Clinical Research

Anxiety

NATIONAL LIBRARY OF MEDICINE FEBRUARY 2021

Micro-Dose, Macro-Impact: Leveraging Psychedelics in Frontline Healthcare Workers During the COVID-19 Pandemic

A retrospective chart review of an open-label trial of low-dose ketamine administered to front-line Healthcare workers who were identified as experiencing acute stress disorder due to the COVID-19 Pandemic.

NATIONAL LIBRARY OF MEDICINE MARCH 2020

Ketamine Infusion for Adolescent Depression and Anxiety

We will conduct a crossover trial in which as many as 36 adolescents (18 with MDD and 18 with anxiety disorders) will be given a single infusion of ketamine (study drug) or midazolam (active control). MDD symptoms and anxiety symptoms will be monitored over a two-week period. If applicable, comorbid school refusal symptoms will also be monitored over a two-week period for both cohorts. A 2-week washout period will be required between infusion doses. Our primary outcomes will be 1) improvement in MDD symptoms (measured by Montgomery-Asberg Depression Rating Scale, revised (MADRS) score) 1 day after infusion, for the cohort of subjects enrolled in the MDD arm of this trial and 2) improvement in the anxiety symptoms (measured by the Multimodal Anxiety Scale for Children (MASC) acute physical symptoms subscale) for the cohort of subjects enrolled in the anxiety disorders arm of the trial.

JOURNAL OF PSYCHOACTIVE DRUGS MAY 2019

Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes

Ketamine is the only clinician-prescribed psychedelic medicine available to mental health providers for the treatment of emotional suffering, and psychedelic experience is an inherent, valued, and well-tolerated part of the authors’ methodology. In this study, 235 patients across three practices received ketamine sublingually (both in-office and at home), intramuscularly, or both, along with psychotherapy. The data support the efficacy of ketamine-assisted psychotherapy for a wide variety of psychiatric diagnoses and human difficulties, significantly diminishing depression, anxiety, and PTSD and increasing well-being.

JOURNAL OF PSYCHOPHARMACOLOGY MARCH 2018

Safety and efficacy of maintenance ketamine treatment in patients with treatment-refractory generalised anxiety and social anxiety disorders

This study sought to evaluate the effect of weekly ketamine treatments for three months on anxiety ratings, safety and tolerability in patients with treatment-refractory generalised anxiety disorder (GAD) and/or social anxiety disorder (SAD), and subsequent assessment of remission post-treatment. Patients received one or two weekly ketamine doses of 1 mg/kg injected subcutaneously for 3 months. Patients reported marked improvements in functionality and in their personal lives. Maintenance ketamine may be a therapeutic alternative for patients with treatment refractory GAD/SAD.

NEUROPSYCHOPHARMACOLOGY JANUARY 2018

Ketamine for Social Anxiety Disorder

Many patients with social anxiety disorder (SAD) experience inadequate symptom relief from available treatments. Ketamine is a potent N-methyl-d-aspartate receptor antagonist with a potentially novel mechanism of action for the treatment of anxiety disorders. This proof-of-concept trial provides initial evidence that ketamine may be effective in reducing anxiety.

Depression

NATIONAL LIBRARY OF MEDICINEJANUARY 11, 2022

Ketamine for Treatment Resistant Late-Life Depression

The purpose of this study is to examine the effectiveness of a single infusion of ketamine (KET), to determine which dose is optimal 7 days after infusion using Bayesian Adaptive Randomization, and to learn about how ketamine works in the body and brain in persons with late-life treatment resistant depression.

NATIONAL LIBRARY OF MEDICINE MAY 25, 2021

Sequential Therapy for the Treatment of Severe Bipolar Depression. (STABIL-B)

NeuroRx is developing NRX-101, a fixed-dose combination oral capsule composed of d-cycloserine (DCS) and lurasidone for the maintenance of remission from Severe Bipolar Depression with Acute Suicidal Ideation (C-SSRS level 4 or 5) or Behavior (ASIB) in following initial stabilization. Patients with Severe Bipolar Depression and ASIB will be recruited in both inpatient and outpatient settings and, following informed consent, will be given an intravenous infusion of ketamine 0.5mg/kg over 40 minutes. Those who exhibit a satisfactory clinical response to ketamine will be randomly allocated to NRX-101 or to lurasidone alone (the comparator group). This study is conducted as a feasibility study for a pivotal phase 2b/3 clinical trial and the primary outcomes for this phase 2 study were blood levels of NRX-101, in order to confirm pharmaco-kinetics with remission from depression, as measured by BISS-derived MADRS and relapse as secondary outcomes.

NATIONAL LIBRARY OF MEDICINE JANUARY 27, 2021

Ketamine in Adolescents With Treatment-Resistant Depression

Depression frequently emerges during adolescence and is associated with severe outcomes. Current interventions do not lead to remission for many adolescents. Treatment-resistant depression (TRD) in adolescence is an ominous prognostic indicator for a lifetime of suffering and increased risk for suicide. Efforts should be directed toward novel interventions that could alter this perilous course. Theoretically, restoration of healthy development during this critical window would substantially improve outcomes over the lifespan.

NATIONAL LIBRARY OF MEDICINE AUGUST 31, 2020

Low Dose Intravenous Ketamine in Treatment Resistant Depression Patients

The primary goal of the project is to study the effect of Ketamine on cortical neurophysiological function in Treatment Resistant Depression(TRD) patients. There are three key preclinical findings regarding Ketamine antidepressant effects that motivate the current study: a) low dose Ketamine causes early increase in glutamate neurotransmission; b) Ketamine initiates synaptic plasticity; c) ketamine infusion leads to rapid improvement in depression symptoms. The proposal essentially employs robust and non-invasive neurophysiological techniques, Auditory Steady State Response(ASSR)-gamma oscillatory response and Transcranial Magnetic Stimulation(TMS) cortical excitability to investigate the above findings in patients with treatment resistant depression.

NATIONAL LIBRARY OF MEDICINE DECEMBER 3, 2019

Efficacy of Repeated Ketamine Infusions for Treatment-resistant Depression

About one-third of depressed patients will not get better after multiple antidepressant treatments. This situation put a high burden on patients with depression due to worsening quality of life and increasing health care costs. Difficult-to-treat depression might be even worse among Veterans given that the frequency of depressive symptoms is 2 to 5 times higher than among the general US population. A breakthrough discovery happened in recent years when investigators found that one infusion from an old anesthetic named ketamine showed high efficacy and rapid antidepressant effect (sometimes within hours) but lasted only up to a week. The investigators propose to study if multiple infusions of ketamine can provide greater and longer antidepressant effects than one infusion. If that is the case, multiple infusions could be an alternative to relieve depressive symptoms that do not response to multiple antidepressant drugs.