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Safety Study of Ketamine for Preventing Depression in Patients Undergoing Treatment for Head and Neck Cancer

Information source: University of California, San Diego
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Head and Neck Cancer; Depression

Intervention: Ketamine (Drug); Placebo (Other)

Phase: Phase 0

Status: Recruiting

Sponsored by: University of California, San Diego

Official(s) and/or principal investigator(s):
Scott A Irwin, MD, PhD, Principal Investigator, Affiliation: University of California, San Diego

Overall contact:
Larissa K Low, Phone: (858) 822-5223, Email: llow@ucsd.edu


The primary purpose of this study is to see if it is safe to give patients with head and neck cancer a low dose of the FDA approved anesthetic drug ketamine at the same time they receive radiation, chemotherapy, and/or surgery for their cancer treatment to prevent depression and its effects. Researchers would also like to see if giving ketamine at the same time as cancer treatment is practical and reasonably acceptable to the patient. The American Psychiatric Association has reported that up to about half of patients with head and neck cancer develop depression which has many negative impacts on cancer care and its outcomes. Therefore, investigators would also like to see if giving patients ketamine during their routine cancer treatment will prevent the onset of depression and its negative effects on cancer treatment outcomes, and also help with anxiety, pain, and quality of life. The study will also use a placebo to compare to the good and/or bad effects of ketamine. A placebo is not an active drug and it will be look the same as ketamine, as a liquid to be taken by mouth. Ketamine is approved by the U. S. Food and Drug Administration (FDA) as a general anesthetic by itself for some diagnostic and surgical procedures or combined with other general anesthetic agents. It has also been shown to reduce cancer pain. Ketamine is considered experimental in this study because it is not approved by the FDA for the prevention of depression.

Clinical Details

Official title: Piloting a Randomized Feasibility Study of Oral Ketamine Versus Placebo for Prevention of Depression in Patients Undergoing Therapy for Head and Neck Cancer

Study design: Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Prevention

Primary outcome:

Proportion of patients approached for study participation that consented to participate

Proportion of eligible patients that participated

Secondary outcome:

treatment-related adverse events

patient-reported tolerability questionnaire (FIBSER)

Detailed description: This is a prospective, single center, double blind, randomized, two-arm feasibility study of oral ketamine versus placebo for the prevention of depression in non-depressed patients with head and neck cancer undergoing curative intent cancer therapy. Approximately 20 patients with head and neck cancer about to undergo cancer therapy will be randomized 1: 1 to receive study treatment with one of the following regimens:

- Arm A: weekly oral administration of 0. 5 mg/kg ketamine

- Arm B: weekly oral administration of placebo

Consenting patients will undergo screening procedures, and if eligible, a baseline interview and brief questionnaires regarding depression, mental and emotional health, and quality of life assessments. Study treatment will be administered for 16 weeks unless the patient experiences unacceptable toxicities, exhibits moderate to severe depressive symptoms, or withdraws consent. Patients on the placebo treatment arm will not be eligible to cross over to the ketamine arm at evidence of depression but will be removed from the study and treated with standard medical management for depression. Patients will be asked to complete psychosocial measurements every two weeks, before study medication/placebo administration, while on study treatment and monthly during a six-month follow-up period.


Minimum age: 18 Years. Maximum age: N/A. Gender(s): Both.


Inclusion Criteria: 1. Ability to understand and the willingness to sign a written informed consent. 2. Stage III or IV epidermoid cancer of the head and neck. 3. Within two weeks of starting or from having started, curative intent therapy for head and neck cancer. 4. Age ≥ 18 years. 5. Adequate liver function as defined by:

- ALT < 5 X institutional upper limit of normal (ULN)

- AST < 5 X institutional ULN

- Total bilirubin < 5 X institutional ULN

6. Both men and women of all races and ethnic groups are eligible for this trial. 7. Use of antidepressants is permitted if dose has been the same for at least 12 weeks prior to study entry. 8. Women of child-bearing potential and men with partners of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately. Exclusion Criteria: 1. Receiving another investigational agent on a clinical trial that prohibits participation in other studies of investigational agents. 2. Meets Mini International Neuropsychiatric interview (MINI) criteria for major depression, schizophrenia, bipolar illness, delirium or psychosis. 3. Has moderate to severe depression according to Quick Inventory of Depressive Symptomatology-Self Rated 16 (QIDS-SR-16) scores of ≥ 11. 4. Has Suicidal Risk Assessment (SRA) scores ≥ 6. 5. Use of monoamine oxidase inhibitors within 14 days of study entry. 6. Diagnosed with melanoma or lymphoma cancer of the head and neck. 7. History of allergic reactions or hypersensitivity to ketamine. 8. Severe cardiac insufficiency (NYHA III or IV), with uncontrolled and/or unstable cardiac or coronary artery disease. 9. History of significant tachyarrhythmia, severe angina, or myocardial ischemia 10. Poorly controlled hypertension (Systolic Blood Pressure > 180 mmHG or Diastolic Blood Pressure > 1000 mmHG), with or without antihypertensives. 11. Pregnant or nursing.

Locations and Contacts

Larissa K Low, Phone: (858) 822-5223, Email: llow@ucsd.edu

University of California, San Diego Moores Cancer Center, La Jolla, California 92093, United States; Recruiting
Larissa K Low, Phone: 858-822-5223, Email: llow@ucsd.edu
Scott A Irwin, MD, PhD, Principal Investigator
Additional Information

Starting date: May 2015
Last updated: May 12, 2015

Page last updated: August 23, 2015

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