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Chart Review of Patients Undergoing Ketamine Treatments for Depression

Completed
Conditions
Depression - Major Depressive Disorder
Interventions
Registration Number
NCT07099235
Lead Sponsor
Sunnybrook Health Sciences Centre
Brief Summary

The Ontario Ketamine and Infusion Centre (OKIC) is a CPSO-certified Level-II OHP and an outpatient centre for intravenous ketamine treatments for treatment-resistant depression. This retrospective, observational study aims to conduct a chart review on patients receiving ketamine in a naturalistic setting to develop our understanding of ketamine as an interventional approach for treatment-resistant depression.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
250
Inclusion Criteria
  • Age ≥ 18
  • Able to provide informed consent
  • Patient diagnosed with treatment-resistant depression
  • Outpatient recommended and approved by psychiatrist for ketamine treatment
  • Individuals who have previously received ECT, rTMS or any other neuromodulation can also receive ketamine
Exclusion Criteria
  • History of psychosis/comorbid psychiatric disorders/psychotic depression/dissociative syndromes, significant personality disorder, as clinically assessed by psychiatrist
  • Using non-prescribed substance (e.g., cannabis) or alcohol use within the preceding 48 hours of treatment
  • History of substance misuse and/or dependence, including chronic alcohol abuse
  • Previous ketamine use
  • Acute dementia/delirium
  • Pregnancy/breastfeeding
  • Previous sensitivity to ketamine or related compounds
  • Unstable medical condition which may require anesthesia consult
  • History of elevated intracranial pressure or cerebrovascular accident
  • Recent (within 6 weeks) major cardiovascular event (such as myocardial infarction)

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Treatment-resistant Major Depressive Disorder (MDD); DSM-5 Diagnosis of MDDketamine hydrochloride-
Primary Outcome Measures
NameTimeMethod
Beck's Depression Inventory-IITreatment Day 1 to Day 8, an average of 4 weeks.

The BDI-II is a 21-item self-report assessment used to evaluate symptoms of depression. Each item is scored form 0-3, with a higher score representing more severe depression. The total score ranges from 0-63, with a score \>29 indicating severe depression.

Patient Health Questionnaire-9 itemTreatment Day 1 to Day 8, an average of 4 weeks.

The PHQ-9 is a 9 item self-report assessment used to evaluate symptoms of depression. Each item has a response of 0 (None at all), 1 (Several days), 2 (More than half the days), and 3 (Nearly every day). The scale ranges from 0-27, with higher scores indicating greater severity of depression symptoms.

Generalized Anxiety Disorder-7 itemTreatment Day 1 to Day 8, an average of 4 weeks.

The GAD-7 is a 7 item self-report assessment used to evaluate symptoms of anxiety. Each item has a response of 0 (Not at all), 1 (Several days), 2 (More than half the days), and 3 (Nearly every day). The scale ranges from 0-21, with higher scores indicating greater severity of anxiety symptoms.

Secondary Outcome Measures
NameTimeMethod
Adverse childhood experiences-10 itemBaseline

The Adverse childhood experiences-10 item (ACE-10) questionnaire is a 10-item self-report assessment used to evaluate a history of adverse childhood experiences in one's life. Each item is a distinct category of an adverse childhood experience, and the 10 items are typically organized into larger categories of abuse, neglect, and family dysfunction. With a minimum score of 0 and maximum score of 10, higher scores indicate having a greater quantity of adverse childhood experiences.

Primary care PTSD screen for DSM-5Baseline

The PC-PTSD-5 is a 5-item self-report assessment used to screen for probable PTSD within a primary care setting. Each item has a response option of 'Yes' or 'No.' The total score is the number of 'Yes' responses to the questions. A score of 0-3 indicates low probability of PTSD and 4 or more indicates probable PTSD.

Multidimensional Scale of Perceived Social Support scaleBaseline

The MSPSS is a 12-item self-report assessment used to evaluate an individual's perceived level of social support. Each item has 7 response options: 1 (Very strongly disagree); 2 (Strongly disagree); 3 (Mildly disagree); 4 (Neutral); 5 (Mildly agree); 6 (Strongly agree); 7 (Very strongly agree). The score ranges from 12-84, with higher scores indicating higher levels of perceived social support.

Personal Inventory for Depression and Seasonal Affective DisorderBaseline

The PIDS is a 6-item self-report assessment used to evaluate seasonal affective disorder. Each item has a response of 0 (no change), 1 (slight change), 2 (moderate change), 3 (marked change), 4 (extreme change). Higher scores indicate a greater change in behaviors or feelings with the seasons.

Quick Inventory of Depressive Symptomatology-Self ReportBaseline

The QIDS-SR is a 16-item self-report assessment used to evaluate symptoms of depression. The scoring range is from 0-27, with higher scores indicating more severe symptoms of depression.

Antidepressant Treatment History Form: Short FormBaseline

The Antidepressant Treatment History Form: Short Form (ATHF-SF) is a clinician-scored form to assess the adequacy of antidepressant treatment trials in the context of treatment-resistant depression. The form collects information regarding history of standard antidepressant medications use, such as SSRIs, SNRIs, TCAs, as well as neuromodulation and psychotherapy approaches. Previous treatments are checked off in a box, with more boxes checked meaning greater level of treatment resistance.

Subject Assessment of Memory ImpairmentBaseline

The SAMI is a brief 2-part self-report assessment used to evaluate self-assessed extent of memory impairment. Part 1 asks to rate memory problems on a scale of 0-10, with 0 indicating no memory problems and 10 indicating very severe memory problems. Part 2 asks to rate the impact of these problems on their work and social activities on a scale of 1-5; 1 indicating no complaints and normal activity, and 5 indicating the symptoms to radically change their normal work and social activities.

Family history of psychiatric conditions and neurological conditionsBaseline

Family history of health and psychiatric conditions is collected in a form with conditions alongside columns with family relationship. Individuals indicate the diagnosis of a relative for the relevant condition/ disorder by a checkmark in the appropriate box. Family history is collected for the following conditions: depression, bipolar disorder, schizophrenia, psychotic illnesses, anxiety disorder, substance abuse, suicide attempt, completed suicide, seizures, dementia, and other brain disorders.

Trial Locations

Locations (1)

Ontario Ketamine and Infusion Centre - Toronto Site

🇨🇦

Mississauga, Ontario, Canada

Ontario Ketamine and Infusion Centre - Toronto Site
🇨🇦Mississauga, Ontario, Canada

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