Ketamine Co-induction for Patients With Major Depressive Disorder
Ketamine Co-induction for Patients With Major Depressive Disorder; a Randomized Clinical Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Contact
Study Contact
- Name: Jonathan Gamble, MD
- Phone Number: 306-655-1183
- Email: j_gamble@yahoo.com
Study Contact Backup
- Name: Jordon Steeg, MD
- Phone Number: 306-222-9782
- Email: jordon.steeg@usask.ca
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Diagnosis of major depressive disorder
- Presentation for gynecologic surgery requiring a general anesthetic
Exclusion Criteria:
- Marked co-morbid cardiovascular disease
- Marked co-morbid respiratory disease
- History of intracranial hypertension
- History of seizures
- ASA Physical Status Classification IV or greater
- History of psychosis
- Current pregnancy
- Contraindication to ketamine administration
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: TRIPLE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
ACTIVE_COMPARATOR: Control Arm
As part of the patient's anesthetic induction, they will receive propofol and fentanyl.
|
As part of the patient's anesthetic induction, they will receive propofol.
As part of the patient's anesthetic induction, they will receive fentanyl.
|
|
ACTIVE_COMPARATOR: Ketamine Arm
As part of the patient's anesthetic induction, they will receive propofol, fentanyl, as well as ketamine hydrochloride.
|
As part of the patient's anesthetic induction, they will receive propofol.
As part of the patient's anesthetic induction, they will receive fentanyl.
As part of anesthetic induction, the addition of ketamine hydrochloride 0.5mg/kg.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Depression Severity
Time Frame: At time of discharge from post-anesthetic care unit, until 3 hours post operatvie
|
Severity of depression as measured by Montgomery-Asberg Depression Rating Scale (MADRS), 0-60 where 0 to 6 is normal, 7-19 is mild depression, 20-34 is moderate depression, and >34 is severe depression.
|
At time of discharge from post-anesthetic care unit, until 3 hours post operatvie
|
|
Depression Severity
Time Frame: 72 hours post-operative
|
Severity of depression as measured by Montgomery-Asberg Depression Rating Scale (MADRS), 0-60 where 0 to 6 is normal, 7-19 is mild depression, 20-34 is moderate depression, and >34 is severe depression.
|
72 hours post-operative
|
|
Depression Severity
Time Frame: 7-days post-operative
|
Severity of depression as measured by Montgomery-Asberg Depression Rating Scale (MADRS), 0-60 where 0 to 6 is normal, 7-19 is mild depression, 20-34 is moderate depression, and >34 is severe depression.
|
7-days post-operative
|
|
Depression Severity
Time Frame: 30-days post-operative
|
Severity of depression as measured by Montgomery-Asberg Depression Rating Scale (MADRS), 0-60 where 0 to 6 is normal, 7-19 is mild depression, 20-34 is moderate depression, and >34 is severe depression.
|
30-days post-operative
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Pain Score
Time Frame: Pre-operatively
|
Verbally reported numeric pain score (out of 10)
|
Pre-operatively
|
|
Pain Score
Time Frame: Upon discharge from PACU, up to 3 hours postoperative
|
Verbally reported numeric pain score (out of 10)
|
Upon discharge from PACU, up to 3 hours postoperative
|
|
Pain Score
Time Frame: 72 hours post-opertaive
|
Verbally reported numeric pain score (out of 10)
|
72 hours post-opertaive
|
|
Pain Score
Time Frame: 7-days post-op
|
Verbally reported numeric pain score (out of 10)
|
7-days post-op
|
|
Pain Score
Time Frame: 30-days post-op
|
Verbally reported numeric pain score (out of 10)
|
30-days post-op
|
|
Analgesia use
Time Frame: Pre-operatively
|
Morphine equivalents (in milligrams)
|
Pre-operatively
|
|
Analgesia use
Time Frame: Upon discharge from PACU, up to 3 hours postoperative
|
Morphine equivalents (in milligrams)
|
Upon discharge from PACU, up to 3 hours postoperative
|
|
Analgesia use
Time Frame: 72 hours post-operative
|
Morphine equivalents (in milligrams)
|
72 hours post-operative
|
|
Analgesia use
Time Frame: 7-days post-operative
|
Morphine equivalents (in milligrams)
|
7-days post-operative
|
|
Analgesia use
Time Frame: 30-days post-operative
|
Morphine equivalents (in milligrams)
|
30-days post-operative
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Berman RM, Cappiello A, Anand A, Oren DA, Heninger GR, Charney DS, Krystal JH. Antidepressant effects of ketamine in depressed patients. Biol Psychiatry. 2000 Feb 15;47(4):351-4. doi: 10.1016/s0006-3223(99)00230-9.
- Fond G, Loundou A, Rabu C, Macgregor A, Lancon C, Brittner M, Micoulaud-Franchi JA, Richieri R, Courtet P, Abbar M, Roger M, Leboyer M, Boyer L. Ketamine administration in depressive disorders: a systematic review and meta-analysis. Psychopharmacology (Berl). 2014 Sep;231(18):3663-76. doi: 10.1007/s00213-014-3664-5. Epub 2014 Jul 20.
- Kudoh A, Takahira Y, Katagai H, Takazawa T. Small-dose ketamine improves the postoperative state of depressed patients. Anesth Analg. 2002 Jul;95(1):114-8, table of contents. doi: 10.1097/00000539-200207000-00020.
- McGirr A, Berlim MT, Bond DJ, Fleck MP, Yatham LN, Lam RW. A systematic review and meta-analysis of randomized, double-blind, placebo-controlled trials of ketamine in the rapid treatment of major depressive episodes. Psychol Med. 2015 Mar;45(4):693-704. doi: 10.1017/S0033291714001603. Epub 2014 Jul 10.
- Lee EE, Della Selva MP, Liu A, Himelhoch S. Ketamine as a novel treatment for major depressive disorder and bipolar depression: a systematic review and quantitative meta-analysis. Gen Hosp Psychiatry. 2015 Mar-Apr;37(2):178-84. doi: 10.1016/j.genhosppsych.2015.01.003. Epub 2015 Jan 15.
- Larkin GL, Beautrais AL. A preliminary naturalistic study of low-dose ketamine for depression and suicide ideation in the emergency department. Int J Neuropsychopharmacol. 2011 Sep;14(8):1127-31. doi: 10.1017/S1461145711000629. Epub 2011 May 5.
- Caddy C, Giaroli G, White TP, Shergill SS, Tracy DK. Ketamine as the prototype glutamatergic antidepressant: pharmacodynamic actions, and a systematic review and meta-analysis of efficacy. Ther Adv Psychopharmacol. 2014 Apr;4(2):75-99. doi: 10.1177/2045125313507739.
Study record dates
Study Major Dates
Study Start (ANTICIPATED)
Study Start
Primary Completion (ANTICIPATED)
Primary Completion
Study Completion (ANTICIPATED)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ACTUAL)
First Posted
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Mental Disorders
- Mood Disorders
- Depressive Disorder
- Depressive Disorder, Major
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Anesthetics, Dissociative
- Anesthetics, Intravenous
- Anesthetics, General
- Anesthetics
- Excitatory Amino Acid Antagonists
- Excitatory Amino Acid Agents
- Analgesics, Opioid
- Narcotics
- Hypnotics and Sedatives
- Adjuvants, Anesthesia
- Ketamine
- Fentanyl
- Propofol
Other Study ID Numbers
Other Study ID Numbers
- Bio 18-19
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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