Ketamine for Suicidal Thoughts

Recruiting in Palo Alto (17 mi)

+1 other location

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Phase 1

Recruiting

Sponsor: Lindsay Maguire, MD

Disqualifiers: Psychosis, Mania, Liver transplant, others

No Placebo Group

Approved in 5 Jurisdictions

Trial Summary

What is the purpose of this trial?

There is currently no readily available pharmacologic intervention for suicidal ideation, a true psychiatric emergency, in the Emergency Department (ED). Investigators aim to trial low-dose, intravenous ketamine, a drug with well-established use in treatment-resistant depression, for patients who present to the ED with suicidal ideation.

Will I have to stop taking my current medications?

The trial protocol does not specify if you need to stop taking your current medications. However, if your medication would interfere with ketamine treatment, the treating physician might advise against participating.

How is the drug ketamine unique in treating suicidal thoughts?

Ketamine is unique in treating suicidal thoughts because it works quickly, often within hours, by affecting the brain's glutamate system, which is different from traditional antidepressants that can take weeks to show effects. ^{1 2 3 4 5}

Research Team

Eligibility Criteria

This trial is for individuals in the emergency department with suicidal thoughts or behaviors, who are fully conscious (GCS 15). It's not suitable for those with a history of psychosis, clinical intoxication, extreme blood pressure issues, pregnancy, inability to consent, known adverse reactions to ketamine, involuntary psychiatric hold or those needing medical admission.

Inclusion Criteria

You are exhibiting signs of active or passive suicidal behavior.

GCS 15

Exclusion Criteria

Allergy, intolerance, or previous adverse reaction to ketamine

Involuntary status

My blood pressure is not higher than 180/100.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

1 day

1 visit (in-person)

Treatment

Participants receive a single IV dose of ketamine and are observed in the ED for 2 hours

2 hours

1 visit (in-person)

Follow-up

Participants are monitored for changes in depressive and suicidal symptoms with surveys at 0, 2, 24, and 72 hours

72 hours

4 visits (virtual)

Hospitalization

Participants are transferred to a psychiatric hospital for further care and monitoring

up to 2 weeks

Treatment Details

Interventions

• Ketamine (NMDA Receptor Antagonist)

Trial Overview The study tests low-dose intravenous ketamine as an immediate treatment for patients presenting with suicidal ideation in the emergency department. The goal is to see if it's feasible and safe to use this drug that has shown promise in treating resistant depression.

Participant Groups

Group I: Ketamine Experimental Treatment 1 Intervention

All patients will receive the experimental drug.

Ketamine is already approved in Canada for the following indications:

Approved in Canada as Spravato for:

• Treatment-resistant depression

Find a Clinic Near You

Research Locations Nearby Select from list below to view details:

University of Kansas Strawberry Hill Campus Kansas City, KS

University of Kansas Medical Center Emergency Department Kansas City, KS

Who Is Running the Clinical Trial?

Lindsay Maguire, MD

Lead Sponsor

Trials

1

Patients Recruited

50+

University of Kansas Medical Center

Lead Sponsor

Trials

527

Patients Recruited

181,000+

Findings from Research

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Bipedicular percutaneous kyphoplasty versus unipedicular percutaneous kyphoplasty in the treatment of asymmetric osteoporotic vertebral compression fractures: a case control study. Liu, L., Song, F., Shang, J., et al.[2023]

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Zoledronic Acid in Osteoporotic Vertebral Compression Fractures Treated With Percutaneous Kyphoplasty: A Meta-Analysis. Tian, P., Liu, Y., Li, ZJ., et al.[2021]

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Conductive keratoplasty for the correction of hyperopia. Asbell, PA., Maloney, RK., Davidorf, J., et al.[2022]

The Sky kyphoplasty system (SK) was found to be the most effective treatment for osteoporotic vertebral compression fractures (OVCFs), significantly reducing pain and improving vertebral height and kyphotic angle based on a network meta-analysis of 56 studies involving 6974 patients.

Radiofrequency kyphoplasty (RFK) demonstrated the best safety profile, effectively reducing the incidence of new fractures and adverse events compared to other interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison Between 7 Osteoporotic Vertebral Compression Fractures Treatments: Systematic Review and Network Meta-analysis. Chang, M., Zhang, C., Shi, J., et al.[2021]

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Treatment of fungal keratitis by penetrating keratoplasty]. Imtirat, A., Levy, J., Lifshitz, T.[2010]

References

1. England pubmed.ncbi.nlm.nih.gov

Bipedicular percutaneous kyphoplasty versus unipedicular percutaneous kyphoplasty in the treatment of asymmetric osteoporotic vertebral compression fractures: a case control study. [2023]

2. Switzerland pubmed.ncbi.nlm.nih.gov

Zoledronic Acid in Osteoporotic Vertebral Compression Fractures Treated With Percutaneous Kyphoplasty: A Meta-Analysis. [2021]

3. United States pubmed.ncbi.nlm.nih.gov

Conductive keratoplasty for the correction of hyperopia. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Comparison Between 7 Osteoporotic Vertebral Compression Fractures Treatments: Systematic Review and Network Meta-analysis. [2021]

5. Israel pubmed.ncbi.nlm.nih.gov

[Treatment of fungal keratitis by penetrating keratoplasty]. [2010]