Status:
COMPLETED
Ketamine Plus Lithium in Treatment-Resistant Depression
Lead Sponsor:
Icahn School of Medicine at Mount Sinai
Conditions:
Depression
Eligibility:
All Genders
21-65 years
Phase:
PHASE2
Brief Summary
The purpose of this study is to test the antidepressant effect of ketamine when given repeatedly over a period of 1 week, as well as the use of Lithium as a relapse-prevention strategy for patients wi...
Detailed Description
Major Depressive Disorder (MDD) is a disabling medical illness and current monoaminergic treatments are slow to act and possess only limited efficacy. In this context, the discovery that the glutamate...
Eligibility Criteria
Inclusion
- Male or female patients, 21-65 years of age;
- Female individuals who are not of childbearing potential (i.e., surgically sterile, postmenopausal for at least one year) or using a medically accepted reliable means of contraception. Women using oral contraceptive medication for birth control must also be using a barrier contraceptive. Women of childbearing potential must also have a negative serum B-HCG at screening and at pre-infusion;
- Participants must fulfill DSM-IV criteria for Major Depression without psychotic features, based on clinical assessment by a study psychiatrist and confirmed by a structured diagnostic interview, the Structured Clinical Interview for DSM-IV TR Axis I Disorders, Patient Edition (SCID-P);
- Participants must have a history of at least one previous episode of depression prior to the current episode (recurrent MDD) or have chronic MDD (of at least two years' duration);
- Participants have not responded to two or more adequate trials of an antidepressant as determined by Antidepressant Treatment History Form (ATHF) criteria (score \>=3);
- Current Major Depressive Episode of at least moderate severity, defined as a QIDS-SR score ≥ 14 and a CGI-S score of ≥ 4;Current major depressive episode is of at least 4 weeks duration;
- Each participant must have a level of understanding sufficient to agree to all tests and examinations required by the protocol and must sign an informed consent document;
- Each participant must be able to identify a family member, physician, or friend who will participate in the Treatment Contract.
Exclusion
- Lifetime history of psychotic features, diagnosis of schizophrenia or any other psychotic disorder, or diagnosis of bipolar disorder;
- Lifetime histories of autism, mental retardation, pervasive developmental disorders, or Tourette's syndrome;
- Current diagnosis of OCD or eating disorder (bulimia nervosa or anorexia nervosa);
- Subjects with DSM-IV drug or alcohol abuse/dependence within the preceding 2 years;
- Patients with schizotypal or antisocial personality disorder, or any clinically significant axis II disorder that would, in the investigator's judgment, preclude safe study participation;
- Patients judged clinically to be at serious and imminent suicidal or homicidal risk;
- Women who are either pregnant or nursing;
- Serious, unstable medical illnesses including hepatic, renal impairment, gastroenterologic (including gastro-esophageal reflux disease), respiratory (including obstructive sleep apnea, or history of difficulty with airway management during previous anesthetics), cardiovascular (including ischemic heart disease and uncontrolled hypertension), endocrinologic, neurologic (including history of severe head injury), immunologic, or hematologic disease;
- Clinically significant abnormal findings of laboratory parameters, physical examination, or ECG;
- Patients who have a positive urine toxicology for illicit substances at screening and within 24 hours of the infusion;
- Patients with one or more seizures without a clear and resolved etiology;
- Treatment with an irreversible MAOI within 2 weeks prior to randomization or fluoxetine within 4 weeks prior to randomization;
- Treatment with other antidepressants within one week of randomization;
- Previous recreational use of PCP or ketamine;
- Hypertension (systolic BP \>160 mm Hg or diastolic BP \>90 mm Hg) not controlled by diuretic or beta-blocker therapy alone or in combination;
- A blood pressure reading over 160/90 or two separate readings over 140/90 at screening or baseline visits;
- Renal impairment, as reflected by a BUN \> 20 mg/dL and/or creatinin clearance of \>1.3 mg/dL;
- Thyroid impairment, as reflected by a TSH \> 4.2 mU/L;
- Cardiac disease, as reflected by an EKG that is abnormal and of concern for cardiac disease;
- Any anticipated change in medications that could affect fluid or salt balance, including the following antihypertensive agents: ACE inhibitor, loop diuretics, calcium channel blockers, thiazide diuretics, angiotensin II receptor blockers.
Key Trial Info
Start Date :
July 1 2013
Trial Type :
INTERVENTIONAL
Allocation :
ACTUAL
End Date :
November 1 2016
Estimated Enrollment :
34 Patients enrolled
Trial Details
Trial ID
NCT01880593
Start Date
July 1 2013
End Date
November 1 2016
Last Update
July 31 2018
Active Locations (1)
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1
Icahn School of Medicine at Mount Sinai
New York, New York, United States, 10029