Pharmacologic treatment augmentation in chronic depression randomised, controlled, double-blinded, Phase II study
Randomised, double-blinded, placebo-controlled Phase II trial (n=60) testing intravenous ketamine (Ketamin Inresa) with CBASP versus placebo+CBASP and ketamine+treatment-as-usual for chronic, treatment-resistant depression in Germany.
Detailed Description
Multi-arm, randomised, double-blinded Phase II study evaluating whether adding intravenous ketamine to CBASP leads to greater reduction in depressive symptoms versus placebo plus CBASP and versus ketamine plus treatment as usual.
Primary outcome is change in MADRS from baseline to six weeks after end of combination treatment; secondary outcomes include longer-term MADRS changes and self-reported BDI scores up to three months follow-up.
Active product: Ketamin Inresa (intravenous infusion). Placebo comparator: 0.9% NaCl infusion. CBASP is delivered as structured psychotherapy for relevant arms.
Study Protocol
Preparation
Dosing
Integration
Therapeutic Protocol
Study Arms & Interventions
Ketamine + CBASP
experimentalIntravenous ketamine (Ketamin Inresa) combined with structured CBASP psychotherapy.
Interventions
- Ketaminevia IV• per protocol
Ketamin Inresa 2 ml intravenous infusion; dose and schedule per protocol; combined with CBASP psychotherapy.
Placebo + CBASP
inactiveIntravenous placebo (0.9% NaCl) combined with CBASP psychotherapy.
Interventions
- Placebovia IV• per protocol
Fresenius Kabi 0.9% NaCl infusion as placebo; combined with CBASP psychotherapy.
Ketamine + TAU
experimentalIntravenous ketamine with treatment as usual (no CBASP group therapy).
Interventions
- Ketaminevia IV• per protocol
Ketamin Inresa 2 ml intravenous infusion; participants receive treatment as usual rather than CBASP.
Participants
Inclusion Criteria
- Age 18–64 years.
- Diagnosis of chronic depression (recurrent depressive disorder, moderate or severe episodes with no full remission between episodes, or an acute depressive episode lasting ≥2 years).
- Treatment-resistant stage 2 (at least two adequate antidepressant trials from two different classes) or insufficient response after ≥12 sessions of psychotherapeutic treatment.
- Ability to understand and voluntarily sign informed consent and to comply with protocol and visit schedule.
- Contraception: males must use condoms during heterosexual contact from first infusion until 65 days after last infusion and must not donate semen; females of childbearing potential must use two reliable forms of contraception simultaneously or practice complete abstinence from study start until 28 days after last infusion.
Exclusion Criteria
- Acute substance misuse as primary diagnosis.
- Neurologic disorders (stroke, cerebral ischaemia, tumour, cerebral infection, autoimmune neurological disease).
- Conditions increasing intracranial pressure or circulatory disturbances of the brain.
- Pregnancy or lactation.
- Participation in another clinical study or receipt of investigational therapy that would interfere with the primary end point.
- Epilepsy.
- Known hypersensitivity to the investigational medicinal products or excipients.
- Prior pretreatment with ketamine hydrochloride and/or CBASP.
- Uncontrolled arterial hypertension (resting systolic/diastolic >150/100 mmHg).
- Untreated hyperthyroidism.
- Unstable angina pectoris or myocardial infarction within the last six months.
- Increased intraocular pressure (glaucoma) or perforating eye injury.
- Recent interventions in the area of the upper respiratory passages.
Study Details
- StatusActive not recruiting
- PhasePhase II
- Typeinterventional
- DesignRandomizeddouble Blind
- Target Enrollment60 participants
- TimelineStart: 2019-07-19End: 2024-12-31
- Compounds
- Topic