Ketamine and Stress in OCD (KET-OCD)
Primary Purpose
Obsessive-Compulsive Disorder, Psychiatric Disorder
Status
Recruiting
Phase
Not Applicable
Locations
Austria
Study Type
Interventional
Intervention
Ketamine 50 MG/ML
Midazolam
Sponsored by
About this trial
This is an interventional treatment trial for Obsessive-Compulsive Disorder focused on measuring Ketamine, stress testing
Eligibility Criteria
Inclusion Criteria:
- Primary diagnosis of obsessive-compulsive disorder
- A score of 16 or higher on the Yale-Brown Obsessive Compulsive Scale and ability to provide written informed consent
- At least one previous treatment for OCD
Exclusion Criteria:
- Any history of current or past psychotic disorder
- A manic episode within the preceding three years
- Current or unstable remitted substance abuse or dependence except nicotine
- Pregnancy or elevated risk of becoming pregnant during study duration (desire to have children) and refusal to utilize a proper method of contraception
- Any current severe personality disorder except comorbid anankastic personality disorder
- Morbus Raynaud
- Inability to follow the study protocol or adhere to operational requirements
- Current and unstable suicidality
- Unstable hypertension
- Untreated hyperthyroidism
- Any unstable cardiovascular disease
- Untreated disorders severely affecting the HPA-axis (M.Addison, M.Cushing)
- Current pharmacological therapy severely affecting the HPA-axis like corticosteroids or ACTH
Sites / Locations
- Medical University of Vienna, Department of Psychiatry and PsychotherapyRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Placebo Comparator
Arm Label
Ketamine
Midazolam
Arm Description
Participants will undergo one infusion of ketamine as active comparator. (R,S-ketamine 50mg/ml solution for injection, dose: 0,5 mg per kg bodyweight) Both medications will be diluted in 100 ml saline and will be adjusted for infusion over 40 minutes, administered with a syringe pump.
Participants will undergo one infusion of midazolam as comparator. (0,045 mg/kg bodyweight) Both medications will be diluted in 100 ml saline and will be adjusted for infusion over 40 minutes, administered with a syringe pump.
Outcomes
Primary Outcome Measures
Change of OCD symptoms (Y-BOCS)
There will be a change of severity of obsessive and compulsive symptoms seven days after ketamine infusion compared to midazolam infusion as measured with Y-BOCS.
Secondary Outcome Measures
Change of OCD symptoms (OCD-VAS)
There will be a change in patients' severity of obsessive and compulsive symptoms as measured with OCD-VAS 24 hours after ketamine infusion compared to midazolam infusion.
Change of OCD symptoms (Y-BOCS)
There will be a change in patients' severity of obsessive and compulsive symptoms as measured with YBOCS 24 hours after ketamine infusion compared to midazolam infusion.
Change of OCD symptoms (OCD-VAS)
There will be a change of symptoms over the course of seven days after ketamine infusion compared to midazolam infusion as measured with OCD-VAS area under the curves.
Change in neuropsychological function
There will be a change in neuropsychological function after 24 hours after ketamine infusion compared to midazolam infusion as measured by four neurocognitive tests (N-Back, WCST, SSRT, ToH)
Change in cortisol response
There will be a change in cortisol response to stress 24 hours after ketamine infusion compared to midazolam infusion.
Change of vegetative stress response (cardiovascular)
There will be a change of vegetative stress response 24 hours after ketamine infusion compared to midazolam infusion as measured with cardiovascular parameters (HR, BP).
Change of vegetative stress response (stress VAS)
There will be a change of vegetative stress response 24 hours after ketamine infusion compared to midazolam infusion as measured with subjective stress VAS.
Full Information
NCT ID
NCT05577585
First Posted
September 25, 2022
Last Updated
October 10, 2022
Sponsor
Medical University of Vienna
1. Study Identification
Unique Protocol Identification Number
NCT05577585
Brief Title
Ketamine and Stress in OCD
Acronym
KET-OCD
Official Title
Ketamine Therapy in Obsessive-compulsive Disorder and Its Effects on Neuropsychological Function Under Stress in a Cross-over Trial
Study Type
Interventional
2. Study Status
Record Verification Date
October 2022
Overall Recruitment Status
Recruiting
Study Start Date
August 1, 2022 (Actual)
Primary Completion Date
June 2023 (Anticipated)
Study Completion Date
June 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Medical University of Vienna
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The main goal of this trial is to demonstrate therapeutic efficacy of low dose ketamine in patients with OCD. We expect that ketamine will alleviate symptoms in the hours following application, but also - if effective - that the anti-OCD effects might last for several days after a single infusion.
Detailed Description
This study will apply a randomized, double blind, comparator-controlled cross-over design and will be conducted at the Department of Psychiatry and Psychotherapy of the Medical University of Vienna. We will include 30 participants with a primary diagnosis of OCD. Participants will undergo ketamine and comparator infusions in either inpatient- or outpatient settings to assess the therapeutic capabilities of ketamine in OCD. Furthermore, participants' neurocognitive function and stress responses will be tested with four neurocognitive tasks and a cold pressor test paradigm.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Obsessive-Compulsive Disorder, Psychiatric Disorder
Keywords
Ketamine, stress testing
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Model Description
This study will apply a randomized, double blind, comparator-controlled cross-over design.
The order of treatment modality will be randomized and double-blind. Participants will undergo one infusion of ketamine and midazolam as comparator. They will be assigned to one of two sequenced treatment groups, with one group first receiving verum and after 14 days the comparator infusion, the other group vice versa. The randomization into these two sequence groups will be stratified for symptom severity, defined as moderate (YBOCS baseline >16) or severe (YBOCS baseline >25).
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
30 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Ketamine
Arm Type
Active Comparator
Arm Description
Participants will undergo one infusion of ketamine as active comparator. (R,S-ketamine 50mg/ml solution for injection, dose: 0,5 mg per kg bodyweight) Both medications will be diluted in 100 ml saline and will be adjusted for infusion over 40 minutes, administered with a syringe pump.
Arm Title
Midazolam
Arm Type
Placebo Comparator
Arm Description
Participants will undergo one infusion of midazolam as comparator. (0,045 mg/kg bodyweight) Both medications will be diluted in 100 ml saline and will be adjusted for infusion over 40 minutes, administered with a syringe pump.
Intervention Type
Drug
Intervention Name(s)
Ketamine 50 MG/ML
Intervention Description
See also Arm description
Intervention Type
Drug
Intervention Name(s)
Midazolam
Intervention Description
See also Arm description
Primary Outcome Measure Information:
Title
Change of OCD symptoms (Y-BOCS)
Description
There will be a change of severity of obsessive and compulsive symptoms seven days after ketamine infusion compared to midazolam infusion as measured with Y-BOCS.
Time Frame
In total 7 YBOCS assessments will take place between week 1 and 5.
Secondary Outcome Measure Information:
Title
Change of OCD symptoms (OCD-VAS)
Description
There will be a change in patients' severity of obsessive and compulsive symptoms as measured with OCD-VAS 24 hours after ketamine infusion compared to midazolam infusion.
Time Frame
in each arm 24 hours after infusion
Title
Change of OCD symptoms (Y-BOCS)
Description
There will be a change in patients' severity of obsessive and compulsive symptoms as measured with YBOCS 24 hours after ketamine infusion compared to midazolam infusion.
Time Frame
in each arm 24 hours after infusion
Title
Change of OCD symptoms (OCD-VAS)
Description
There will be a change of symptoms over the course of seven days after ketamine infusion compared to midazolam infusion as measured with OCD-VAS area under the curves.
Time Frame
in each arm 1 week after the infusion
Title
Change in neuropsychological function
Description
There will be a change in neuropsychological function after 24 hours after ketamine infusion compared to midazolam infusion as measured by four neurocognitive tests (N-Back, WCST, SSRT, ToH)
Time Frame
in each arm 24 hours after infusion
Title
Change in cortisol response
Description
There will be a change in cortisol response to stress 24 hours after ketamine infusion compared to midazolam infusion.
Time Frame
in each arm 24 hours after infusion
Title
Change of vegetative stress response (cardiovascular)
Description
There will be a change of vegetative stress response 24 hours after ketamine infusion compared to midazolam infusion as measured with cardiovascular parameters (HR, BP).
Time Frame
in each arm 24 hours after infusion
Title
Change of vegetative stress response (stress VAS)
Description
There will be a change of vegetative stress response 24 hours after ketamine infusion compared to midazolam infusion as measured with subjective stress VAS.
Time Frame
in each arm 24 hours after infusion
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Primary diagnosis of obsessive-compulsive disorder
A score of 16 or higher on the Yale-Brown Obsessive Compulsive Scale and ability to provide written informed consent
At least one previous treatment for OCD
Exclusion Criteria:
Any history of current or past psychotic disorder
A manic episode within the preceding three years
Current or unstable remitted substance abuse or dependence except nicotine
Pregnancy or elevated risk of becoming pregnant during study duration (desire to have children) and refusal to utilize a proper method of contraception
Any current severe personality disorder except comorbid anankastic personality disorder
Morbus Raynaud
Inability to follow the study protocol or adhere to operational requirements
Current and unstable suicidality
Unstable hypertension
Untreated hyperthyroidism
Any unstable cardiovascular disease
Untreated disorders severely affecting the HPA-axis (M.Addison, M.Cushing)
Current pharmacological therapy severely affecting the HPA-axis like corticosteroids or ACTH
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Christoph Kraus, MD PhD
Phone
+4314040035680
Email
christoph.kraus@muv.ac.at
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Christoph Kraus, MD PhD
Organizational Affiliation
Medical University of Vienna, Department of Psychiatry and Psychotherapy
Official's Role
Principal Investigator
Facility Information:
Facility Name
Medical University of Vienna, Department of Psychiatry and Psychotherapy
City
Vienna
ZIP/Postal Code
1090
Country
Austria
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Christoph Kraus, MD PhD
12. IPD Sharing Statement
Plan to Share IPD
No
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