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Trial registered on ANZCTR
Registration number
ACTRN12615000573550
Ethics application status
Approved
Date submitted
21/05/2015
Date registered
3/06/2015
Date last updated
25/10/2021
Date data sharing statement initially provided
25/10/2021
Date results provided
25/10/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
A randomised controlled study of an N-Methyl-D-Aspartate antagonist in major depression
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Scientific title
A randomised, double blind, active placebo-controlled crossover trial to evaluate the short term efficacy of an N-Methyl-D-Aspartate antagonist for patients with treatment resistant depression
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Secondary ID [1]
286248
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Depression
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Major depressive disorder
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Condition category
Condition code
Mental Health
294627
294627
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0
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Depression
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Ketamine IV. – bolus dose 0.25mg/kg then infusion at 0.25 mg/kg/hr for 45 minutes
Washout 3 weeks. Follow-ups at 1,7,14,21 days.
Study duration 42 days.
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Intervention code [1]
291266
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Treatment: Drugs
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Comparator / control treatment
Remifentanil IV. 0.1 ng /ml according to the Minto pharmacokinetic model for 8 minutes
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Control group
Active
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Outcomes
Primary outcome [1]
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Montomery-Asberg Depressive Rating Scale (MADRS)
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Assessment method [1]
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Timepoint [1]
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4 hours post administration
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Secondary outcome [1]
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BDNF plasma concentration
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Assessment method [1]
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Timepoint [1]
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4 hours post intervention
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Secondary outcome [2]
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Functional connectivity measured with electroencephalography (EEG)
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Assessment method [2]
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Timepoint [2]
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4 hours 30 minutes
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Eligibility
Key inclusion criteria
* Participant is willing and able to give informed consent for participation in the trial.
* Male or female, aged 18 years or above and less than 60.
* In the Investigators’ opinion, is able and willing to comply with all trial requirements.
* Major depressive disorder for at least three months, as assessed by a Clinical Interview using DSM-IV criteria
* MADRS >20
* An inadequate response to at least two antidepressants courses (Antidepressant Treatment History Form) one of which can include the current episode
* Stable on antidepressant medication for four weeks prior to Study Day 1
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Minimum age
18
Years
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Maximum age
60
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Female participant who is pregnant, lactating or planning pregnancy during the course of the trial.
* Significant renal or hepatic impairment.
* Cardiovascular conditions including abnormal heart rate and blood pressure checked at screening.
* Participants who have participated in another research trial involving an investigational product in the past 12 weeks.
* History of psychosis
* Any unstable medical or neurologic condition.
* Planned major changes to psychotropic medication.
* Imminent risk of suicide as determined by the CSSRS.
* Planned or probable use of ECT.
* Substance abuse or dependence in previous 6 months.
* Any history of abuse of ketamine or phencyclidine.
* Contraindication to the use of ketamine according to manufacturer guidelines.
* Planned use of ketamine, for example, for pain control.
* Unable to fast for four hours prior to each administration of trial drug.
* Any other condition judged by the treating clinician as likely to impact on the ability of the participant to complete the trial.
* Body-weight <50kg or >120kg.
* Current use of NMDA antagonist medications (e.g. memantine / amantadine / rimantadine / lamotrigine / dextromethorphan/procyclidine).
* Inability to speak or read English.
* Contraindications for MRI scanning
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
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Intervention assignment
Crossover
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Other design features
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Phase
Phase 2 / Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/08/2016
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Actual
27/10/2016
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Date of last participant enrolment
Anticipated
1/12/2018
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Actual
16/08/2018
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Date of last data collection
Anticipated
1/02/2019
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Actual
5/10/2018
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Sample size
Target
30
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Accrual to date
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Final
30
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Recruitment outside Australia
Country [1]
6685
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New Zealand
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State/province [1]
6685
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Royal Society of New Zealand
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Address [1]
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11 Turnbull St,
Thorndon,
Wellington 6011
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Country [1]
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New Zealand
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Primary sponsor type
University
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Name
University of Auckland
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Address
Private Bag 92019
Auckland 1142
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
289496
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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HDEC Northern
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Ethics committee address [1]
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Ministry of Health No 1 The Terrace PO Box 5013 Wellington, 6011
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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10/03/2015
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Approval date [1]
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14/05/2015
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Ethics approval number [1]
292435
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Summary
Brief summary
Depression is the most prevalent mental health disorder in New Zealand. Although many treatments are available for approximately one third of patients these treatments will be ineffective and they will be classified as "treatment-resistant". New research indicates that the approved medicine ketamine given at low doses can be used successfully as antidepressant in approximately two thirds of patients with treatment resistant depression. Moreover ketamine’s rapid antidepressant actions, within several hours, make it remarkable compared to usual therapies. In addition to offering hope to patients, for scientists studying depression ketamine allows new opportunities to study the disease. In this study we will give patients with treatment-resistant depression ketamine to rapidly move them from a state of depression to nondepression. We will use brain imaging technologies and blood biomarkers to attempt to understand what processes occur in these patients that underlie the transition to elevated mood.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Suresh Muthukumaraswamy
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Address
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School of Pharmacy
The University of Auckland
Private Bag 92019
Auckland 1142
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Country
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New Zealand
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Phone
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+64 9373 7599 ext:85398
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
55267
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Suresh Muthukumaraswamy
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Address
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School of Pharmacy
The University of Auckland
Private Bag 92019
Auckland 1142
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Country
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New Zealand
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Phone
55267
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+64 9373 7599 ext:85398
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Suresh Muthukumaraswamy
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Address
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School of Pharmacy
The University of Auckland
Private Bag 92019
Auckland 1142
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Country
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New Zealand
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Phone
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+64 9373 7599 ext:85398
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Ketamine improves short-term plasticity in depression by enhancing sensitivity to prediction errors.
2020
https://dx.doi.org/10.1016/j.euroneuro.2020.07.009
N.B. These documents automatically identified may not have been verified by the study sponsor.
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