Trial Outcomes & Findings for Trial of the Rapid Antisuicidal Effects of Intranasal Ketamine in Comorbid Depression and Alcohol Abuse (NCT NCT03539887)

NCT ID: NCT03539887

Last Updated: 2023-03-01

Results Overview

The scale contains 19 items rated on a scale from 0 to 2, allowing score range from 0 to 38, score over 4 (first five items) will be considered inclusion criteria. Higher values indicate worsening or presence of suicidal ideation.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

33 participants

Primary outcome timeframe

24 hours

Results posted on

2023-03-01

Participant Flow

5 participants who were enrolled were not randomized and did not start the study.

Participant milestones

Participant milestones
Measure
Intranasal Ketamine
Intranasal ketamine Intranasal ketamine: Intranasal ketamine will be prepared as 100mg/ml ketamine in 0.9% saline. An mucosal atomization device will be used to provide 5 intranasal applications of solution (volume 100 μl), separated by 3 minutes, over a total of 15 minutes. Each of five ketamine applications will provide 10 mg of study drug, for a total of 50mg. The dose to be used (0.5-1mg/Kg) is 6 to 18 times lower than the sedation dose (6-9mg/Kg).
Placebo
non-active placebo Placebo: Saline alone. An mucosal atomization device will be used to provide 5 intranasal applications of saline (volume 100 μl), separated by 3 minutes, over a total of 15 minutes.
Overall Study
STARTED
17
11
Overall Study
COMPLETED
17
11
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Trial of the Rapid Antisuicidal Effects of Intranasal Ketamine in Comorbid Depression and Alcohol Abuse

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Intranasal Ketamine
n=17 Participants
Intranasal ketamine Intranasal ketamine: Intranasal ketamine will be prepared as 100mg/ml ketamine in 0.9% saline. An mucosal atomization device will be used to provide 5 intranasal applications of solution (volume 100 μl), separated by 3 minutes, over a total of 15 minutes. Each of five ketamine applications will provide 10 mg of study drug, for a total of 50mg. The dose to be used (0.5-1mg/Kg) is 6 to 18 times lower than the sedation dose (6-9mg/Kg).
Placebo
n=11 Participants
non-active placebo Placebo: Saline alone. An mucosal atomization device will be used to provide 5 intranasal applications of saline (volume 100 μl), separated by 3 minutes, over a total of 15 minutes.
Total
n=28 Participants
Total of all reporting groups
Age, Continuous
39 years
STANDARD_DEVIATION 9 • n=99 Participants
38.5 years
STANDARD_DEVIATION 13.8 • n=107 Participants
38.8 years
STANDARD_DEVIATION 11.1 • n=206 Participants
Sex: Female, Male
Female
5 Participants
n=99 Participants
2 Participants
n=107 Participants
7 Participants
n=206 Participants
Sex: Female, Male
Male
12 Participants
n=99 Participants
9 Participants
n=107 Participants
21 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants
n=99 Participants
0 Participants
n=107 Participants
3 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
14 Participants
n=99 Participants
11 Participants
n=107 Participants
25 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Asian
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Black or African American
3 Participants
n=99 Participants
3 Participants
n=107 Participants
6 Participants
n=206 Participants
Race (NIH/OMB)
White
11 Participants
n=99 Participants
8 Participants
n=107 Participants
19 Participants
n=206 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Unknown or Not Reported
3 Participants
n=99 Participants
0 Participants
n=107 Participants
3 Participants
n=206 Participants
Region of Enrollment
United States
17 Participants
n=99 Participants
11 Participants
n=107 Participants
28 Participants
n=206 Participants

PRIMARY outcome

Timeframe: 24 hours

Population: Data for this outcome measure were not collected for 1 participant in the placebo arm.

The scale contains 19 items rated on a scale from 0 to 2, allowing score range from 0 to 38, score over 4 (first five items) will be considered inclusion criteria. Higher values indicate worsening or presence of suicidal ideation.

Outcome measures

Outcome measures
Measure
Placebo
n=10 Participants
non-active placebo Placebo: Saline alone. An mucosal atomization device will be used to provide 5 intranasal applications of saline (volume 100 μl), separated by 3 minutes, over a total of 15 minutes.
Intranasal Ketamine
n=17 Participants
Intranasal ketamine Intranasal ketamine: Intranasal ketamine will be prepared as 100mg/ml ketamine in 0.9% saline. An mucosal atomization device will be used to provide 5 intranasal applications of solution (volume 100 μl), separated by 3 minutes, over a total of 15 minutes. Each of five ketamine applications will provide 10 mg of study drug, for a total of 50mg. The dose to be used (0.5-1mg/Kg) is 6 to 18 times lower than the sedation dose (6-9mg/Kg).
Suicidal Ideation as Assessed by the Scale for Suicide Ideation (SSI)
12.3 score on a scale
Standard Deviation 7.83
10.8 score on a scale
Standard Deviation 8.08

SECONDARY outcome

Timeframe: 24 hours

Population: Data for this outcome measure were not collected for 1 participant in the placebo arm.

It has ten items, each item yields a score of 0 to 6. Hence the overall score ranges from 0 to 60. Higher scores indicate more severe depression.

Outcome measures

Outcome measures
Measure
Placebo
n=10 Participants
non-active placebo Placebo: Saline alone. An mucosal atomization device will be used to provide 5 intranasal applications of saline (volume 100 μl), separated by 3 minutes, over a total of 15 minutes.
Intranasal Ketamine
n=17 Participants
Intranasal ketamine Intranasal ketamine: Intranasal ketamine will be prepared as 100mg/ml ketamine in 0.9% saline. An mucosal atomization device will be used to provide 5 intranasal applications of solution (volume 100 μl), separated by 3 minutes, over a total of 15 minutes. Each of five ketamine applications will provide 10 mg of study drug, for a total of 50mg. The dose to be used (0.5-1mg/Kg) is 6 to 18 times lower than the sedation dose (6-9mg/Kg).
Depression as Assessed by the Montgomery-Åsberg Depression Rating Scale (MADRS)
22.5 score on a scale
Standard Deviation 17.7
16.8 score on a scale
Standard Deviation 13.7

SECONDARY outcome

Timeframe: 24 hours

Population: Data for this outcome measure were not collected for 1 participant in the placebo arm.

The Snaith-Hamilton Pleasure Scale (SHAPS) is an assessment of anhedonia, which is the inability to experience pleasure. The SHAPS has 14 items. Each item has four possible responses: strongly disagree, disagree, agree, or strongly agree. A response of "strongly disagree" or "disagree" equals one point, and a response of "strongly agree" or "agree" equals 0 points. Thus, the final score ranges from 0 to 14. A score of 2 or less constitutes a "normal" score, while an "abnormal" score is defined as 3 or more.

Outcome measures

Outcome measures
Measure
Placebo
n=10 Participants
non-active placebo Placebo: Saline alone. An mucosal atomization device will be used to provide 5 intranasal applications of saline (volume 100 μl), separated by 3 minutes, over a total of 15 minutes.
Intranasal Ketamine
n=17 Participants
Intranasal ketamine Intranasal ketamine: Intranasal ketamine will be prepared as 100mg/ml ketamine in 0.9% saline. An mucosal atomization device will be used to provide 5 intranasal applications of solution (volume 100 μl), separated by 3 minutes, over a total of 15 minutes. Each of five ketamine applications will provide 10 mg of study drug, for a total of 50mg. The dose to be used (0.5-1mg/Kg) is 6 to 18 times lower than the sedation dose (6-9mg/Kg).
Snaith-Hamilton Pleasure Scale
5.00 score on a scale
Standard Deviation 4.29
4.12 score on a scale
Standard Deviation 4.81

SECONDARY outcome

Timeframe: 24 hours

Population: Data for this outcome measure were not collected for 1 participant in the ketamine arm and one participant in the placebo arm.

Alcohol Urge Questionnaire (AUQ) is a multi-item measure of self-reported urges to drink alcohol, predictor of drinking abuse and relapse. AUQ is an 8-item questionnaire. Each item is scored on a 1 to 7 scale (Strongly Disagree = 1 and Strongly Agree = 7). Items 2 and 7 are reverse scored. Total score ranges from 8 to 56, and a higher score reflects greater craving.

Outcome measures

Outcome measures
Measure
Placebo
n=10 Participants
non-active placebo Placebo: Saline alone. An mucosal atomization device will be used to provide 5 intranasal applications of saline (volume 100 μl), separated by 3 minutes, over a total of 15 minutes.
Intranasal Ketamine
n=16 Participants
Intranasal ketamine Intranasal ketamine: Intranasal ketamine will be prepared as 100mg/ml ketamine in 0.9% saline. An mucosal atomization device will be used to provide 5 intranasal applications of solution (volume 100 μl), separated by 3 minutes, over a total of 15 minutes. Each of five ketamine applications will provide 10 mg of study drug, for a total of 50mg. The dose to be used (0.5-1mg/Kg) is 6 to 18 times lower than the sedation dose (6-9mg/Kg).
Alcohol Urge Questionnaire (AUQ)
16.3 score on a scale
Standard Deviation 11.2
13.8 score on a scale
Standard Deviation 12.2

SECONDARY outcome

Timeframe: 24 hours

Population: Data for this outcome measure were not collected for 1 participant in the placebo arm

The YMRS has 11 items, and total score ranges from 0 to 88, with a higher score indicating greater mania.

Outcome measures

Outcome measures
Measure
Placebo
n=10 Participants
non-active placebo Placebo: Saline alone. An mucosal atomization device will be used to provide 5 intranasal applications of saline (volume 100 μl), separated by 3 minutes, over a total of 15 minutes.
Intranasal Ketamine
n=17 Participants
Intranasal ketamine Intranasal ketamine: Intranasal ketamine will be prepared as 100mg/ml ketamine in 0.9% saline. An mucosal atomization device will be used to provide 5 intranasal applications of solution (volume 100 μl), separated by 3 minutes, over a total of 15 minutes. Each of five ketamine applications will provide 10 mg of study drug, for a total of 50mg. The dose to be used (0.5-1mg/Kg) is 6 to 18 times lower than the sedation dose (6-9mg/Kg).
Manic Symptoms as Assessed by Score on the Young Mania Rating Scale (YMRS)
2.40 score on a scale
Standard Deviation 2.12
2.29 score on a scale
Standard Deviation 2.85

SECONDARY outcome

Timeframe: 24 hours

Population: Data for this outcome measure were not collected for 1 participant in the placebo arm.

The CADSS consists of 23 items, and each item is rated on a scale from 0 (not at all) to 4 (severe), with the total score ranging from 0 to 92. A higher score indicates greater severity of dissociative state.

Outcome measures

Outcome measures
Measure
Placebo
n=10 Participants
non-active placebo Placebo: Saline alone. An mucosal atomization device will be used to provide 5 intranasal applications of saline (volume 100 μl), separated by 3 minutes, over a total of 15 minutes.
Intranasal Ketamine
n=17 Participants
Intranasal ketamine Intranasal ketamine: Intranasal ketamine will be prepared as 100mg/ml ketamine in 0.9% saline. An mucosal atomization device will be used to provide 5 intranasal applications of solution (volume 100 μl), separated by 3 minutes, over a total of 15 minutes. Each of five ketamine applications will provide 10 mg of study drug, for a total of 50mg. The dose to be used (0.5-1mg/Kg) is 6 to 18 times lower than the sedation dose (6-9mg/Kg).
Dissociative State as Assessed by Score on Clinician-Administered Dissociative States Scale (CADSS)
1.60 score on a scale
Standard Deviation 3.20
0.824 score on a scale
Standard Deviation 2.90

Adverse Events

Intranasal Ketamine

Serious events: 0 serious events
Other events: 12 other events
Deaths: 0 deaths

Placebo

Serious events: 0 serious events
Other events: 4 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Intranasal Ketamine
n=17 participants at risk
Intranasal ketamine Intranasal ketamine: Intranasal ketamine will be prepared as 100mg/ml ketamine in 0.9% saline. An mucosal atomization device will be used to provide 5 intranasal applications of solution (volume 100 μl), separated by 3 minutes, over a total of 15 minutes. Each of five ketamine applications will provide 10 mg of study drug, for a total of 50mg. The dose to be used (0.5-1mg/Kg) is 6 to 18 times lower than the sedation dose (6-9mg/Kg).
Placebo
n=11 participants at risk
non-active placebo Placebo: Saline alone. An mucosal atomization device will be used to provide 5 intranasal applications of saline (volume 100 μl), separated by 3 minutes, over a total of 15 minutes.
Nervous system disorders
Cognitive side effect
70.6%
12/17 • Number of events 12 • 48 hours
36.4%
4/11 • Number of events 4 • 48 hours

Additional Information

Rodrigo Machado-Vieira, MD, PhD, MSc

The University of Texas Health Science Center at Houston

Phone: (713) 741-5000

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place