- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03475277
Stanford Regulating Circuits of the Brain Study- Ketamine (RBRAIN-KET)
Mapping the Influence of Drugs of Abuse on Risk and Reward Circuits
Study Overview
Detailed Description
The investigators will assess the effect of acute ketamine modulation on the functioning of reward-related human brain circuits. Reward-related brain circuits will be assessed using functional magnetic resonance imaging.
Participants will include volunteers who report more than two prior uses of ketamine (also known as "Special K"), when they were 18 years or older.
The investigators will recruit individuals who have previously tried ketamine rather than those who are ketamine-naïve.
Participants will receive an IV infusion of ketamine (~.05mg/kg and 0.5mg/kg) or placebo (saline). Following established procedures, these three sessions will be randomized in a blinded protocol in order to limit expectancy effects.
Throughout each session, participants will be monitored. Functional imaging will commence after the drug has reached peak levels, following previously established time courses for ketamine infusion. Participants will also be monitored after the functional imaging session. Secondary effects of ketamine on behavior and self-reported experience will be assessed.
In the assessment of the acute effects of ketamine, the investigators will take into account the cumulative effects of prior drug exposure.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Claire Bertrand
- Phone Number: (650) 721-8707
- Email: Claireeb@stanford.edu
Study Locations
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California
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Palo Alto, California, United States, 94304
- Recruiting
- Stanford Psychiatry
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Contact:
- Claire Bertrand
- Phone Number: 650-721-8707
- Email: claireeb@stanford.edu
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Ages 18-55 years
- At least 2 prior uses of ketamine when aged 18+
- BMI within healthy range (18-30)
- Ability to speak, read, or understand English
Exclusion Criteria:
- Current active suicide ideation or history of suicide attempts
- Current mood, anxiety, eating, psychotic, or substance use disorder
- Lifetime psychotic or bipolar disorder
- Schizophrenia in a first degree relative
- Current use of psychotropic medication
- Prior adverse ketamine response
- Allergy or hypersensitivity to ketamine
- Use of ketamine in past 7 days
- Cannabis use in the past 7 days, illicit recreational drug use in the 48 hours prior to sessions, and/or alcohol use in the 24 hours prior to sessions
- Concurrent use of any medications that might increase the risk of participation (e.g., drug interactions)
- History of epilepsy, convulsions, seizures, LOC >10 min
- Renal/hepatic impairment
- Hypertension (Stage 1 defined as systolic blood pressure >140 mmHg or diastolic blood pressure >90 mmHg on 2 of 3 measurements at least 15 min apart at initial screening; systolic blood pressure >155 mmHg or diastolic blood pressure >99 mmHg on 2 of 3 measurements at least 15 min apart during infusion visits)
- Heart rate <50 bpm or >150 bpm at initial screening
- Chronic congestive heart failure, tachyarrhythmias, myocardial ischemia assessed via EKG at initial screening
- EKG QTcF intervals >430 ms for men and >470 ms for women
- Direct physical access to or routine handling of addicting drugs in the regular course of work duties
- MRI contraindication
- Pregnant or nursing females
Study Plan
How is the study designed?
Design Details
- Observational Models: Other
- Time Perspectives: Other
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Volunteers
Participants will receive an IV infusion of ketamine (~.05mg/kg and 0.5mg/kg) or placebo. Ketamine is an FDA-approved dissociative anesthetic. The study doses are in the subanesthetic range. During the infusion, an ACLS-certified psychiatrist or anesthesiologist will provide continuous monitoring. Afterwards, patients will be monitored on-site by an ACLS-certified MD or highly skilled research nursing staff, and an on-call emergency response team for 4 hours (ketamine's half-life is 15 min; 4 hrs= 16 half-lives). |
Acute administration
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Circuit activation as assessed by functional magnetic resonance imaging
Time Frame: Up to 2 weeks after infusion of ketamine or placebo
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During functional magnetic resonance imaging the reward and negative affect circuits will be engaged by reward and related emotional tasks, and circuit activation will be quantified by blood flow in regions of interest and the extent of functional connectivity between them
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Up to 2 weeks after infusion of ketamine or placebo
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Behavioral responses on the WebNeuro computerized test battery assessing cognitive capacity
Time Frame: Up to 5 hours after infusion of ketamine or placebo
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Accuracy data are quantified as number of errors and lower values indicate better performance
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Up to 5 hours after infusion of ketamine or placebo
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Self-reported responses as assessed by the 21-item Depression, Anxiety and Stress Scale (DASS)
Time Frame: Up to 5 hours after infusion of ketamine or placebo
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Responses are quantified on a 4-point scale and summed for total DASS score and for each Depression, Anxiety and Subscale score.
Higher scores indicate more severe symptoms of depression, anxiety and stress
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Up to 5 hours after infusion of ketamine or placebo
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Level of subjectively experienced intoxication, dissociation, and mood and feelings as assessed by rating scale.
Time Frame: Up to 5 hours after infusion of ketamine or placebo
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Responses will be quantified in intervals of 10 on a visual analogue of 1 to 100
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Up to 5 hours after infusion of ketamine or placebo
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Self-reported responses as assessed by the 29-item Rotter's Locus of Control (RLoC)
Time Frame: Up to 5 hours after infusion of ketamine or placebo
|
Responses are quantified as a summed score from 0 to 23 and determine the degree to which a person perceives an outcome as being contingent on their own actions or those of external forces.
Higher scores indicate greater levels of external locus of control.
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Up to 5 hours after infusion of ketamine or placebo
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Self-reported responses as assessed by the 15-item Mini Brief Risk-Resilience Index for Screening (BRISC).
Time Frame: Up to 5 hours after infusion of ketamine or placebo
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Responses are quantified on a 5-point Likert scale and is a measure of emotional self-regulation.
Scores measure three core domains: negativity bias, emotional resilience, and social skills.
Higher scores indicate higher functioning and better coping.
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Up to 5 hours after infusion of ketamine or placebo
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Self-reported responses as assessed by the 14-item Snaith-Hamilton Please Scale (SHAPS).
Time Frame: Up to 5 hours after infusion of ketamine or placebo
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Responses are quantified on a 4-point scale and measures anhedonia, the inability to experience pleasure.
Scores measure domains of social interaction, food and drink, sensory experience, and interest/pastimes.
An "abnormal" score is defined as 3 or more.
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Up to 5 hours after infusion of ketamine or placebo
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Self-reported responses as assessed by the 24-item Dimensional Apathy Scale (DAS).
Time Frame: Up to 5 hours after infusion of ketamine or placebo
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Responses are quantified on a 4-point scale and measure demotivation in three domains: executive apathy, emotional apathy, and initiation apathy.
Higher scores indicate higher apathy level.
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Up to 5 hours after infusion of ketamine or placebo
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Self-reported responses as assessed by the 18-item Motivation and Pleasure Scale Self-Report (MAP-SR).
Time Frame: Up to 5 hours after infusion of ketamine or placebo
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Responses are quantified on a 5-point Likert scale and assesses an individual's motivation and pleasure.
Higher scores indicate higher levels of motivation and pleasure.
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Up to 5 hours after infusion of ketamine or placebo
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Self-reported responses as assessed by the 17-item Dimensional Anhedonia Rating Scale (DARS).
Time Frame: Up to 5 hours after infusion of ketamine or placebo
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Responses are summed on a 5-point scale.
Scores assess interest, motivation, effort, and consummatory pleasure across four domains: hobbies, food/drink, social activities, and sensory experiences.
Lower scores represent a higher level of anhedonia.
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Up to 5 hours after infusion of ketamine or placebo
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Self-reported responses as assessed by the 94-item 5-Dimensional Altered States of Consciousness Rating Scale (DASC).
Time Frame: Up to 5 hours after infusion of ketamine or placebo
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Responses are recorded on a sliding scale with one side reading 'No, not more than usually' and the opposite reading 'Yes, much more than usually'.
More agreeance to the statements represents that the individual is experiencing higher levels of altered states of consciousness.
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Up to 5 hours after infusion of ketamine or placebo
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Self-reported responses as assessed by the 23-item Clinician Administered Dissociative States Scale (CADSS).
Time Frame: Up to 5 hours after infusion of ketamine or placebo
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Responses are summed on a 5-point scale in rating one's agreeance to the dissociative statements as 'not at all' to 'extreme'.
Scores assess individual's dissociative state.
A higher score represents more dissociation.
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Up to 5 hours after infusion of ketamine or placebo
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Self-reported responses as assessed by a clinician on the 18-item Brief Psychiatric Rating Scale (BPRS).
Time Frame: Up to 5 hours after infusion of ketamine or placebo
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Responses are summed on a 7-point scale in rating one's severity to the statements as 'not assessed' to 'extremely severe'.
Scores assess psychiatric symptoms like anxiety, depression, and psychoses.
A higher score means the individual is presenting more extreme symptoms.
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Up to 5 hours after infusion of ketamine or placebo
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Steroid hormone assay via saliva collection
Time Frame: Up to 5 hours after infusion of ketamine or placebo
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At 5 different time points throughout infusion visits the participant chews on a cotton swab for 30 seconds to collect saliva.
A steroid hormone assay is conducted to collect data on cortisol, testosterone, progesterone, and estradiol levels.
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Up to 5 hours after infusion of ketamine or placebo
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Leanne M Williams, PhD, Study PI
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- 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
- Ketamine
Other Study ID Numbers
- 41173
- 1P50DA042012-01A1 (U.S. NIH Grant/Contract)
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.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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