Trial Outcomes & Findings for Initiating Ketamine in Acutely Suicidal Patients in the Emergency Department (NCT NCT04260607)

NCT ID: NCT04260607

Last Updated: 2025-05-14

Results Overview

Suicidal severity is measured by the total score on the Beck Scale for Suicide Ideation (BSS or BSSI). The BSS is a 21-item scale, where each item contains a group of statements that are rated from 0 to 2. Items 1 to 5 comprise a screening subscale. If the patient scores 0 in total on items 4 and 5, items 6 to 19 are skipped. Item 21 is only asked if the patient has attempted suicide at least once. The screening subscale can range from 0 to 10 points, whereas the total score can range from 0 to 42 points. A high total score corresponds with an increased number of specific suicidal characteristics that require greater clinical scrutiny.

Recruitment status

TERMINATED

Study phase

PHASE3

Target enrollment

1 participants

Primary outcome timeframe

4 hour+/1 after infusion completion (performed for placebo and drug arms)

Results posted on

2025-05-14

Participant Flow

Subjects recruitment occurred from main ED from 2019-2021

Medical Record review completed

Participant milestones

Participant milestones
Measure
Experimental-Ketamine
single dose IV Ketamine (Ketalar) 0.5mg/kg in 100ml Normal Saline infused over 40 minutes Ketamine Hydrochloride: Experimental Procedure 1. Baseline evaluation of suicidal severity (BSSI) \& degree of depressive symptoms (MADRS-S) will be evaluated through self-administered questionnaires. 2. The experimental and placebo arms will receive a single dose of IV ketamine, 0.5 mg/kg in 100 cc NS or 100 cc of NS infused over 40 minutes. 3. Post ketamine re-evaluation of outcome measures at four and twenty-four hours will determine clinical effectiveness of ketamine intervention 4. Inspection of admission and transfer time provides time measurement for LOS. This secondary measure is needed to determine efficiency of intervention. 5. Post ketamine re-evaluation of outcome measure at one-week post infusion will elucidate ketamine's durability of effect.
Placebo-Saline
100ml Normal Saline infused over 40 minutes Normal saline: Experimental Procedure 1. Baseline evaluation of suicidal severity (BSSI) \& degree of depressive symptoms (MADRS-S) will be evaluated through self-administered questionnaires. 2. The placebo arms will receive a single dose of 100 cc of NS infused over 40 minutes. 3. Post Placebo infusion re-evaluation of outcome measures at four and twenty-four hours 4. Inspection of admission and transfer time provides time measurement for LOS. This secondary measure is needed to determine efficiency of intervention. 5. Post Normal Saline re-evaluation of outcome measure at one-week post infusion.
Overall Study
STARTED
1
0
Overall Study
COMPLETED
1
0
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Experimental-Ketamine
n=1 Participants
single dose IV Ketamine (Ketalar) 0.5mg/kg in 100ml Normal Saline infused over 40 minutes Ketamine Hydrochloride: Experimental Procedure 1. Baseline evaluation of suicidal severity (BSSI) \& degree of depressive symptoms (MADRS-S) will be evaluated through self-administered questionnaires. 2. The experimental and placebo arms will receive a single dose of IV ketamine, 0.5 mg/kg in 100 cc NS or 100 cc of NS infused over 40 minutes. 3. Post ketamine re-evaluation of outcome measures at four and twenty-four hours will determine clinical effectiveness of ketamine intervention 4. Inspection of admission and transfer time provides time measurement for LOS. This secondary measure is needed to determine efficiency of intervention. 5. Post ketamine re-evaluation of outcome measure at one-week post infusion will elucidate ketamine's durability of effect.
Placebo-Saline
100ml Normal Saline infused over 40 minutes Normal saline: Experimental Procedure 1. Baseline evaluation of suicidal severity (BSSI) \& degree of depressive symptoms (MADRS-S) will be evaluated through self-administered questionnaires. 2. The placebo arms will receive a single dose of 100 cc of NS infused over 40 minutes. 3. Post Placebo infusion re-evaluation of outcome measures at four and twenty-four hours 4. Inspection of admission and transfer time provides time measurement for LOS. This secondary measure is needed to determine efficiency of intervention. 5. Post Normal Saline re-evaluation of outcome measure at one-week post infusion.
Total
n=1 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=1 Participants
0 Participants
n=1 Participants
Age, Categorical
Between 18 and 65 years
1 Participants
n=1 Participants
1 Participants
n=1 Participants
Age, Categorical
>=65 years
0 Participants
n=1 Participants
0 Participants
n=1 Participants
Age, Continuous
23 Years
n=1 Participants
23 Years
n=1 Participants
Sex: Female, Male
Female
0 Participants
n=1 Participants
0 Participants
n=1 Participants
Sex: Female, Male
Male
1 Participants
n=1 Participants
1 Participants
n=1 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.
Beck Scale for Suicide Ideation (BSS)
Screening Subscore
7 units on a scale
n=1 Participants
7 units on a scale
n=1 Participants
Beck Scale for Suicide Ideation (BSS)
Total Score
29 units on a scale
n=1 Participants
29 units on a scale
n=1 Participants
Montgomery Asberg Depression Rating Scale (MADRS)
20 units on a scale
n=1 Participants
20 units on a scale
n=1 Participants

PRIMARY outcome

Timeframe: 4 hour+/1 after infusion completion (performed for placebo and drug arms)

Population: As a busy MTF we were unable to retain a health care provider with the appropriate expertise to buy-in to this study once the initiating PI left military service. At the time the PI left military service, only 1 patient had been assigned to the experimental group, and 0 patients to the placebo group.

Suicidal severity is measured by the total score on the Beck Scale for Suicide Ideation (BSS or BSSI). The BSS is a 21-item scale, where each item contains a group of statements that are rated from 0 to 2. Items 1 to 5 comprise a screening subscale. If the patient scores 0 in total on items 4 and 5, items 6 to 19 are skipped. Item 21 is only asked if the patient has attempted suicide at least once. The screening subscale can range from 0 to 10 points, whereas the total score can range from 0 to 42 points. A high total score corresponds with an increased number of specific suicidal characteristics that require greater clinical scrutiny.

Outcome measures

Outcome measures
Measure
Experimental-Ketamine
n=1 Participants
single dose IV Ketamine (Ketalar) 0.5mg/kg in 100ml Normal Saline infused over 40 minutes Ketamine Hydrochloride: Experimental Procedure 1. Baseline evaluation of suicidal severity (BSSI) \& degree of depressive symptoms (MADRS-S) will be evaluated through self-administered questionnaires. 2. The experimental and placebo arms will receive a single dose of IV ketamine, 0.5 mg/kg in 100 cc NS or 100 cc of NS infused over 40 minutes. 3. Post ketamine re-evaluation of outcome measures at four and twenty-four hours will determine clinical effectiveness of ketamine intervention 4. Inspection of admission and transfer time provides time measurement for LOS. This secondary measure is needed to determine efficiency of intervention. 5. Post ketamine re-evaluation of outcome measure at one-week post infusion will elucidate ketamine's durability of effect.
Placebo-Saline
100ml Normal Saline infused over 40 minutes Normal saline: Experimental Procedure 1. Baseline evaluation of suicidal severity (BSSI) \& degree of depressive symptoms (MADRS-S) will be evaluated through self-administered questionnaires. 2. The placebo arms will receive a single dose of 100 cc of NS infused over 40 minutes. 3. Post Placebo infusion re-evaluation of outcome measures at four and twenty-four hours 4. Inspection of admission and transfer time provides time measurement for LOS. This secondary measure is needed to determine efficiency of intervention. 5. Post Normal Saline re-evaluation of outcome measure at one-week post infusion.
Suicidal Severity - Clinical Efficacy
3 Units on a Scale
Interval 3.0 to 3.0

PRIMARY outcome

Timeframe: 24-36 hours after infusion completion (performed for placebo and drug arms)

Population: As a busy MTF we were unable to retain a health care provider with the appropriate expertise to buy-in to this study once the initiating PI left military service. At the time the PI left military service, only 1 patient had been assigned to the experimental group, and 0 patients to the placebo group.

Suicidal severity is measured by the total score on the Beck Scale for Suicide Ideation (BSS or BSSI). The BSS is a 21-item scale, where each item contains a group of statements that are rated from 0 to 2. Items 1 to 5 comprise a screening subscale. If the patient scores 0 in total on items 4 and 5, items 6 to 19 are skipped. Item 21 is only asked if the patient has attempted suicide at least once. The screening subscale can range from 0 to 10 points, whereas the total score can range from 0 to 42 points. A high total score corresponds with an increased number of specific suicidal characteristics that require greater clinical scrutiny.

Outcome measures

Outcome measures
Measure
Experimental-Ketamine
n=1 Participants
single dose IV Ketamine (Ketalar) 0.5mg/kg in 100ml Normal Saline infused over 40 minutes Ketamine Hydrochloride: Experimental Procedure 1. Baseline evaluation of suicidal severity (BSSI) \& degree of depressive symptoms (MADRS-S) will be evaluated through self-administered questionnaires. 2. The experimental and placebo arms will receive a single dose of IV ketamine, 0.5 mg/kg in 100 cc NS or 100 cc of NS infused over 40 minutes. 3. Post ketamine re-evaluation of outcome measures at four and twenty-four hours will determine clinical effectiveness of ketamine intervention 4. Inspection of admission and transfer time provides time measurement for LOS. This secondary measure is needed to determine efficiency of intervention. 5. Post ketamine re-evaluation of outcome measure at one-week post infusion will elucidate ketamine's durability of effect.
Placebo-Saline
100ml Normal Saline infused over 40 minutes Normal saline: Experimental Procedure 1. Baseline evaluation of suicidal severity (BSSI) \& degree of depressive symptoms (MADRS-S) will be evaluated through self-administered questionnaires. 2. The placebo arms will receive a single dose of 100 cc of NS infused over 40 minutes. 3. Post Placebo infusion re-evaluation of outcome measures at four and twenty-four hours 4. Inspection of admission and transfer time provides time measurement for LOS. This secondary measure is needed to determine efficiency of intervention. 5. Post Normal Saline re-evaluation of outcome measure at one-week post infusion.
Suicidal Severity - Clinical Efficacy
2 Units on a Scale
Interval 2.0 to 2.0

PRIMARY outcome

Timeframe: 1week+/-1 day after infusion completion (performed for placebo and drug arms)

Population: As a busy MTF we were unable to retain a health care provider with the appropriate expertise to buy-in to this study once the initiating PI left military service. At the time the PI left military service, only 1 patient had been assigned to the experimental group, and 0 patients to the placebo group.

Suicidal severity is measured by the total score on the Beck Scale for Suicide Ideation (BSS or BSSI). The BSS is a 21-item scale, where each item contains a group of statements that are rated from 0 to 2. Items 1 to 5 comprise a screening subscale. If the patient scores 0 in total on items 4 and 5, items 6 to 19 are skipped. Item 21 is only asked if the patient has attempted suicide at least once. The screening subscale can range from 0 to 10 points, whereas the total score can range from 0 to 42 points. A high total score corresponds with an increased number of specific suicidal characteristics that require greater clinical scrutiny.

Outcome measures

Outcome measures
Measure
Experimental-Ketamine
n=1 Participants
single dose IV Ketamine (Ketalar) 0.5mg/kg in 100ml Normal Saline infused over 40 minutes Ketamine Hydrochloride: Experimental Procedure 1. Baseline evaluation of suicidal severity (BSSI) \& degree of depressive symptoms (MADRS-S) will be evaluated through self-administered questionnaires. 2. The experimental and placebo arms will receive a single dose of IV ketamine, 0.5 mg/kg in 100 cc NS or 100 cc of NS infused over 40 minutes. 3. Post ketamine re-evaluation of outcome measures at four and twenty-four hours will determine clinical effectiveness of ketamine intervention 4. Inspection of admission and transfer time provides time measurement for LOS. This secondary measure is needed to determine efficiency of intervention. 5. Post ketamine re-evaluation of outcome measure at one-week post infusion will elucidate ketamine's durability of effect.
Placebo-Saline
100ml Normal Saline infused over 40 minutes Normal saline: Experimental Procedure 1. Baseline evaluation of suicidal severity (BSSI) \& degree of depressive symptoms (MADRS-S) will be evaluated through self-administered questionnaires. 2. The placebo arms will receive a single dose of 100 cc of NS infused over 40 minutes. 3. Post Placebo infusion re-evaluation of outcome measures at four and twenty-four hours 4. Inspection of admission and transfer time provides time measurement for LOS. This secondary measure is needed to determine efficiency of intervention. 5. Post Normal Saline re-evaluation of outcome measure at one-week post infusion.
Suicidal Severity - Efficacy at 1 Week
6 Units on a Scale
Interval 6.0 to 6.0

PRIMARY outcome

Timeframe: 4 hours +/-1 after infusion completion (Performed for placebo and drug arms)

Population: As a busy MTF we were unable to retain a health care provider with the appropriate expertise to buy-in to this study once the initiating PI left military service. At the time the PI left military service, only 1 patient had been assigned to the experimental group, and 0 patients to the placebo group.

Depression symptoms are measured by the total score on the Montgomery Asberg Depression Rating Scale (MADRS). The MADRS scale consists of 9 items. Each item is scored between 0 and 3, in intervals of 0.5 The total scores range between 0 and 27, with higher scores indicating more severe depressive symptoms.

Outcome measures

Outcome measures
Measure
Experimental-Ketamine
n=1 Participants
single dose IV Ketamine (Ketalar) 0.5mg/kg in 100ml Normal Saline infused over 40 minutes Ketamine Hydrochloride: Experimental Procedure 1. Baseline evaluation of suicidal severity (BSSI) \& degree of depressive symptoms (MADRS-S) will be evaluated through self-administered questionnaires. 2. The experimental and placebo arms will receive a single dose of IV ketamine, 0.5 mg/kg in 100 cc NS or 100 cc of NS infused over 40 minutes. 3. Post ketamine re-evaluation of outcome measures at four and twenty-four hours will determine clinical effectiveness of ketamine intervention 4. Inspection of admission and transfer time provides time measurement for LOS. This secondary measure is needed to determine efficiency of intervention. 5. Post ketamine re-evaluation of outcome measure at one-week post infusion will elucidate ketamine's durability of effect.
Placebo-Saline
100ml Normal Saline infused over 40 minutes Normal saline: Experimental Procedure 1. Baseline evaluation of suicidal severity (BSSI) \& degree of depressive symptoms (MADRS-S) will be evaluated through self-administered questionnaires. 2. The placebo arms will receive a single dose of 100 cc of NS infused over 40 minutes. 3. Post Placebo infusion re-evaluation of outcome measures at four and twenty-four hours 4. Inspection of admission and transfer time provides time measurement for LOS. This secondary measure is needed to determine efficiency of intervention. 5. Post Normal Saline re-evaluation of outcome measure at one-week post infusion.
Depression Symptoms - Clinical Efficacy
7 units on a scale
Interval 7.0 to 7.0

PRIMARY outcome

Timeframe: 24-46 hours after infusion completion (Performed for placebo and drug arms)

Population: As a busy MTF we were unable to retain a health care provider with the appropriate expertise to buy-in to this study once the initiating PI left military service. At the time the PI left military service, only 1 patient had been assigned to the experimental group, and 0 patients to the placebo group.

Depression symptoms are measured by the total score on the Montgomery Asberg Depression Rating Scale (MADRS). The MADRS scale consists of 9 items. Each item is scored between 0 and 3, in intervals of 0.5 The total scores range between 0 and 27, with higher scores indicating more severe depressive symptoms.

Outcome measures

Outcome measures
Measure
Experimental-Ketamine
n=1 Participants
single dose IV Ketamine (Ketalar) 0.5mg/kg in 100ml Normal Saline infused over 40 minutes Ketamine Hydrochloride: Experimental Procedure 1. Baseline evaluation of suicidal severity (BSSI) \& degree of depressive symptoms (MADRS-S) will be evaluated through self-administered questionnaires. 2. The experimental and placebo arms will receive a single dose of IV ketamine, 0.5 mg/kg in 100 cc NS or 100 cc of NS infused over 40 minutes. 3. Post ketamine re-evaluation of outcome measures at four and twenty-four hours will determine clinical effectiveness of ketamine intervention 4. Inspection of admission and transfer time provides time measurement for LOS. This secondary measure is needed to determine efficiency of intervention. 5. Post ketamine re-evaluation of outcome measure at one-week post infusion will elucidate ketamine's durability of effect.
Placebo-Saline
100ml Normal Saline infused over 40 minutes Normal saline: Experimental Procedure 1. Baseline evaluation of suicidal severity (BSSI) \& degree of depressive symptoms (MADRS-S) will be evaluated through self-administered questionnaires. 2. The placebo arms will receive a single dose of 100 cc of NS infused over 40 minutes. 3. Post Placebo infusion re-evaluation of outcome measures at four and twenty-four hours 4. Inspection of admission and transfer time provides time measurement for LOS. This secondary measure is needed to determine efficiency of intervention. 5. Post Normal Saline re-evaluation of outcome measure at one-week post infusion.
Depression Symptoms - Clinical Efficacy
2 units on a scale
Interval 2.0 to 2.0

PRIMARY outcome

Timeframe: 1 week +/-1 day after infusion completion, performed for placebo and drug arms

Population: As a busy MTF we were unable to retain a health care provider with the appropriate expertise to buy-in to this study once the initiating PI left military service. At the time the PI left military service, only 1 patient had been assigned to the experimental group, and 0 patients to the placebo group.

Depression symptoms are measured by the total score on the Montgomery Asberg Depression Rating Scale (MADRS). The MADRS scale consists of 9 items. Each item is scored between 0 and 3, in intervals of 0.5 The total scores range between 0 and 27, with higher scores indicating more severe depressive symptoms.

Outcome measures

Outcome measures
Measure
Experimental-Ketamine
n=1 Participants
single dose IV Ketamine (Ketalar) 0.5mg/kg in 100ml Normal Saline infused over 40 minutes Ketamine Hydrochloride: Experimental Procedure 1. Baseline evaluation of suicidal severity (BSSI) \& degree of depressive symptoms (MADRS-S) will be evaluated through self-administered questionnaires. 2. The experimental and placebo arms will receive a single dose of IV ketamine, 0.5 mg/kg in 100 cc NS or 100 cc of NS infused over 40 minutes. 3. Post ketamine re-evaluation of outcome measures at four and twenty-four hours will determine clinical effectiveness of ketamine intervention 4. Inspection of admission and transfer time provides time measurement for LOS. This secondary measure is needed to determine efficiency of intervention. 5. Post ketamine re-evaluation of outcome measure at one-week post infusion will elucidate ketamine's durability of effect.
Placebo-Saline
100ml Normal Saline infused over 40 minutes Normal saline: Experimental Procedure 1. Baseline evaluation of suicidal severity (BSSI) \& degree of depressive symptoms (MADRS-S) will be evaluated through self-administered questionnaires. 2. The placebo arms will receive a single dose of 100 cc of NS infused over 40 minutes. 3. Post Placebo infusion re-evaluation of outcome measures at four and twenty-four hours 4. Inspection of admission and transfer time provides time measurement for LOS. This secondary measure is needed to determine efficiency of intervention. 5. Post Normal Saline re-evaluation of outcome measure at one-week post infusion.
Depression Symptoms - Efficacy at 1 Week
9.5 units on a scale
Interval 9.5 to 9.5

SECONDARY outcome

Timeframe: Performed on medical record review at 1 week

Population: The length of hospital stay was not recorded for the patient.

Difference in time between date of hospital admission to transfer or hospital discharge.

Outcome measures

Outcome data not reported

Adverse Events

Experimental-Ketamine

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Placebo-Saline

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

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Experimental-Ketamine
n=1 participants at risk
single dose IV Ketamine (Ketalar) 0.5mg/kg in 100ml Normal Saline infused over 40 minutes Ketamine Hydrochloride: Experimental Procedure 1. Baseline evaluation of suicidal severity (BSSI) \& degree of depressive symptoms (MADRS-S) will be evaluated through self-administered questionnaires. 2. The experimental and placebo arms will receive a single dose of IV ketamine, 0.5 mg/kg in 100 cc NS or 100 cc of NS infused over 40 minutes. 3. Post ketamine re-evaluation of outcome measures at four and twenty-four hours will determine clinical effectiveness of ketamine intervention 4. Inspection of admission and transfer time provides time measurement for LOS. This secondary measure is needed to determine efficiency of intervention. 5. Post ketamine re-evaluation of outcome measure at one-week post infusion will elucidate ketamine's durability of effect.
Placebo-Saline
100ml Normal Saline infused over 40 minutes Normal saline: Experimental Procedure 1. Baseline evaluation of suicidal severity (BSSI) \& degree of depressive symptoms (MADRS-S) will be evaluated through self-administered questionnaires. 2. The placebo arms will receive a single dose of 100 cc of NS infused over 40 minutes. 3. Post Placebo infusion re-evaluation of outcome measures at four and twenty-four hours 4. Inspection of admission and transfer time provides time measurement for LOS. This secondary measure is needed to determine efficiency of intervention. 5. Post Normal Saline re-evaluation of outcome measure at one-week post infusion.
Psychiatric disorders
Mild Severity AE
100.0%
1/1 • Number of events 1 • 2 years
N/A; Definition of adverse event and/or serious adverse event, is the same as the clinicaltrials.gov definition.
0/0 • 2 years
N/A; Definition of adverse event and/or serious adverse event, is the same as the clinicaltrials.gov definition.

Additional Information

Naval Medical Center Camp Lejeune

Naval Medical Center Camp Lejeune

Phone: 317-691-1718

Results disclosure agreements

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