Clinical TrialTreatment-Resistant Depression (TRD)KetaminePlaceboRecruiting

Glutamate Emotion Memory Study

Randomised, double-blind, placebo-controlled parallel study (n=60) comparing a single IV ketamine infusion (0.5 mg/kg) to saline in patients with treatment-resistant depression to assess effects on autobiographical memory, emotional and reward processing, and brain connectivity.

Target Enrollment
60 participants
Study Type
Phase NA interventional
Design
Randomized, double Blind

Detailed Description

This randomised, double-blind, placebo-controlled parallel-group study in participants with treatment-resistant depression examines the acute effects of a single intravenous ketamine infusion (0.5 mg/kg) versus saline on autobiographical memory reconsolidation, emotional processing and reward learning, and associated brain connectivity.

Participants undergo screening, behavioural tasks, questionnaires, and an MRI scan after drug administration to measure changes in memory, emotion and network connectivity; outcomes will inform mechanisms of glutamatergic rapid-acting antidepressant effects.

Safety exclusions include active suicidality, bipolar disorder, psychosis, recent substance use disorder, pregnancy, significant cardiac or MRI contraindications; ketamine is administered for research purposes at an antidepressant dose.

Study Protocol

Preparation

sessions

Dosing

1 sessions

Integration

sessions

Study Arms & Interventions

Ketamine

experimental

Single intravenous antidepressant-dose ketamine infusion (0.5 mg/kg).

Interventions

  • Ketamine0.5 mg/kg
    via IV• single dose• 1 doses total

    Antidepressant dose, single infusion.

Placebo

inactive

Single intravenous saline infusion (0.9% sodium chloride).

Interventions

  • Placebo
    via IV• single dose• 1 doses total

    Saline placebo (0.9% sodium chloride).

Participants

Ages
20 – 60
Sexes
Male & Female

Inclusion Criteria

  • Inclusion Criteria:
  • Willing and able to give informed consent for participation in the study
  • Sufficiently fluent English to understand and complete the tasks
  • Registered with a GP and consents to GP being informed of participation in the study
  • Participants need to meet a number of concurrent clinical criteria:
  • Current criteria for Major Depressive Disorder, in a current major depressive episode as determined by the SCID-5.
  • Inadequate response to at least one and no more than three antidepressant treatments.
  • Currently taking a licensed antidepressant at a therapeutic dose for at least four weeks.
  • Pre-menopausal women and male participants engaging in sex with a risk of pregnancy must agree to use a highly effective method of contraception from Screening Visit until 30 days after receiving the study medication treatment.
  • Acceptable methods of contraception include:
  • Condoms
  • Combined (estrogen- and progestogen-containing) hormonal contraception associated with inhibition of ovulation: oral, intravaginal or transdermal
  • Progestogen-only hormonal contraception associated with inhibition of ovulation oral, injectable or implantable
  • Intrauterine device (IUD)
  • Intrauterine hormone-releasing system (IUS)
  • Bilateral tubal occlusion
  • Vasectomy (or vasectomised partner)
  • Sexual abstinence. [Periodic abstinence (calendar, symptothermal, post-ovulation methods), withdrawal (coitus interruptus), and spermicides only are not acceptable methods of contraception.]
  • Male participants must not donate sperm until 30 days after receiving the study medication.
  • Participants taking non-prescription/prescription medication may still be entered into the study, if, in the opinion of the Investigator, the medication received will not interfere with the study procedures or compromise safety
  • Willingness to refrain from driving, cycling, or operating heavy machinery, until the following morning or a restful sleep has occurred, whichever is later.
  • Willingness to refrain from drinking alcohol for 3 days before the infusion visit and one day before any of the other visits throughout the study.

Exclusion Criteria

  • Exclusion Criteria:
  • History of or current DSM-5 bipolar disorder, schizophrenia or emotionally unstable personality disorder [co-morbid anxiety disorders (including agoraphobia, generalized anxiety disorder, social anxiety disorder and panic disorder) and Posttraumatic Stress Disorder (PTSD) are allowed]
  • Diagnosis of a major cognitive disorder or evidence of cognitive impairment
  • Clinically significant risk of suicide
  • Participants undergoing or who have undergone electroconvulsive therapy for the treatment of the current episode of depression
  • Substance or alcohol use disorder over the past 6 months
  • Regular alcohol consumption of more than 21 units a week or excessive alcohol consumption up to three days before any of the in-person study visits or inability to abstain from alcohol for more than 3 days
  • Moderate cigarette use (> 10 cigarettes per day)
  • History of, or current general medical conditions that in the opinion of the Investigator may interfere with the safety of the participant or the scientific integrity of the study
  • Current pregnancy (as determined by urine pregnancy test), breastfeeding, planning a pregnancy, or unwillingness to practice birth control during the course of the study
  • Clinically significant abnormalities of laboratory tests, physical examination, or ECG. A participant with a clinical abnormality or parameters outside the reference range for the population being studied may be included only if the Investigator considers that the finding is unlikely to introduce additional risk factors and will not interfere with the study procedures
  • Current or past history of heart rhythm disorders
  • Clinically significant untreated hypertension
  • Any contraindication to MRI including claustrophobia, any trauma or surgery which may have left magnetic material in the body, magnetic implants or pacemakers, and inability to lie still for 1 hour or more
  • Previous participation in a study using the same, or similar, emotional processing tasks in the last three months
  • Previous lifetime use of ketamine or phencyclidine
  • Participant with planned medical treatment within the study period that might interfere with the study procedures
  • Participant who is unlikely to comply with the clinical study protocol or is unsuitable for any other reason, in the opinion of the Investigator.

Study Details

Locations

Department of Psychiatry, University of Oxford — Oxford, United Kingdom

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