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Propofol-Enhanced Assessment of Ketamine for Chronic Pain and Depression

Phase 4
Recruiting
Conditions
Chronic Pain
Depression
Interventions
Drug: Normal saline
Registration Number
NCT06317636
Lead Sponsor
Stanford University
Brief Summary

The goal of this clinical trial is to compare ketamine to a placebo when given as a single infusion during IV sedation in adults with chronic pain and depression. We do not know whether ketamine will be more effective than placebo under these circumstances.

This study aims to:

* Evaluate whether placebo is non-inferior to ketamine in treating chronic pain and depression, when delivered under propofol sedation

* Confirm that propofol sedation is a safe way to keep participants blinded to treatment

* Assess patients' comfort with the sedation process to improve future studies

* Explore whether patient expectations affects their pain and depression

Participants will:

* Need to qualify for the study based on stringent medical criteria

* Undergo sedation with propofol

* Randomly receive either a ketamine or a placebo (saline) infusion during sedation

* Complete several study assessments over 5-7 weeks

Detailed Description

Ketamine is a dissociative anesthetic that has been in clinical use for more than 50 years. In addition to its well-known anesthetic and pain-relieving properties, ketamine has been found to have fast-acting antidepressant effects in patients with depression. However, the mechanisms underlying ketamine's ability to treat chronic pain and depression are poorly understood. A most basic question regarding ketamine's therapeutic mechanism is still unresolved: do patients need to consciously experience and recall ketamine's acute dissociative effects to receive lasting analgesic and antidepressant benefits? In this clinical trial, participants will receive either ketamine or a placebo when they are under sedation with propofol. A n=6 pilot feasibility phase will precede the fully-powered n=34 randomized controlled trial.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Age 18 to 70 years old
  • Comfortable speaking and writing in English
  • Chronic pain present daily for at least 3 months
  • Currently experiencing depression
  • Able to comply with the study protocol and communicate with study personnel about adverse events and other clinically important information
Exclusion Criteria
  • Pregnant or breastfeeding
  • One or more health conditions that makes study unsafe or unfeasible, determined by study physicians
  • Regular use of medications that may have problematic interactions with the study drugs
  • Participating in another clinical trial which may conflict with this one

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
KetamineKetamineA one-time intravenous infusion of ketamine (0.5 mg/kg)
SalineNormal salineA one-time intravenous infusion of normal saline
Primary Outcome Measures
NameTimeMethod
Pain intensity in the past 24 hoursscreening; 1, 7, 14, 21 and 28 days after treatment

A numerical rating scale ranging from 0 (no pain) to 10 (worst possible pain) over the past 24 hours will be used to assess pain intensity.

Secondary Outcome Measures
NameTimeMethod
Depression severityscreening; day of infusion pre-treatment; 7, 14, 21 and 28 days after treatment

The 16-item Quick Inventory of Depressive Symptomatology Self-Report will be used to assess the severity of depressive symptoms. Items are self-rated on a 4-point scale tailored to each depression-related symptom. Higher total scores indicate greater depression symptom severity.

Trial Locations

Locations (1)

Stanford University

🇺🇸

Stanford, California, United States

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