Ketamine Infusions for PTSD and Treatment-Resistant Depression

This is an interventional treatment trial for Depressive Disorder, Treatment-Resistant focused on measuring ketamine, stress disorders, post-traumatic, stress disorders, traumatic, anxiety disorders, mental disorders, adjuvants, anesthesia, analgesics, anesthetics, anesthetics, dissociative, anesthetics, general, anesthetics, intravenous, excitatory amino acid agents, excitatory amino acid antagonists, hypnotics and sedatives, molecular mechanisms of pharmacological action, neurotransmitter agents, peripheral nervous system agents, pharmacologic actions, physiological effects of drugs, psychotropic drugs, sensory system agents, central nervous system agents, central nervous system depressants, depression, depressive disorder, depressive disorder, treatment-resistant, behavioral symptoms, mood disorders, therapeutic uses Read More

Inclusion Criteria:

• Male or female veterans aged 18 to 75 years.
• Participants must have a telephone in their home and ability to hear telephone conversations.
• Participants must meet current DSM-IV criteria for major depressive disorder (MDD), single or recurrent, without psychotic features
• Participants must meet DSM-5 criteria for current post-traumatic stress disorder (PTSD) and have received a diagnosis of PTSD greater than or equal to 3 months prior to assessment.
• Current major depressive episode resistant to treatment.
• If applicable, current antidepressant dosages including augmenting agents and/or frequency and duration of psychotherapy sessions must remain stable for at least 6 weeks prior to beginning of the study.

Exclusion Criteria:

• Inability to speak English
• Inability or unwillingness to provide written informed consent
• Moderate/severe cognitive impairment .
• Current or lifetime diagnosis of psychosis-related disorder, bipolar I or II disorder, substance-induced mood disorder, or any mood disorder due to a general medical condition.
• Current or lifetime diagnosis of a Cluster B disorder.
• History of moderate or severe traumatic brain injury, Parkinson's disease, dementia of any type, multiple sclerosis, seizures or other CNS related disorders.
• History of comorbid substance disorder within 6 months of screening as assessed using the Mini International Neuropsychiatric Interview (MINI), plus positive urine toxicology screen test during baseline assessments.
• Prior use of ketamine as an antidepressant.
• Clinically unstable medical illness that could compromise the patient's ability to tolerate or likely interfere with the study procedures (e.g., history of or current myocardial ischemia or arrhythmias, congestive heart failure, severe pulmonary, renal, or hepatic disease, uncontrolled hypertension)
• Current or within less than 14 days use of barbiturates or monoamine oxidase inhibitors (MAOI).
• History of antidepressant- or substance-induced hypomania.
• History of first degree relative(s) with an Axis I psychotic disorder.
• For women: pregnancy (confirmed by baseline lab test), the initiation of female hormonal treatments within 3 months of screening, or inability or unwillingness to use a medically accepted contraceptive method for the duration of the study.
• Imminent risk of suicidal/homicidal ideation and/or behavior with intent and/or plan.