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Frontline Clinician Psilocybin Study

Primary Purpose

Burnout, Caregiver, Burnout, Professional, COVID-19

Status
Active
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Psilocybin (Usona Institute)
Active placebo
Sponsored by
University of Washington
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Burnout, Caregiver focused on measuring psilocybin, psychedelic assisted psychotherapy

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Participants must be physicians or nurses with at least 1 month of frontline clinical experience during the COVID pandemic who rate at least 2 of 4 items from the COVID Exposure index as 'more than half the days' during their peak 2 week period of exposure: i. Caring for someone critically ill with COVID-19, or who became critically ill while you were involved; ii. Working longer hours than usual in order to provide assistance or care to individuals with COVID-19; iii. Witnessing or responding to a death related to COVID-19, or losing a patient you had been caring for to COVID-19; iv. Caring for patients who have died without family physically present due to COVID-19 precautions
  2. Have a Montgomery-Asberg Depression Rating Scale (MADRS) clinician-administered depression score >21, indicating moderately severe symptoms.
  3. Have had persistent symptoms despite at least one medication and/or therapy trial of standard care treatment for depression.
  4. English speaking - able to understand the process of consent and the risk and benefits associated with the study, and able to give written informed consent.
  5. Must be willing to sign a medical release for the investigators to communicate directly with their therapist and doctors to confirm a medication and/or medical history. This is decided on a case-by-case basis upon the discretion of the PI.
  6. Must be driven home after the medication dosing session by a driver (which could be a friend, family, rideshare or taxi).
  7. Must provide at least one adult to have continuous contact with the participant, provide participant transportation, monitor changes in the participant's behavior, and notify research staff of behavior changes.
  8. Has been off selective serotonin inhibitors (SSRIs) for at least five half-lives of the drug plus 2 weeks.
  9. Must avoid taking any psychiatric medications or starting a new psychiatric medication during the study. Should participant's doctor recommend starting a new psychiatric medication, participant will be required to notify the study team and the subject would withdraw from the study
  10. Must provide a contact (relative, spouse, close friend or other caregiver) who is willing and able to be reached by the Clinical Investigators in the event of a participant becoming suicidal.
  11. If able to bear children, must have a negative pregnancy test at study entry.
  12. Are willing to commit to preparation sessions, medication dosing sessions, integration sessions, to complete evaluation instruments and commit to be contacted for all necessary telephone contacts.

Exclusion Criteria:

  1. Personal or immediate family history of schizophrenia, bipolar affective disorder, delusion disorder, paranoid disorder, or schizoaffective disorder.
  2. Suicidal ideation with a Columbia Suicide Severity Rating Scale (C-SSRS) > 3
  3. Current substance abuse disorder (except in the case of mild alcohol use )
  4. Neuroleptic and SSRI medications that cannot be tapered and discontinued in conjunction with the participant's prescribing physician.
  5. Unstable neurological or medical condition; history of seizure, chronic/severe headaches.
  6. Positive urine pregnancy test at the time of screening
  7. Any unstable medical condition that my render study procedures unsafe.
  8. Any use of psychedelic drugs within the prior 12 months.
  9. Use of tramadol, due to the potential for serotonin syndrome with concomitant use of psilocybin.

Sites / Locations

  • University of Washington

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Psilocybin arm

Placebo

Arm Description

psychedelic assisted psychotherapy + 25mg psilocybin

Psychedelic assisted psychotherapy + 250mg niacin

Outcomes

Primary Outcome Measures

Montgomery-Asberg Depression Rating Scale
Assesses symptoms of depression (clinician-assessed): minimum score 0, max 60; higher score indicates more severe symptoms

Secondary Outcome Measures

Montgomery-Asberg Depression Rating Scale
Assesses symptoms of depression (clinician-assessed): minimum score 0, max 60; higher score indicates more severe symptoms
Stanford Fulfillment Index
Assesses professional burnout in 3 components that are scored separately (professional fulfillment, interpersonal disengagement, work exhaustion)
PTSD Checklist for DSM-5 (PCL5)
Assesses symptoms of post-traumatic stress disorder; minimum score 0, max 80; higher scores indicate more severe symptoms of PTSD
Moral injury symptom scale
Assesses symptoms of moral injury: minimum score 10, max 100; higher score indicates more severe symptoms
Beck Depression Index
Assess self-reported symptoms of depression: minimum score 0, max 63; higher score indicates more severe symptoms of depression

Full Information

First Posted
December 6, 2021
Last Updated
May 17, 2023
Sponsor
University of Washington
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1. Study Identification

Unique Protocol Identification Number
NCT05163496
Brief Title
Frontline Clinician Psilocybin Study
Official Title
A Randomized, Placebo-controlled Trial of Psychedelic-assisted Psychotherapy With Single Dose Psilocybin for Frontline Clinicians Experiencing COVID-related Symptoms of Depression and Burnout
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
March 3, 2022 (Actual)
Primary Completion Date
March 30, 2024 (Anticipated)
Study Completion Date
March 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Washington

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This study aims to investigate the effects of a single dose of psilocybin, delivered in the contextof pre- and post-dose psychotherapy, on symptoms of depression and burnout suffered by healthcare clinicians as a result of frontline work in the COVID pandemic.
Detailed Description
Aim 1: To assess short- and longer-term effects of psilocybin-assisted psychotherapy (PAP) on symptoms of depression experienced by physicians and nurses with frontline work exposure in the COVID pandemic. Hypothesis 1.1: Compared to active placebo, PAP will result in short term improvement in symptoms of depression 1 day and 1 week after the psilocybin dose session. Hypothesis 1.2: Compared to active placebo, PAP will result in longer term improvement of symptoms of depression 4 weeks after the medication dosing session. The primary outcome will be a comparison between the psilocybin 25 mg vs control groups of a combination of depression symptoms measured at 4 weeks post medication dose session. 1.1.2. Aim 2: To explore short- and longer-term effects of psilocybin-assisted psychotherapy (PAP) on symptoms of burnout experienced by physicians and nurses with frontline work exposure in the COVID pandemic. Hypothesis 2.1: Compared to active placebo, PAP will result in short term improvement in symptoms of burnout 1 day and 1 week after the psilocybin dose session.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Burnout, Caregiver, Burnout, Professional, COVID-19, Depression, Post Traumatic Stress Disorder, Moral Injury
Keywords
psilocybin, psychedelic assisted psychotherapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
This study tests a hypothesis that a single session of psilocybin (the 'medication dosing' session) in the context of pre- and post-dose psychotherapy will result in improvement of symptoms of depression and burnout measured 4 weeks post-dose. This study hypothesis will be tested in a single site, double-blind, randomized controlled design involving 30 clinician participants that will compare effects of a single 25mg oral dose of psilocybin to a 250 mg of niacin (active placebo). The primary outcome measurements will be collected 4 weeks after the psilocybin dose, after which the participant group assignment will be unblinded, and participants who received niacin will be offered the opportunity to have a second dose session with a 25 mg dose (with pre- and post-dose psychotherapy).
Masking
ParticipantInvestigatorOutcomes Assessor
Masking Description
The investigators, study therapists, and outcomes assessors will all be blinded in the randomized phase of the study. Participants will be unblinded after the primary outcome, and those receiving placebo will be eligible to receive open label psilocybin.
Allocation
Randomized
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Psilocybin arm
Arm Type
Experimental
Arm Description
psychedelic assisted psychotherapy + 25mg psilocybin
Arm Title
Placebo
Arm Type
Active Comparator
Arm Description
Psychedelic assisted psychotherapy + 250mg niacin
Intervention Type
Drug
Intervention Name(s)
Psilocybin (Usona Institute)
Other Intervention Name(s)
Psychedelic-assisted psychotherapy (PAP)
Intervention Description
PAP + psilocybin 25 mg
Intervention Type
Drug
Intervention Name(s)
Active placebo
Other Intervention Name(s)
PAP with placebo
Intervention Description
PAP + niacin 250mg
Primary Outcome Measure Information:
Title
Montgomery-Asberg Depression Rating Scale
Description
Assesses symptoms of depression (clinician-assessed): minimum score 0, max 60; higher score indicates more severe symptoms
Time Frame
4-weeks post psilocybin-assisted psychotherapy
Secondary Outcome Measure Information:
Title
Montgomery-Asberg Depression Rating Scale
Description
Assesses symptoms of depression (clinician-assessed): minimum score 0, max 60; higher score indicates more severe symptoms
Time Frame
1, 8, 12, 24 weeks post-psilocybin-assisted psychotherapy
Title
Stanford Fulfillment Index
Description
Assesses professional burnout in 3 components that are scored separately (professional fulfillment, interpersonal disengagement, work exhaustion)
Time Frame
1,4,8,12,24 -weeks post psilocybin-assisted psychotherapy
Title
PTSD Checklist for DSM-5 (PCL5)
Description
Assesses symptoms of post-traumatic stress disorder; minimum score 0, max 80; higher scores indicate more severe symptoms of PTSD
Time Frame
1, 4, 8, 12, 24-weeks post-psilocybin-assisted psychotherapy
Title
Moral injury symptom scale
Description
Assesses symptoms of moral injury: minimum score 10, max 100; higher score indicates more severe symptoms
Time Frame
4, 24 weeks post-psilocybin-assisted psychotherapy
Title
Beck Depression Index
Description
Assess self-reported symptoms of depression: minimum score 0, max 63; higher score indicates more severe symptoms of depression
Time Frame
1, 4, 8, 12, 24-weeks post-psilocybin-assisted psychotherapy

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Participants must be physicians or nurses with at least 1 month of frontline clinical experience during the COVID pandemic who rate at least 2 of 4 items from the COVID Exposure index as 'more than half the days' during their peak 2 week period of exposure: i. Caring for someone critically ill with COVID-19, or who became critically ill while you were involved; ii. Working longer hours than usual in order to provide assistance or care to individuals with COVID-19; iii. Witnessing or responding to a death related to COVID-19, or losing a patient you had been caring for to COVID-19; iv. Caring for patients who have died without family physically present due to COVID-19 precautions Have a Montgomery-Asberg Depression Rating Scale (MADRS) clinician-administered depression score >21, indicating moderately severe symptoms. Have had persistent symptoms despite at least one medication and/or therapy trial of standard care treatment for depression. English speaking - able to understand the process of consent and the risk and benefits associated with the study, and able to give written informed consent. Must be willing to sign a medical release for the investigators to communicate directly with their therapist and doctors to confirm a medication and/or medical history. This is decided on a case-by-case basis upon the discretion of the PI. Must be driven home after the medication dosing session by a driver (which could be a friend, family, rideshare or taxi). Must provide at least one adult to have continuous contact with the participant, provide participant transportation, monitor changes in the participant's behavior, and notify research staff of behavior changes. Has been off selective serotonin inhibitors (SSRIs) for at least five half-lives of the drug plus 2 weeks. Must avoid taking any psychiatric medications or starting a new psychiatric medication during the study. Should participant's doctor recommend starting a new psychiatric medication, participant will be required to notify the study team and the subject would withdraw from the study Must provide a contact (relative, spouse, close friend or other caregiver) who is willing and able to be reached by the Clinical Investigators in the event of a participant becoming suicidal. If able to bear children, must have a negative pregnancy test at study entry. Are willing to commit to preparation sessions, medication dosing sessions, integration sessions, to complete evaluation instruments and commit to be contacted for all necessary telephone contacts. Exclusion Criteria: Personal or immediate family history of schizophrenia, bipolar affective disorder, delusion disorder, paranoid disorder, or schizoaffective disorder. Suicidal ideation with a Columbia Suicide Severity Rating Scale (C-SSRS) > 3 Current substance abuse disorder (except in the case of mild alcohol use ) Neuroleptic and SSRI medications that cannot be tapered and discontinued in conjunction with the participant's prescribing physician. Unstable neurological or medical condition; history of seizure, chronic/severe headaches. Positive urine pregnancy test at the time of screening Any unstable medical condition that my render study procedures unsafe. Any use of psychedelic drugs within the prior 12 months. Use of tramadol, due to the potential for serotonin syndrome with concomitant use of psilocybin.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Anthony Back, MD
Organizational Affiliation
University of Washington
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Washington
City
Seattle
State/Province
Washington
ZIP/Postal Code
98195
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
IPD that underlie results in a publication
IPD Sharing Time Frame
We anticipate sharing these data starting with publication of study results and for at least 3 years.
IPD Sharing Access Criteria
To be determined.

Learn more about this trial

Frontline Clinician Psilocybin Study

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