Clinical Trial of the Use of Ketamine in Treatment Resistant Depression

NCT ID: NCT02610712

Last Updated: 2016-09-21

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-05-31

Brief Summary

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The purpose of this study is to determine the efficacy of the use of intravenous low-dose ketamine in the treatment of treatment-resistant depression (TRD), as well as the changes in Glutamate neurotransmission and inflammatory serum markers.

Detailed Description

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The purpose of this study is to determine the efficacy of the use of intravenous low-dose ketamine (0.5 mg/kg) in the treatment of treatment-resistant depression (TRD), as well as the changes in Glutamate neurotransmission measured by Magnetic Resonance Imaging Spectroscopy and inflammatory serum markers (IL-6, TNF-alpha).

Conditions

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Depressive Disorder, Treatment-Resistant

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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TRD patients

Treatment-Resistant (TRD) patients to receive intravenous ketamine at 0.5 mg/kg dose.

Group Type EXPERIMENTAL

Ketamine

Intervention Type DRUG

Interventions

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Ketamine

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Treatment-Resistant Depression (Failure to respond to two or more trials of antidepressant monotherapy or failure to respond to four or more trials of different antidepressant therapies)
* Acceptance of participation via the informed consent

Exclusion Criteria

* Psychiatric comorbidity (except anxiety related disorders)
* Substance abuse or dependence in the previous 3 months
* Evidence of structural abnormalities in brain imaging
* Pregnancy
* Previous hypersensitivity to ketamine
* Heart failure or insufficiency
* Familial or personal history of psychosis
* Glaucoma
* Major neurological disease
* Uncontrolled systemic arterial hypertension
* MRI contraindications
* Non-acceptance of participation via informed consent
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Neurology and Neurosurgery, Mexico

OTHER

Sponsor Role lead

Responsible Party

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Rodrigo Pérez Esparza

Fourth-year Psychiatry Resident

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Rodrigo Pérez-Esparza, MD

Role: PRINCIPAL_INVESTIGATOR

National Institute of Neurology and Neurosurgery, Mexico

Jesús Ramírez-Bermúdez, MD, MSc

Role: PRINCIPAL_INVESTIGATOR

National Institute of Neurology and Neurosurgery, Mexico

Locations

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National Institute of Neurology and Neurosurgery

Mexico City, Mexico City, Mexico

Site Status RECRUITING

Countries

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Mexico

Central Contacts

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Rodrigo Pérez-Esparza, MD

Role: CONTACT

56063822 ext. 1034

Jesús Ramírez-Bermúdez, MD, MSc

Role: CONTACT

56063822 ext. 1034

Facility Contacts

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Rodrigo Pérez-Esparza, MD

Role: primary

56063822 ext. 1034

Jesús Ramírez-Bermúdez, MD, MSc

Role: backup

56063822 ext. 1034

References

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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)

DiazGranados N, Ibrahim LA, Brutsche NE, Ameli R, Henter ID, Luckenbaugh DA, Machado-Vieira R, Zarate CA Jr. Rapid resolution of suicidal ideation after a single infusion of an N-methyl-D-aspartate antagonist in patients with treatment-resistant major depressive disorder. J Clin Psychiatry. 2010 Dec;71(12):1605-11. doi: 10.4088/JCP.09m05327blu. Epub 2010 Jul 13.

Reference Type BACKGROUND
PMID: 20673547 (View on PubMed)

Valentine GW, Mason GF, Gomez R, Fasula M, Watzl J, Pittman B, Krystal JH, Sanacora G. The antidepressant effect of ketamine is not associated with changes in occipital amino acid neurotransmitter content as measured by [(1)H]-MRS. Psychiatry Res. 2011 Feb 28;191(2):122-7. doi: 10.1016/j.pscychresns.2010.10.009. Epub 2011 Jan 12.

Reference Type BACKGROUND
PMID: 21232924 (View on PubMed)

Zarate CA Jr, Brutsche NE, Ibrahim L, Franco-Chaves J, Diazgranados N, Cravchik A, Selter J, Marquardt CA, Liberty V, Luckenbaugh DA. Replication of ketamine's antidepressant efficacy in bipolar depression: a randomized controlled add-on trial. Biol Psychiatry. 2012 Jun 1;71(11):939-46. doi: 10.1016/j.biopsych.2011.12.010. Epub 2012 Jan 31.

Reference Type BACKGROUND
PMID: 22297150 (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)

Diazgranados N, Ibrahim L, Brutsche NE, Newberg A, Kronstein P, Khalife S, Kammerer WA, Quezado Z, Luckenbaugh DA, Salvadore G, Machado-Vieira R, Manji HK, Zarate CA Jr. A randomized add-on trial of an N-methyl-D-aspartate antagonist in treatment-resistant bipolar depression. Arch Gen Psychiatry. 2010 Aug;67(8):793-802. doi: 10.1001/archgenpsychiatry.2010.90.

Reference Type BACKGROUND
PMID: 20679587 (View on PubMed)

Horn DI, Yu C, Steiner J, Buchmann J, Kaufmann J, Osoba A, Eckert U, Zierhut KC, Schiltz K, He H, Biswal B, Bogerts B, Walter M. Glutamatergic and resting-state functional connectivity correlates of severity in major depression - the role of pregenual anterior cingulate cortex and anterior insula. Front Syst Neurosci. 2010 Jul 15;4:33. doi: 10.3389/fnsys.2010.00033. eCollection 2010.

Reference Type BACKGROUND
PMID: 20700385 (View on PubMed)

Murrough JW, Iosifescu DV, Chang LC, Al Jurdi RK, Green CE, Perez AM, Iqbal S, Pillemer S, Foulkes A, Shah A, Charney DS, Mathew SJ. Antidepressant efficacy of ketamine in treatment-resistant major depression: a two-site randomized controlled trial. Am J Psychiatry. 2013 Oct;170(10):1134-42. doi: 10.1176/appi.ajp.2013.13030392.

Reference Type BACKGROUND
PMID: 23982301 (View on PubMed)

Musazzi L, Treccani G, Mallei A, Popoli M. The action of antidepressants on the glutamate system: regulation of glutamate release and glutamate receptors. Biol Psychiatry. 2013 Jun 15;73(12):1180-8. doi: 10.1016/j.biopsych.2012.11.009. Epub 2012 Dec 28.

Reference Type BACKGROUND
PMID: 23273725 (View on PubMed)

Luykx JJ, Laban KG, van den Heuvel MP, Boks MP, Mandl RC, Kahn RS, Bakker SC. Region and state specific glutamate downregulation in major depressive disorder: a meta-analysis of (1)H-MRS findings. Neurosci Biobehav Rev. 2012 Jan;36(1):198-205. doi: 10.1016/j.neubiorev.2011.05.014. Epub 2011 Jun 6.

Reference Type BACKGROUND
PMID: 21672551 (View on PubMed)

Stone JM, Dietrich C, Edden R, Mehta MA, De Simoni S, Reed LJ, Krystal JH, Nutt D, Barker GJ. Ketamine effects on brain GABA and glutamate levels with 1H-MRS: relationship to ketamine-induced psychopathology. Mol Psychiatry. 2012 Jul;17(7):664-5. doi: 10.1038/mp.2011.171. Epub 2012 Jan 3. No abstract available.

Reference Type BACKGROUND
PMID: 22212598 (View on PubMed)

Miller AH, Maletic V, Raison CL. Inflammation and its discontents: the role of cytokines in the pathophysiology of major depression. Biol Psychiatry. 2009 May 1;65(9):732-41. doi: 10.1016/j.biopsych.2008.11.029. Epub 2009 Jan 15.

Reference Type BACKGROUND
PMID: 19150053 (View on PubMed)

Dowlati Y, Herrmann N, Swardfager W, Liu H, Sham L, Reim EK, Lanctot KL. A meta-analysis of cytokines in major depression. Biol Psychiatry. 2010 Mar 1;67(5):446-57. doi: 10.1016/j.biopsych.2009.09.033. Epub 2009 Dec 16.

Reference Type BACKGROUND
PMID: 20015486 (View on PubMed)

Other Identifiers

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63/13

Identifier Type: -

Identifier Source: org_study_id

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