The Effects of Ketamine and Guanfacine on Working Memory in Healthy Subjects (GuaKet)

July 20, 2017 updated by: Yale University

The purpose of the study is

  1. To establish the feasibility of fMRI studies of the interaction of guanfacine and ketamine.
  2. To explore the possibility that guanfacine can ameliorate the negative effects of ketamine on task-related prefrontal activation.
  3. To assess the strength of any interaction between guanfacine and ketamine.

Study Overview

Status

Completed

Intervention / Treatment

Detailed Description

Potential subjects will be interviewed over the phone and, if appropriate, will be scheduled for a screening session. Participants who meet study criteria will participate in two study sessions separated by at least two weeks. The sessions will be identical except on one day they will receive guanfacine and on the other, they will receive a placebo.

This study was initially completed in 2014. Upon analysis of the collected data, it was decided to add additional subjects and gather additional data to verify results seen in the collected data. The study was reopened and new data was added beginning in September 2016. Information about the study beginning in 2016 is available in a separate record.

Study Type

Interventional

Enrollment (Actual)

16

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Connecticut
      • New Haven, Connecticut, United States, 06511
        • Connecticut Mental Health Center
      • New Haven, Connecticut, United States, 06520
        • Yale Magnetic Resonance Research Center
      • West Haven, Connecticut, United States, 06516
        • Veterans Affairs Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

21 years to 45 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Age between 21 and 45, inclusive
  • Right-handed
  • Have at least a 12th grade education level or equivalent
  • Able to read and write English as a primary language
  • Willing to refrain from caffeine and alcohol use for one week prior to each MRI session.

Exclusion Criteria:

  • Abnormality on physical examination
  • A 12 lead ECG at screening has clinically significant abnormalities as determined by the physician reading the ECG
  • A positive pre-study urine drug screen or, at the study physicians' discretion on any drug screens given before the scans
  • Abnormality on clinical chemistry or hematology examination at the pre-study medical screening.
  • History of positive HIV or Hepatitis B.
  • Has received either prescribed or over-the-counter (OTC) centrally active medicine or herbal supplements within the week prior to the MRI scan.
  • History of any substance abuse disorder meeting DSM-IV criteria with the exception of nicotine
  • Any history of DSM-IV Axis I psychiatric disorders,
  • Any history of major medical or neurological disorders
  • Any history indicating learning disability, mental retardation, or attention deficit disorder.
  • First-degree relative with Axis I DSM-IV disorder including substance abuse or dependence.
  • Any clinically significant abnormalities on screening electrocardiogram
  • Any history of head injury
  • Any evidence of psychosis-like symptoms, as indicated by elevated scores on the Perceptual Aberration-Magical Ideation (Chapman, Chapman et al. 1978; Eckblad, Chapman et al. 1983) and the revised Social Anhedonia scales(Eckblad, Chapman et al. unpublished)
  • A positive urine toxicology screen for illicit substance use or positive alcohol breathalyzer test conducted at screening interview and prior to each MRI session
  • Known sensitivity to ketamine.
  • Body circumference of 52 inches or greater.
  • History of claustrophobia
  • Any clinically significant impairment of color vision or visual acuity after correction available in the scanner.
  • Presence of cardiac pacemaker or other electronic device or ferromagnetic metal foreign bodies in vulnerable positions as assessed by a standard pre-MRI screening questionnaire
  • Pregnancy or breast-feeding would exclude potential participants and all female subjects will receive a urine pregnancy test at screening and before each MRI scan.
  • Donation of blood in excess of 500 mL within 56 days prior to dosing.
  • History of sensitivity to heparin or heparin-induced thrombocytopenia.
  • Blood pressure must be higher than 90/70. Pulse must be greater than 40 unless the participant is cleared by a study physician

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Basic Science
  • Allocation: Randomized
  • Interventional Model: Crossover Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Guanfacine then Placebo
During the first study session, the participant will receive guanfacine before undergoing a ketamine-infusion fMRI. During the second study session, at least two weeks later, the participant will receive a placebo before undergoing a ketamine-infusion fMRI.
Subjects will be given 3mg of guanfacine before the fMRI scan. Then when in the scanner, a bolus of ketamine (0.23mg/kg over 1 min) will be given during the visual fixation scan. Immediately after completion of the 1 min bolus, the participant will receive a steady state ketamine infusion of 0.58 mg/kg/hour and brain activation will be measured during a spatial working memory task. The entire scan will last approximately two and a half hours and the ketamine infusion will be up to one hour and 15 minutes.
Subjects will be given a placebo before the fMRI scan. Then when in the scanner, a bolus of ketamine (0.23mg/kg over 1 min) will be given during the visual fixation scan. Immediately after completion of the 1 min bolus, the participant will receive a steady state ketamine infusion of 0.58 mg/kg/hour and brain activation will be measured during a spatial working memory task. The entire scan will last approximately two and a half hours and the ketamine infusion will be up to one hour and 15 minutes.
Active Comparator: Placebo then Guanfacine
During the first study session, the participant will receive a placebo before undergoing a ketamine-infusion fMRI. During the second study session, at least two weeks later, the participant will receive guanfacine before undergoing a ketamine-infusion fMRI.
Subjects will be given 3mg of guanfacine before the fMRI scan. Then when in the scanner, a bolus of ketamine (0.23mg/kg over 1 min) will be given during the visual fixation scan. Immediately after completion of the 1 min bolus, the participant will receive a steady state ketamine infusion of 0.58 mg/kg/hour and brain activation will be measured during a spatial working memory task. The entire scan will last approximately two and a half hours and the ketamine infusion will be up to one hour and 15 minutes.
Subjects will be given a placebo before the fMRI scan. Then when in the scanner, a bolus of ketamine (0.23mg/kg over 1 min) will be given during the visual fixation scan. Immediately after completion of the 1 min bolus, the participant will receive a steady state ketamine infusion of 0.58 mg/kg/hour and brain activation will be measured during a spatial working memory task. The entire scan will last approximately two and a half hours and the ketamine infusion will be up to one hour and 15 minutes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percent Change in Amelioration of Ketamine-related Task Activation as Measured by Functional Magnetic Resonance Imaging in Inferior Parietal Lobule
Time Frame: Within 4 hours of dose administration, after up to 1.25 hours of ketamine infusion

Scans will be analyzed for task-related prefrontal activation

Difference Score: Percent Signal Change in Regions of Interest (ketamine - saline)

Within 4 hours of dose administration, after up to 1.25 hours of ketamine infusion
Percent Change in Amelioration of Ketamine-related Task Activation as Measured by Functional Magnetic Resonance Imaging in Middle Frontal Gyrus
Time Frame: Within 4 hours of dose administration, after up to 1.25 hours of ketamine infusion
Difference Score: Percent Signal Change in Regions of Interest (ketamine - saline)
Within 4 hours of dose administration, after up to 1.25 hours of ketamine infusion
Percent Change in Amelioration of Ketamine-related Task Activation as Measured by Functional Magnetic Resonance Imaging in Superior Frontal Gyrus
Time Frame: Within 4 hours of dose administration, after up to 1.25 hours of ketamine infusion
Difference Score: Percent Signal Change in Regions of Interest (ketamine - saline)
Within 4 hours of dose administration, after up to 1.25 hours of ketamine infusion

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: John H Krystal, M.D., Yale University
  • Study Director: Naomi R Driesen, Ph.D., Yale University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

August 1, 2008

Primary Completion (Actual)

December 1, 2014

Study Completion (Actual)

December 1, 2014

Study Registration Dates

First Submitted

May 15, 2012

First Submitted That Met QC Criteria

May 16, 2012

First Posted (Estimate)

May 17, 2012

Study Record Updates

Last Update Posted (Actual)

August 21, 2017

Last Update Submitted That Met QC Criteria

July 20, 2017

Last Verified

July 1, 2017

More Information

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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