RecruitingPhase 2Phase 3NCT06891300

Understanding and Treating Suicidal Ideation With Ketamine

Understanding and Treating Suicidal Ideation With Ketamine: A Diffusion Magnetic Resonance Imaging Study

Sponsor

The Royal's Institute of Mental Health Research

Enrollment

36 participants

Start Date

Apr 8, 2025

Study Type

INTERVENTIONAL

Conditions

Suicidal Ideation Major Depressive Disorder (MDD)

Summary

The goal of this clinical trial is to treat active suicidal ideation in individuals with Major Depressive Disorder (MDD) using ketamine and to understand suicidal ideation by examining biological mechanisms using magnetic resonance imaging (MRI), and psychological mechanisms through validated clinical scales and qualitative interviews. The main questions it aims to answer are: 1. Will ketamine will reduce suicidal ideation in a significant proportion of study participants? 2. Will reduction in suicidal ideation will be accompanied by rapid changes in neuroimaging biomarkers? Participants will receive four intravenous (IV) ketamine infusions administered twice weekly for two weeks. Participants will undergo two identical MRI scans: 1) within 48 hours prior to starting ketamine treatment, and 2) 24 hours after the fourth ketamine infusion. Suicidal ideation and depressive symptoms will be assessed prior to each imaging session alongside additional self-report measures. Qualitative interviews will occur within 72 hours after the fourth ketamine treatment.

Eligibility

Min Age: 18 YearsMax Age: 65 Years

Plain Language Summary

Simplified for easier understanding

This study is investigating whether ketamine — a medication sometimes used for depression — can reduce suicidal thoughts in people with Major Depressive Disorder (MDD) and active thoughts of suicide. It also aims to better understand the brain processes behind suicidal thinking. **You may be eligible if...** - You are 18–65 years old and English-speaking - You have been diagnosed with Major Depressive Disorder (MDD) - You currently have active suicidal thoughts (not just passive thoughts, but thinking about a method) - You are under the care of a doctor or psychiatrist - You are willing to keep your current medications stable during the study **You may NOT be eligible if...** - You have medical conditions that make ketamine unsafe (e.g., uncontrolled high blood pressure) - You are currently pregnant - You have a history of psychosis or certain other psychiatric diagnoses that may interfere - You have a substance use disorder involving ketamine or dissociative drugs Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

DRUGketamine hydrochloride

Participants will undergo intravenous (IV) ketamine infusions (0.5 mg/kg infused over 40 minutes) under medical supervision. Treatments will be administered twice weekly for two weeks, for a total of four infusions.