5mg/kg
Midazolam
n=12 Participants
single dose IV midazolam, .045mg/kg
Patient Rated Inventory of Side Effects (PRISE)
29 events
23 events

Adverse Events

Ketamine

Serious events: 5 serious events
Other events: 12 other events
Deaths: 0 deaths

Midazolam

Serious events: 0 serious events
Other events: 12 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Ketamine
n=12 participants at risk
single dose IV ketamine, .5mg/kg
Midazolam
n=12 participants at risk
single dose IV midazolam, .45mg/kg
Psychiatric disorders
Hospitalizations
33.3%
4/12
0.00%
0/12
Respiratory, thoracic and mediastinal disorders
Death
8.3%
1/12
0.00%
0/12

Other adverse events

Other adverse events
Measure
Ketamine
n=12 participants at risk
single dose IV ketamine, .5mg/kg
Midazolam
n=12 participants at risk
single dose IV midazolam, .45mg/kg
Nervous system disorders
Headache
58.3%
7/12 • Number of events 7
25.0%
3/12 • Number of events 3
Nervous system disorders
Dizziness on standing
16.7%
2/12 • Number of events 2
25.0%
3/12 • Number of events 3
General disorders
Nausea/Vomiting
8.3%
1/12 • Number of events 1
25.0%
3/12 • Number of events 3
General disorders
Diarrhea
0.00%
0/12
25.0%
3/12 • Number of events 3
Psychiatric disorders
Anxiety
16.7%
2/12 • Number of events 2
16.7%
2/12 • Number of events 2
General disorders
Poor concentration
16.7%
2/12 • Number of events 2
8.3%
1/12 • Number of events 1
Nervous system disorders
Poor coordination
16.7%
2/12 • Number of events 2
0.00%
0/12
General disorders
General malaise
16.7%
2/12 • Number of events 2
0.00%
0/12
General disorders
Restlessness
16.7%
2/12 • Number of events 2
0.00%
0/12
General disorders
Dry mouth
0.00%
0/12
16.7%
2/12 • Number of events 2
Cardiac disorders
Chest pain
0.00%
0/12
16.7%
2/12 • Number of events 2
Eye disorders
Blurred vision
8.3%
1/12 • Number of events 1
8.3%
1/12 • Number of events 1
Renal and urinary disorders
Frequent urination
8.3%
1/12 • Number of events 1
8.3%
1/12 • Number of events 1
General disorders
Difficulty sleeping
8.3%
1/12 • Number of events 1
8.3%
1/12 • Number of events 1
Gastrointestinal disorders
Constipation
8.3%
1/12 • Number of events 1
8.3%
1/12 • Number of events 1

Additional Information

Dr. J. W. Murrough

Mood and Anxiety Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai

Phone: 212-241-7574

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place