Overview

Ketamine for the Treatment of Depression in Parkinson's Disease

Status:
Not yet recruiting
Trial end date:
2024-08-01
Target enrollment:
0
Participant gender:
All
Summary
The main purpose of this study is to examine the efficacy, safety and mechanistic underpinnings of a repeated dosing ketamine infusion paradigm compared to placebo in individuals with PD. A subset of participants in each arm will undergo baseline and post-treatment PET and fMRI scans, to examine whether changes in synaptic density and reorganization of functional networks underlie ketamine's putative antidepressant effects in PD.
Phase:
N/A
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
Yale University
Collaborator:
Fox (Michael J.) Foundation for Parkinson's Research
Treatments:
Ketamine
Criteria
Inclusion Criteria:

1. Male or female ages 40-70 years, inclusive

2. Clinical diagnosis of Parkinson's disease, stage 1 or 2 as determined by the Hoehn and
Yahr Scale

3. Meet criteria for major depressive disorder (MDD) as determined by the Structured
Clinical Interview for DSM-5 (SCID-575), and at least 15 on the MADRS, which has shown
maximum discrimination between depressed and non-depressed PD patients.

4. Physically healthy by medical history, physical, ECG and laboratory examinations.

5. For women of reproductive potential, use of highly effective contraception for at
least 1 month prior to screening and agreement to use such a method during study
participation, as well as a negative pregnancy test at screening.

6. Abstinence from drugs of abuse, other than alcohol, cannabis, nicotine and caffeine
for the duration of the study.

7. Stated willingness to comply with all study procedures and availability for the
duration of the study.

8. Provision of signed and dated informed consent form.

Exclusion Criteria:

An individual who meets any of the following criteria will be excluded from participation
in this study:

1. Presence of Dementia (Montreal Cognitive Assessment (MoCA) score < 21)

2. A significant DSM-5 psychiatric disorder except for MDD

3. Active suicidal ideation with intent

4. History of substance dependence

5. Current DSM-5 substance use disorder, except tobacco use disorder

6. Prior participation in a ketamine study, prior clinical psychiatric treatment with
ketamine, or prior recreational use of ketamine

7. A history of significant medical (e.g. cardiovascular, renal), or neurological (e.g.
cerebrovascular, seizure, traumatic brain injury) illness other than PD that is
unstable and/or might affect the study objectives

8. History of hypertension

9. Orthostatic hypotension (OH) that presents with symptoms sustained longer than a few
minutes (e.g., light-headedness, blurred vision, dizziness, weakness, fatigue) or with
syncope. OH is defined by a decrease in systolic blood pressure of 20 mm Hg or a
decrease in diastolic blood pressure of 10 mm Hg within 3 minutes of standing compared
with blood pressure from the sitting position.

10. Inability to provide written informed consent according to the Yale Human
Investigation Committee (HIC) guidelines in English.

For participation in the PET/fMRI only:

11. Prior radiation exposure for research purposes within such that participation in this
study would place them over FDA limits for annual radiation exposure (5 rem per yr)

12. Contraindications to MRI scanning.

13. Presence of a bleeding disorder as determined by the PT/INR (Prothrombin time and
international normalized ratio) test