Ketamine Interleaved With Electroconvulsive Therapy for Depression

NCT ID: NCT04082858

Last Updated: 2021-09-09

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

TERMINATED

Clinical Phase

PHASE1

Total Enrollment

3 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-06

Study Completion Date

2020-06-03

Brief Summary

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Pragmatic, randomised, controlled, parallel group, pilot clinical trial of ketamine vs. midazolam interleaved with electroconvulsive therapy (ECT) as an adjunctive treatment for a major depressive episode. The main purpose of the pilot study is to assess trial processes to help inform a future definitive trial.

Detailed Description

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Patients referred for treatment with ECT at St Patrick's Mental Health Services for treatment of a depressive episode will be eligible for recruitment to the clinical trial. Participants will be invited to be randomised to a course of twice-weekly ketamine or midazolam infusions for the duration of ECT. Participants will receive the first allocated infusion following the first or second treatment with ECT. Block randomisation will be independently performed. Infusions will be delivered on separate days to ECT. Physical, psychotomimetic and cognitive outcomes will be monitored before, during and after infusions.Treatment-as-usual will continue throughout the entire trial.

Trial Interventions: participants will receive twice-weekly infusions of either ketamine at 0.5mg/Kg or midazolam at 0.045mg/Kg. All infusions will be administered by a Consultant Anaesthetist. Repeated infusions of allocated drug have been shown to be safe and well tolerated by patients with mental illness. Minor haemodynamic changes and psychotomimetic side effects can occur and will be assessed regularly during infusions and for 120 minutes afterwards. Participants will be followed-up at six weeks and three months after the final infusion to assess for relapse according to standardised criteria.

Conditions

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Depression

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Pragmatic, randomised, controlled, parallel group, pilot clinical trial
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
Quadruple

Study Groups

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Ketamine

Participants will receive twice-weekly infusions of ketamine at 0.05mg/kg for the duration of treatment with ECT. All infusions will be administered by a Consultant Anaesthetist.

Group Type EXPERIMENTAL

Ketamine

Intervention Type DRUG

A sub-anaesthetic dose of ketamine will be administered in twice-weekly infusions

Midazolam

Participants will receive twice-weekly infusions of midazolam at 0.045mg/kg for the duration of treatment with ECT. All infusions will be administered by a Consultant Anaesthetist.

Group Type ACTIVE_COMPARATOR

Midazolam

Intervention Type DRUG

A sub-anaesthetic dose of midazolam will be administered in twice-weekly infusions

Interventions

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Ketamine

A sub-anaesthetic dose of ketamine will be administered in twice-weekly infusions

Intervention Type DRUG

Midazolam

A sub-anaesthetic dose of midazolam will be administered in twice-weekly infusions

Intervention Type DRUG

Other Intervention Names

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Ketalar Hyponovel

Eligibility Criteria

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Inclusion Criteria

* ≥18 years old
* Able to provide informed consent
* Voluntary admission for treatment of an acute depressive episode
* Meet DSM-V criteria for a major depressive disorder (MDD) and bipolar affective disorder (current episode depression)
* Montgomery Asberg Depression Rating Scale 10 item version (MADRS) score of ≥20
* Referred for treatment with ECT
* Sufficiently physically healthy to receive ketamine/midazolam and ECT

Exclusion Criteria

* Inability to provide informed consent
* Current involuntary admission
* History of Axis 1 diagnosis other than major depression
* Medical condition rendering unfit for ECT
* Active suicidal intention
* Presence of major neurological or organic brain disorder
* Alcohol/substance dependence in previous six-months
* Pregnancy or inability to confirm use of adequate contraception during the trial
* Breastfeeding women
* Contraindications to ketamine
* Contraindications to midazolam
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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St Patrick's Hospital, Ireland

OTHER

Sponsor Role lead

Responsible Party

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Prof Declan McLoughlin

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Declan McLoughlin, PhD

Role: PRINCIPAL_INVESTIGATOR

St Patrick's Hospital

Locations

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St Patrick's University Hospital

Dublin, Co. Dublin, Ireland

Site Status

Countries

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Ireland

Other Identifiers

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11/18

Identifier Type: -

Identifier Source: org_study_id

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