Sustained Mood Improvement With Laughing Gas Exposure: A Randomized Controlled Pilot Trial

NCT ID: NCT04957368

Last Updated: 2024-05-08

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

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-11-03

Study Completion Date

2024-02-27

Brief Summary

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The purpose of the study is to investigate a short-term treatment option for major depressive disorders by administering nitrous oxide gas. At this time, the main purpose is to complete a feasibility study with 40 participants suffering from treatment-resistant depression. Participants will be randomized to (1) Study group: Nitrous oxide (inhaled) + solution of saline (injected) and the (2) Control group: Oxygen (inhaled) + Midazolam (injected) as an Active Placebo.

Detailed Description

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Conditions

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Treatment Resistant Depression Major Depressive Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Nitrous Oxide + saline solution

Group Type EXPERIMENTAL

Nitrous Oxide 99 %

Intervention Type DRUG

Nitrous oxide will be administered at an inspiratory concentration of 50% with concurrent intravenous saline (100ml) for one hour.

Oxygen + Midazolam

Group Type ACTIVE_COMPARATOR

Oxygen + Midazolam

Intervention Type DRUG

Oxygen will be administered at 50% with intravenous midazolam (0.02mg/kg in 100ml) for one hour

Interventions

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Nitrous Oxide 99 %

Nitrous oxide will be administered at an inspiratory concentration of 50% with concurrent intravenous saline (100ml) for one hour.

Intervention Type DRUG

Oxygen + Midazolam

Oxygen will be administered at 50% with intravenous midazolam (0.02mg/kg in 100ml) for one hour

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. 18 to 65 years of age
2. Meeting Diagnostic and Statistical Manual for Mental Disorders (DSM-5) criteria for Major Depressive Disorder (MDD)
3. Current major depressive episode as confirmed by the Mini International Neuropsychiatric Interview (MINI) for DSM-5
4. Experiencing moderate to severe depressive episode, as defined by the Hamilton Depression Rating Scale (HAMD)\>17
5. Failure of two trials of antidepressant therapy of adequate dose and duration, during the current depressive episode
6. For women of childbearing potential, use of highly effective or double-barrier methods of contraception. Abstinence is acceptable if it is the preferred and usual lifestyle of the female participant
7. Capacity to provide informed consent.

Exclusion Criteria

1. Acute suicidality defined as score ≥3 on HAMD item 3
2. Major Depressive Episode in people with Bipolar Disorder
3. Current substance abuse or dependence and/or history of alcohol abuse or dependence within the past year
4. Dementia
5. Current or lifetime history of schizophrenia or schizoaffective disorder
6. Current history of dissociative disorders
7. Known history of hypersensitivity or allergy to Nitrous Oxide, Midazolam or any ingredients in the study formulations
8. Contraindication to receiving nitrous oxide
9. Chronic cobalamin or folate deficiency
10. Contraindication to receiving the placebo midazolam
11. Use of centrally acting medicinal products, such as opioid agonists, morphine derivatives, benzodiazepines and/or other central nervous system depressants such as barbiturates and alcohol
12. Pregnancy or breastfeeding in female participants
13. Electroconvulsive therapy within the current depressive episode
14. Receiving ketamine treatment within the current depressive episode
15. Unwilling to maintain current antidepressant regimen.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Unity Health Toronto

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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St. Michael's Hospital

Toronto, Ontario, Canada

Site Status

Countries

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Canada

References

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Ladha KS, Lee J, Mattina GF, Pazmino-Canizares J, Wijeysundera DN, Gholamali Nezhad F, Philip K, Tassone VK, Adamsahib F, Bhat V; SMILE Study Investigators. Sustained Mood Improvement with Laughing Gas Exposure (SMILE): Study protocol for a randomized placebo-controlled pilot trial of nitrous oxide for treatment-resistant depression. PLoS One. 2024 Jan 19;19(1):e0297330. doi: 10.1371/journal.pone.0297330. eCollection 2024.

Reference Type DERIVED
PMID: 38241247 (View on PubMed)

Other Identifiers

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21-096

Identifier Type: -

Identifier Source: org_study_id

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