MedPath

Intramuscular Ketamine for Suicidal Ideation

Phase 2
Withdrawn
Conditions
Suicidal Ideation
Interventions
Registration Number
NCT05105061
Lead Sponsor
Icahn School of Medicine at Mount Sinai
Brief Summary

The objective of the present research protocol, a cross-over, subject-blinded, clinical trial, is to correlate changes in brain activity with reduction in suicidal ideation in response to a single intramuscular dose of ketamine. While ketamine is increasingly used as a rapid, antidepressant agent, there is accumulating evidence of additional anti-suicidal properties that may be distinct from its effects on depression. This pilot study will be used to determine (1) whether specific electroencephalogram (EEG) findings are correlated with response of SI to intramuscular (IM) ketamine, and (2) the effectiveness of IM ketamine in the treatment of acute SI.

Detailed Description

Not available

Recruitment & Eligibility

Status
WITHDRAWN
Sex
All
Target Recruitment
Not specified
Inclusion Criteria
  • Current clinically significant suicidal ideation, defined as a score of > or = 4 on the MADRS item 10 and a positive answer on items 3,4 or 5 of the C-SSRS.
  • Inpatient status at the time of study initiation.
  • 18 to 70 years of age
  • Capacity to consent

Exclusion criteria:

  • Diagnosis of a primary psychotic disorder (e.g., schizoaffective disorder)
  • Diagnosis of pervasive developmental disorder
  • Diagnosis of a major neurocognitive disorder
  • A positive urine pregnancy test
  • Currently breastfeeding
  • Drug or alcohol abuse or dependence within the preceding 3 months; a rather narrow time period was chosen, however, in order to allow participation by individuals with a history of substance abuse or dependence problems that could be secondary to their SI, and to more closely approximate patients seen in real-world settings. Given the increasingly widespread use of marijuana, and in an effort to recruit a naturalistic study population, concurrent marijuana use is not an exclusion criterion, as long as they are not actively intoxicated.
  • Current positive UTOX for amphetamine, benzodiazepines, cocaine, opiates (if not prescribed)
  • Medical issues or laboratory abnormalities requiring acute intervention
  • Patients for whom an increase in blood pressure or intracranial pressure would pose a serious risk (e.g., aneurysmal vascular disease, arteriovenous malformation, history of intracerebral hemorrhage, unstable angina)
  • Any lifetime history of ketamine or phencyclidine abuse
  • A known hypersensitivity to or history of a serious adverse effect from to ketamine
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Ketamine (1) then Placebo (2)PlaceboParticipants will receive an intramuscular injection of racemic ketamine, followed the next day by an intramuscular injection of saline (placebo)
Placebo (1) then Ketamine (2)Ketamine (Ketalar)Participants will receive an intramuscular injection of saline (placebo), followed the next day by an intramuscular injection of racemic ketamine
Placebo (1) then Ketamine (2)PlaceboParticipants will receive an intramuscular injection of saline (placebo), followed the next day by an intramuscular injection of racemic ketamine
Ketamine (1) then Placebo (2)Ketamine (Ketalar)Participants will receive an intramuscular injection of racemic ketamine, followed the next day by an intramuscular injection of saline (placebo)
Primary Outcome Measures
NameTimeMethod
Change in Auditory Mismatch Negativity (EEG)Baseline and One hour post injection

Change in Mismatch Negativity (MMN) amplitude or latency from baseline up to one hour after injection.

Secondary Outcome Measures
NameTimeMethod
Change in Montgomery-Asberg Depression Rating Scale (MADRS) #10 (SI)Baseline and 24 hours post injection

Change in MADRS #10 from baseline to 24 hours post-injection. Score range from 0-5, with higher score indicating higher severity of symptoms.

Trial Locations

Locations (1)

Icahn School of Medicine at Mount Sinai

🇺🇸

New York, New York, United States

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