Skip to content

Double-Blind, Placebo-Controlled Trial of Ketamine Therapy in Treatment-Resistant Depression (TRD)

Double-Blind, Placebo-Controlled Trial of Ketamine Therapy in Treatment-Resistant Depression (TRD)

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01920555
Enrollment
99
Registered
2013-08-12
Start date
2014-12-31
Completion date
2017-02-28
Last updated
2018-06-19

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Treatment Resistant Depression

Keywords

Depression, Treatment Resistant Depression, Ketamine, Antidepressant, MDD, Major Depression

Brief summary

This study is looking at the efficacy, durability, safety, and tolerability of multiple single doses of Ketamine vs. active placebo for treating patients with treatment resistant depression who are taking an antidepressant that is not working for them.

Detailed description

The primary objective is to investigate whether all doses (0.1 mg/kg, 0.2 mg/kg, 0.5 mg/kg, and 1.0 mg/kg) of ketamine are superior to active placebo (midazolam 0.045 mg/kg) therapy in the acute treatment of patients with treatment resistant depression within 72 hours (Day 3), when added to ongoing and stable antidepressant therapy.

Interventions

DRUGKetamine

Dose of Ketamine will be 0.1 mg/kg - one single infusion

DRUGPlacebo Midazolam

Dose of Midazolam (active placebo) will be 0.045 mg/kg - one single infusion

Sponsors

National Institute of Mental Health (NIMH)
CollaboratorNIH
Baylor College of Medicine
CollaboratorOTHER
Icahn School of Medicine at Mount Sinai
CollaboratorOTHER
Stanford University
CollaboratorOTHER
University of Texas
CollaboratorOTHER
Yale University
CollaboratorOTHER
Massachusetts General Hospital
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No

Inclusion criteria

* Male or female, 18-70 years old. * Able to read, understand, and provide written, dated informed consent prior to screening. * Diagnosed with Major Depressive Disorder (MDD), single or recurrent, and currently experiencing a Major Depressive Episode (MDE) of at least eight weeks in duration, prior to screening. * Has a history of TRD during the current MDE. * Meet the threshold on the total MADRS score of greater than or equal to 20 at both screening and baseline visits (Day -7/-28 and Day 0), as confirmed by the remote centralized MGH CTNI rater between the screen visit and the baseline visit. * In good general health * For female participants, status of non-childbearing potential or use of an acceptable form of birth control * Body mass index between 18-35 kg/m2 * Concurrent psychotherapy will be allowed if the type and frequency of the therapy has been stable for at least three months prior to screening and is expected to remain stable during participation in the study * Concurrent hypnotic therapy will be allowed if the therapy has been stable for at least 4 weeks prior to screening and if it is expected to remain stable during the course of the subject's participation in the study.

Exclusion criteria

* Female of childbearing potential who is not willing to use one of the specified forms of birth control during the study * Female that is pregnant or breastfeeding * Female with a positive pregnancy test at screening or baseline * History during the current MDE of failure to achieve a satisfactory response to \>7 treatment courses of a therapeutic dose of an antidepressant therapy of at least 8 weeks duration during the current episode * Total MADRS score of \<20 at the screen or baseline visits, or as assessed by the remote, independent MGH CTNI rater and reported to the site * Current diagnosis of a Substance Use Disorder (Abuse or Dependence) with the exception of nicotine dependence, at screening or within 6 months prior to screening * Current Axis I disorder that is the principal focus of treatment and MDD the secondary focus of treatment for the past 6 months or more * History of bipolar disorder, schizophrenia or schizoaffective disorders, or any history of psychotic symptoms in the current or previous depressive episodes * History of eating disorders within five years of screening * Any Axis I or Axis II Disorder, which at screening is clinically predominant to their MDD or has been predominant at any time within 6 months prior to screening * Subject is considered at significant risk for suicidal behavior during the course of their participation in the study * Has failed to respond to electroconvulsive therapy (ECT) during the current depressive episode * Has received vagus nerve stimulation (VNS) at any time prior to screening * Has dementia, delirium, amnestic, or any other cognitive disorder * Has a clinically significant abnormality on the screening physical examination * Participation in any clinical trial with an investigational drug or device within the past month or concurrent to study participation * Current episode of: 1. Hypertension, Stage 1 as defined by a systolic blood pressure ≥140mmHg or diastolic blood pressure ≥90 mmHg at screening on two of three measurements (standing and supine) at least 15 minutes apart. 2. Hypertension, Stage 1 as defined by a systolic blood pressure ≥155 mmHg or diastolic blood pressure ≥99 mmHg at the Baseline Visit (Visit 1) within 1.5 hours prior to randomization on two of three measurements (standing and supine) at least 15 minutes apart. 3. Recent myocardial infarction (within one year) or a history of myocardial infarction. 4. Syncopal event within the past year. 5. Congestive heart failure (CHF) New York Heart Association Criteria \>Stage 2 6. Angina pectoris. 7. Heart rate \<50 or \>105 beats per minute at screening or randomization (Baseline Visit). 8. QTcF (Fridericia-corrected) ≥450 msec at screening or randomization (Baseline Visit). * Current history of hypertension, or on antihypertensives for the purpose of lowering blood pressure, who have either had an increase in antihypertensive dose or increase in the number of antihypertensive drugs used to treat hypertension over the last 2 months. * Chronic lung disease excluding asthma. * Lifetime history of surgical procedures involving the brain or meninges, encephalitis, meningitis, degenerative central nervous system disorder, epilepsy, mental retardation, or any other disease/procedure/accident/intervention associated with significant injury to or malfunction of the central nervous system, or a history of significant head trauma within the past 2 years * Presents with any of the following lab abnormalities: 1. Thyroid stimulating hormone outside of the normal limits and clinically significant as determined by the investigator. Free thyroxine (T4) levels may be measured if TSH level is high. Subject will be excluded if T4 level is clinically significant. 2. Patients with diabetes mellitus fulfilling any of the following criteria: i. Unstable diabetes mellitus defined as glycosylated hemoglobin (HbA1c) \>8.5% at screening ii. Admitted to hospital for treatment of diabetes mellitus or diabetes mellitus related illness in the past 12 weeks iii. Not under physician care for diabetes mellitus iv. Has not been on the same dose of oral hypoglycaemic drug(s) and/or diet for the 4 weeks prior to screening. For thiazolidinediones (glitazones) this period should not be less than 8 weeks. c. Any other clinically significant abnormal laboratory result (as determined after evaluation by study investigator and MGH CTNI medical monitor) at the time of the screening exam. * History of hypothyroidism and has been on a stable dosage of thyroid replacement medication for less than 2 months prior to screening. (Subjects on a stable dosage of thyroid replacement medication for at least 2 months or more prior to screening are eligible for enrollment.) * History of hyperthyroidism which was treated (medically or surgically) less than six months prior to screening * Any current or past history of any physical condition which in the investigator's opinion might put the subject at risk or interfere with study results interpretation * History of positive screening urine test for drugs of abuse at screening * Patients with exclusionary laboratory values, or requiring treatment with exclusionary concomitant medications * Patients on exclusionary concomitant psychotropic medications, the half-life of which would not allow sufficient time for patients to have been free of the medication post-taper for five half-lives within the maximum screening period (28 days). * Patient who have participated in studies of ketamine or AZD6765 or other NMDA receptor antagonists for depression and received active treatment. * Patients with narrow angle glaucoma * Patients with a lifetime history of PCP/Ketamine drug use * Liver Function Tests higher than 2.5 times upper limit of normal

Design outcomes

Primary

MeasureTime frameDescription
Hamilton Rating Scale for Depression - 6 ItemsA baseline assessment was made on Day 0, preceding infusion (i.e., treatment). Outcome assessments were made on days 1, 3, 5, 7, 14, and 30. The primary endpoint for this study was Day 3. Thus, the outcome measure table provides data on Days 0, 1, & 3The HAMD6 is a 6-item clinician-rated scale, where clinicians rate the presence of depression symptoms (i.e., depressed mood, guilt, work and interests, psychomotor retardation, psychic anxiety, somatic symptoms) on a 5-point scale, where 0 = not present, and 1-4 represent increasingly severe symptoms. One item (i.e., somatic symptoms) is rated on only a 3-point scale, ranging from 0-2. The possible scale range is 0-22, where higher values represent more severe depression. This instrument is completed with a structured interview guide by the clinician based on his/her assessment of the patient's symptoms. This structured interview has been validated for use with time frames shorter than one week. In this study, the HAMD6 was used to assess symptoms occurring in the past 24 hours.

Secondary

MeasureTime frameDescription
Clinical Global Impressions-Severity (CGI-S)A baseline assessment was made on Day 0, preceding infusion (i.e., treatment). Outcome assessments were made on days 1, 3, 5, 7, 14, and 30. The primary endpoint for this study was Day 3. Thus, the outcome measure table provides data on Days 0, 1 and 3The CGI-S is a clinician rated single-item scale: How depressed is the patient at this time?, rated on a 7-point response scale: 1 = Normal, not at all depressed, 2 = Borderline depressed, 3 = Mildly depressed, 4 = Moderately depressed. 5 = Markedly depressed, 6 = severely depressed, 7 = Among the most severely depressed patients. When rating patients, clinicians were asked to consider the past 24 hours.
Clinical Global Impressions-Improvement (CGI-I) ScaleA baseline assessment was made on Day 0, preceding infusion (i.e., treatment). Outcome assessments were made on days 1, 3, 5, 7, 14, and 30. The primary endpoint for this study was Day 3. Thus, the outcome measure table provides data on Days 0, 1 and 3The CGI-I is a clinician rated single-item scale: Compared to the patient's condition at admission, how much has the patient changed?, rated on a 7-point response scale: 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, and 7 = Very much worse. In this case, admission referred to the CGI-S screening assessments performed between Day -28 an -7, one conducted during the screening visit, and a second rating conducted by a remote, independent rater.
Symptoms of Depression Questionnaire (SDQ)A baseline assessment was made on Day 0, preceding infusion (i.e., treatment). Outcome assessments were made on days 1, 3, 5, 7, 14, and 30. The primary endpoint for this study was Day 3. Thus, the outcome measure table provides data on Days 0, 1 and 3The SDQ is a 44-item self-report scale, which aims to measure depression more comprehensively by including the assessment of symptoms in the anxiety-depression spectrum, including symptoms of irritability, anger attacks, and anxiety. Items are rated on an 6-point Likert scale, where participants are asked to rate if a specific symptom (e.g. How has your mood been over the past 24 hours?) is normal for him or her (score = 2), what is better than normal (score = 1), and what is worse than normal (scores = 3-6). The total scale score is calculated by averaging across the items, resulting in a possible range from 1 to 6. Higher scores indicate greater depression severity. When rating, patients were asked to consider their symptoms during the past 24 hours.
Clinical Positive Affect Scale (CPAS)A baseline assessment was made on Day 0, preceding infusion (i.e., treatment). Outcome assessments were made on days 1, 3, 5, 7, 14, and 30. The primary endpoint for this study was Day 3. Thus, the outcome measure table provides data on Days 0, 1 and 3The CPAS is a 16-item self-report scale to assess the level to which participants experience persistent distress due to feeling that they have not returned to their normal or premorbid state. Items (e.g., I look forward to things) are rated on a 5-point scale (0=not at all, 1=very much less than normal, 2=much less than normal, 3=slightly less than normal, 4=same as best or normal self). The possible scale range is 0 to 64, with higher scores indicating greater recovery from depression. Patients were asked to rate their experience of the past 24 hours.
Montgomery-Asberg Depression Rating Scale (MADRS)A baseline assessment was made on Day 0, preceding infusion (i.e., treatment). Outcome assessments were made on days 3, 5, 7, 14, and 30. The primary endpoint for this study was Day 3. Thus, the outcome measure table provides data on Days 0 and 3.The MADRS is a 10-item clinician-rated scale measuring depression severity. Symptoms are rated on a 7-point scale, where 0 = not present, and 1-6 represent increasing severity. Values 2, 4, and 6 have specific anchoring text (e.g., 2=Difficulties in starting activities. 4=Difficulties in starting simple routine activities which are carried out with effort, 6=Complete lassitude. Unable to do anything without help.) Values 1, 3, and 5 do not have specific text. The possible scale range is 0-60, where higher values represent higher severity. In this study, the MADRS was used to rate symptoms occurring in the past 3 days.
Clinician-Administered Dissociative States Scale (CADSS) Scores During InfusionDay 0/baseline at 0, 40, 80, and 120 minutesThe CADSS is a 23-item self-report scale for the assessment of dissociative states. It is a reliable, valid self-report instrument. The severity of each dissociative symptom ranges from 0 (not present) to 4 (extreme). The total score is calculated by summing across items, with a total possible range of 0-92. The CADSS was administered right before infusion, and 40, 80 minute and 120 minutes after the start of infusion. The timeframe is at this moment.
Number of Participants Reporting Suicidal Ideation/Behavior on the Columbia Suicide Severity Rating Scale (C-SSRS)Screening Visit and Days 0, 1, 3, 5, 7, 14 and 30 combinedThe Columbia Suicide Severity Rating Scale (C-SSRS): The C-SSRS is a low-burden measure of the spectrum of suicidal ideation and behavior that was developed in the National Institute of Mental Health Treatment of Adolescent Suicide Attempters Study to assess severity and track suicidal events through any treatment. It is a clinical interview providing a summary of both ideation and behavior that can be administered during any evaluation or risk assessment to identify the level and type of suicidality present. The C-SSRS can also be used during treatment to monitor for clinical worsening or improvement. It contains 5 rating scale questions (yes/no) for suicidal ideation increasing severity and 5 rating scale questions (yes/no) for suicidal behavior of increasing severity. The time frame is for both lifetime and the past six months for the Baseline/Screening scale and since the last visit for the Since Last Visit scale.
Number of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentDay 3 and Early Termination Visit (approximately 3 weeks following intervention)1. CBC 2. Chemistry (Total bilirubin, AST, ALT, GGT, ALK Phosphatase, Creatinine, BUN/Urea, Glucose, Uric Acid) Testing was performed by study site laboratories and used institutional normal lab value ranges.
Snaith-Hamilton Pleasure-Scale (SHAPS)A baseline assessment was made on Day 0, preceding infusion (i.e., treatment). Outcome assessments were made on days 1, 3, 5, 7, 14, and 30. The primary endpoint for this study was Day 3. Thus, the outcome measure table provides data on Days 0, 1 and 3The SHAPS is a 14-item self-report scale to measure hedonic tone. Items (e.g., I would enjoy reading a book, magazine, or newspaper.) are rated on a 4-point scale (1=strongly disagree, 2=disagree, 3=agree, 4=strongly agree). Either of the 'disagree' responses scores 1 point, and either of the 'agree' responses scores 0 points, for a total scale range of 0-14. Higher scores indicate greater inability to experience pleasure. Patients were asked to rate their experience of the past 24 hours.

Countries

United States

Participant flow

Pre-assignment details

The screening period served as a wash-out period for any prohibited medications that could be discontinued safely. Discontinuation of medications were discussed in consultation with the prescribing clinician.

Participants by arm

ArmCount
Ketamine 0.1mg
Patients in this arm will receive 0.1 mg/kg of Ketamine - one single infusion Ketamine: Dose of Ketamine will be 0.1 mg/kg - one single infusion
18
Ketamine 0.2mg
Patients in this arm will receive 0.2 mg/kg of Ketamine - one single infusion Ketamine: Dose of Ketamine will be 0.2 mg/kg - one single infusion
20
Ketamine 0.5mg
Patients in this arm will receive 0.5 mg/kg of Ketamine - one single infusion Ketamine: Dose of Ketamine will be 0.5 mg/kg - one single infusion
22
Ketamine 1.0mg
Patients in this arm will receive 1.0 mg/kg of Ketamine - one single infusion Ketamine: Dose of Ketamine will be 1.0 mg/kg - one single infusion
20
Midazolam (Active Placebo)
Patients in this arm will receive 0.045 mg/kg of midazolam - one single infusion Placebo Midazolam: Dose of Midazolam (active placebo) will be 0.045 mg/kg - one single infusion
19
Total99

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004
Overall StudyLack of Efficacy20000
Overall StudyLost to Follow-up01010
Overall StudyPhysician Decision12120
Overall StudyTravel Difficulties11001

Baseline characteristics

CharacteristicKetamine 0.1mgTotalMidazolam (Active Placebo)Ketamine 1.0mgKetamine 0.5mgKetamine 0.2mg
Abnormal and Clinically Significant Labs
CBC
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Abnormal and Clinically Significant Labs
Chemistry
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Abnormal and Clinically Significant Labs
Hormonal Measures (DHEA)
0 Participants1 Participants0 Participants1 Participants0 Participants0 Participants
Abnormal and Clinically Significant Labs
Hormonal Measures (remaining tests)
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Abnormal and Clinically Significant Labs
Hormonal Measures (testosterone, SHBG, Free T)
0 Participants2 Participants0 Participants0 Participants0 Participants2 Participants
Abnormal and Clinically Significant Labs
Pregnancy Test
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Abnormal and Clinically Significant Labs
Urine Toxicology Screen
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Age, Continuous43.1 years
STANDARD_DEVIATION 11.9
46.04 years
STANDARD_DEVIATION 12.64
45.6 years
STANDARD_DEVIATION 13.8
47.4 years
STANDARD_DEVIATION 10.1
48.6 years
STANDARD_DEVIATION 12.9
45.5 years
STANDARD_DEVIATION 14.6
BMI25.2 kg/m^2
STANDARD_DEVIATION 3.1
24.96 kg/m^2
STANDARD_DEVIATION 4.08
26.3 kg/m^2
STANDARD_DEVIATION 4.1
26.1 kg/m^2
STANDARD_DEVIATION 3.8
25.3 kg/m^2
STANDARD_DEVIATION 5.7
24.9 kg/m^2
STANDARD_DEVIATION 3.7
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants3 Participants0 Participants0 Participants2 Participants0 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
17 Participants96 Participants19 Participants20 Participants20 Participants20 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Sex: Female, Male
Female
10 Participants49 Participants11 Participants8 Participants11 Participants9 Participants
Sex: Female, Male
Male
8 Participants50 Participants8 Participants12 Participants11 Participants11 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
deaths
Total, all-cause mortality
0 / 180 / 200 / 220 / 200 / 19
other
Total, other adverse events
17 / 1818 / 2014 / 2217 / 2010 / 19
serious
Total, serious adverse events
0 / 181 / 200 / 220 / 200 / 19

Outcome results

Primary

Hamilton Rating Scale for Depression - 6 Items

The HAMD6 is a 6-item clinician-rated scale, where clinicians rate the presence of depression symptoms (i.e., depressed mood, guilt, work and interests, psychomotor retardation, psychic anxiety, somatic symptoms) on a 5-point scale, where 0 = not present, and 1-4 represent increasingly severe symptoms. One item (i.e., somatic symptoms) is rated on only a 3-point scale, ranging from 0-2. The possible scale range is 0-22, where higher values represent more severe depression. This instrument is completed with a structured interview guide by the clinician based on his/her assessment of the patient's symptoms. This structured interview has been validated for use with time frames shorter than one week. In this study, the HAMD6 was used to assess symptoms occurring in the past 24 hours.

Time frame: A baseline assessment was made on Day 0, preceding infusion (i.e., treatment). Outcome assessments were made on days 1, 3, 5, 7, 14, and 30. The primary endpoint for this study was Day 3. Thus, the outcome measure table provides data on Days 0, 1, & 3

Population: Several subjects dropped out of the study in between Day 0, Day 1 and Day 3.

ArmMeasureGroupValue (MEAN)Dispersion
Ketamine 0.1mgHamilton Rating Scale for Depression - 6 ItemsDay 012.5555556 units on a scaleStandard Deviation 1.8221585
Ketamine 0.1mgHamilton Rating Scale for Depression - 6 ItemsDay 36.8000000 units on a scaleStandard Deviation 4.6167397
Ketamine 0.1mgHamilton Rating Scale for Depression - 6 ItemsDay 17.5000000 units on a scaleStandard Deviation 4.3204938
Ketamine 0.2mgHamilton Rating Scale for Depression - 6 ItemsDay 19.2631579 units on a scaleStandard Deviation 3.6944719
Ketamine 0.2mgHamilton Rating Scale for Depression - 6 ItemsDay 012.7500000 units on a scaleStandard Deviation 2.4894514
Ketamine 0.2mgHamilton Rating Scale for Depression - 6 ItemsDay 38.4736842 units on a scaleStandard Deviation 4.9818384
Ketamine 0.5mgHamilton Rating Scale for Depression - 6 ItemsDay 15.8636364 units on a scaleStandard Deviation 4.4859087
Ketamine 0.5mgHamilton Rating Scale for Depression - 6 ItemsDay 012.5909091 units on a scaleStandard Deviation 1.4690162
Ketamine 0.5mgHamilton Rating Scale for Depression - 6 ItemsDay 35.9047619 units on a scaleStandard Deviation 4.3000554
Ketamine 1.0mgHamilton Rating Scale for Depression - 6 ItemsDay 012.6315789 units on a scaleStandard Deviation 2.087277
Ketamine 1.0mgHamilton Rating Scale for Depression - 6 ItemsDay 37.2000000 units on a scaleStandard Deviation 3.819617
Ketamine 1.0mgHamilton Rating Scale for Depression - 6 ItemsDay 16.9000000 units on a scaleStandard Deviation 4.5061362
Midazolam 0.045mgHamilton Rating Scale for Depression - 6 ItemsDay 110.6666667 units on a scaleStandard Deviation 3.3606722
Midazolam 0.045mgHamilton Rating Scale for Depression - 6 ItemsDay 013.0526316 units on a scaleStandard Deviation 2.296705
Midazolam 0.045mgHamilton Rating Scale for Depression - 6 ItemsDay 39.0555556 units on a scaleStandard Deviation 4.5435439
Comparison: Ketamine 0.1mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.1495% CI: [-5.93, -0.43]Mixed Models Analysis
Comparison: Ketamine 0.2mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.7995% CI: [-3.75, 1.49]Mixed Models Analysis
Comparison: Ketamine 0.5mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: <0.0195% CI: [-7.35, -2.24]Mixed Models Analysis
Comparison: Ketamine 1.0mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.0495% CI: [-6.37, -1.15]Mixed Models Analysis
Comparison: Ketamine 0.1mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.7295% CI: [-5.04, 0.95]Mixed Models Analysis
Comparison: Ketamine 0.2mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.895% CI: [-3.18, 2.46]Mixed Models Analysis
Comparison: Ketamine 0.5mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.1495% CI: [-5.97, -0.44]Mixed Models Analysis
Comparison: Ketamine 1.0mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.7295% CI: [-4.65, 0.96]Mixed Models Analysis
Secondary

Clinical Global Impressions-Improvement (CGI-I) Scale

The CGI-I is a clinician rated single-item scale: Compared to the patient's condition at admission, how much has the patient changed?, rated on a 7-point response scale: 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, and 7 = Very much worse. In this case, admission referred to the CGI-S screening assessments performed between Day -28 an -7, one conducted during the screening visit, and a second rating conducted by a remote, independent rater.

Time frame: A baseline assessment was made on Day 0, preceding infusion (i.e., treatment). Outcome assessments were made on days 1, 3, 5, 7, 14, and 30. The primary endpoint for this study was Day 3. Thus, the outcome measure table provides data on Days 0, 1 and 3

Population: Several subjects dropped out of the study in between Day 0, Day 1 and Day 3.

ArmMeasureGroupValue (MEAN)Dispersion
Ketamine 0.1mgClinical Global Impressions-Improvement (CGI-I) ScaleDay 13.0625000 units on a scaleStandard Deviation 1.4361407
Ketamine 0.1mgClinical Global Impressions-Improvement (CGI-I) ScaleDay 03.8888889 units on a scaleStandard Deviation 0.3233808
Ketamine 0.1mgClinical Global Impressions-Improvement (CGI-I) ScaleDay 32.9333333 units on a scaleStandard Deviation 1.2798809
Ketamine 0.2mgClinical Global Impressions-Improvement (CGI-I) ScaleDay 32.8421053 units on a scaleStandard Deviation 1.2588865
Ketamine 0.2mgClinical Global Impressions-Improvement (CGI-I) ScaleDay 04.0500000 units on a scaleStandard Deviation 0.2236068
Ketamine 0.2mgClinical Global Impressions-Improvement (CGI-I) ScaleDay 13.3684211 units on a scaleStandard Deviation 1.0651305
Ketamine 0.5mgClinical Global Impressions-Improvement (CGI-I) ScaleDay 04.1363636 units on a scaleStandard Deviation 0.7101613
Ketamine 0.5mgClinical Global Impressions-Improvement (CGI-I) ScaleDay 32.5714286 units on a scaleStandard Deviation 0.9258201
Ketamine 0.5mgClinical Global Impressions-Improvement (CGI-I) ScaleDay 12.6363636 units on a scaleStandard Deviation 0.9021379
Ketamine 1.0mgClinical Global Impressions-Improvement (CGI-I) ScaleDay 13.0500000 units on a scaleStandard Deviation 1.234376
Ketamine 1.0mgClinical Global Impressions-Improvement (CGI-I) ScaleDay 32.5500000 units on a scaleStandard Deviation 1.0990426
Ketamine 1.0mgClinical Global Impressions-Improvement (CGI-I) ScaleDay 04.0000000 units on a scaleStandard Deviation 0.4588315
Midazolam 0.045mgClinical Global Impressions-Improvement (CGI-I) ScaleDay 33.1666667 units on a scaleStandard Deviation 1.0431852
Midazolam 0.045mgClinical Global Impressions-Improvement (CGI-I) ScaleDay 04.1578947 units on a scaleStandard Deviation 0.6021404
Midazolam 0.045mgClinical Global Impressions-Improvement (CGI-I) ScaleDay 13.6111111 units on a scaleStandard Deviation 0.607685
Comparison: Ketamine 0.1 mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.5495% CI: [-1.25, 0.17]Mixed Models Analysis
Comparison: Ketamine 0.2 mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 195% CI: [-0.78, 0.58]Mixed Models Analysis
Comparison: Ketamine 0.5 mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.0395% CI: [-1.64, -0.31]Mixed Models Analysis
Comparison: Ketamine 1.0 mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.5495% CI: [-1.24, 0.11]Mixed Models Analysis
Comparison: Ketamine 0.1 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 195% CI: [-0.96, 0.57]Mixed Models Analysis
Comparison: Ketamine 0.2 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 195% CI: [-0.93, 0.51]Mixed Models Analysis
Comparison: Ketamine 0.5 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.5295% CI: [-1.35, 0.06]Mixed Models Analysis
Comparison: Ketamine 1.0 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.5495% CI: [-1.33, 0.1]Mixed Models Analysis
Secondary

Clinical Global Impressions-Severity (CGI-S)

The CGI-S is a clinician rated single-item scale: How depressed is the patient at this time?, rated on a 7-point response scale: 1 = Normal, not at all depressed, 2 = Borderline depressed, 3 = Mildly depressed, 4 = Moderately depressed. 5 = Markedly depressed, 6 = severely depressed, 7 = Among the most severely depressed patients. When rating patients, clinicians were asked to consider the past 24 hours.

Time frame: A baseline assessment was made on Day 0, preceding infusion (i.e., treatment). Outcome assessments were made on days 1, 3, 5, 7, 14, and 30. The primary endpoint for this study was Day 3. Thus, the outcome measure table provides data on Days 0, 1 and 3

Population: Several subjects dropped out of the study in between Day 0, Day 1 and Day 3.

ArmMeasureGroupValue (MEAN)Dispersion
Ketamine 0.1mgClinical Global Impressions-Severity (CGI-S)Day 33.4000000 units on a scaleStandard Deviation 1.6388149
Ketamine 0.1mgClinical Global Impressions-Severity (CGI-S)Day 13.5625000 units on a scaleStandard Deviation 1.4591664
Ketamine 0.1mgClinical Global Impressions-Severity (CGI-S)Day 05.0000000 units on a scaleStandard Deviation 0.766965
Ketamine 0.2mgClinical Global Impressions-Severity (CGI-S)Day 33.7368421 units on a scaleStandard Deviation 1.4848159
Ketamine 0.2mgClinical Global Impressions-Severity (CGI-S)Day 05.2000000 units on a scaleStandard Deviation 0.6958524
Ketamine 0.2mgClinical Global Impressions-Severity (CGI-S)Day 14.2631579 units on a scaleStandard Deviation 1.240166
Ketamine 0.5mgClinical Global Impressions-Severity (CGI-S)Day 33.1428571 units on a scaleStandard Deviation 1.3887301
Ketamine 0.5mgClinical Global Impressions-Severity (CGI-S)Day 13.2727273 units on a scaleStandard Deviation 1.2792043
Ketamine 0.5mgClinical Global Impressions-Severity (CGI-S)Day 04.8636364 units on a scaleStandard Deviation 0.6396021
Ketamine 1.0mgClinical Global Impressions-Severity (CGI-S)Day 13.5000000 units on a scaleStandard Deviation 1.1002392
Ketamine 1.0mgClinical Global Impressions-Severity (CGI-S)Day 05.2000000 units on a scaleStandard Deviation 0.7677719
Ketamine 1.0mgClinical Global Impressions-Severity (CGI-S)Day 33.3000000 units on a scaleStandard Deviation 1.4545754
Midazolam 0.045mgClinical Global Impressions-Severity (CGI-S)Day 34.1666667 units on a scaleStandard Deviation 1.3394468
Midazolam 0.045mgClinical Global Impressions-Severity (CGI-S)Day 14.555556 units on a scaleStandard Deviation 0.7838234
Midazolam 0.045mgClinical Global Impressions-Severity (CGI-S)Day 05.000000 units on a scaleStandard Deviation 0.745356
Comparison: Ketamine 0.1 mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.0895% CI: [-1.83, -0.22]Mixed Models Analysis
Comparison: Ketamine 0.2 mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.8295% CI: [-1.02, 0.51]Mixed Models Analysis
Comparison: Ketamine 0.5 mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.007295% CI: [-2.02, -0.54]Mixed Models Analysis
Comparison: Ketamine 1.0 mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.0488495% CI: [-1.81, -0.29]Mixed Models Analysis
Comparison: Ketamine 0.1 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.4895% CI: [-1.7, 0.28]Mixed Models Analysis
Comparison: Ketamine 0.2 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.8295% CI: [-1.32, 0.55]Mixed Models Analysis
Comparison: Ketamine 0.5 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.1695% CI: [-1.91, -0.09]Mixed Models Analysis
Comparison: Ketamine 1.0 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.2795% CI: [-1.78, 0.07]Mixed Models Analysis
Secondary

Clinical Positive Affect Scale (CPAS)

The CPAS is a 16-item self-report scale to assess the level to which participants experience persistent distress due to feeling that they have not returned to their normal or premorbid state. Items (e.g., I look forward to things) are rated on a 5-point scale (0=not at all, 1=very much less than normal, 2=much less than normal, 3=slightly less than normal, 4=same as best or normal self). The possible scale range is 0 to 64, with higher scores indicating greater recovery from depression. Patients were asked to rate their experience of the past 24 hours.

Time frame: A baseline assessment was made on Day 0, preceding infusion (i.e., treatment). Outcome assessments were made on days 1, 3, 5, 7, 14, and 30. The primary endpoint for this study was Day 3. Thus, the outcome measure table provides data on Days 0, 1 and 3

Population: Several subjects dropped out of the study in between Day 0, Day 1 and Day 3.

ArmMeasureGroupValue (MEAN)Dispersion
Ketamine 0.1mgClinical Positive Affect Scale (CPAS)Day 019.3333333 units on a scaleStandard Deviation 12.1896774
Ketamine 0.1mgClinical Positive Affect Scale (CPAS)Day 338.8666667 units on a scaleStandard Deviation 22.8666667
Ketamine 0.1mgClinical Positive Affect Scale (CPAS)Day 135.2500000 units on a scaleStandard Deviation 20.9936498
Ketamine 0.2mgClinical Positive Affect Scale (CPAS)Day 127.0526316 units on a scaleStandard Deviation 18.8516833
Ketamine 0.2mgClinical Positive Affect Scale (CPAS)Day 020.5000000 units on a scaleStandard Deviation 15.4357753
Ketamine 0.2mgClinical Positive Affect Scale (CPAS)Day 328.3888889 units on a scaleStandard Deviation 20.245955
Ketamine 0.5mgClinical Positive Affect Scale (CPAS)Day 140.8696964 units on a scaleStandard Deviation 19.5284785
Ketamine 0.5mgClinical Positive Affect Scale (CPAS)Day 020.6363636 units on a scaleStandard Deviation 11.7008158
Ketamine 0.5mgClinical Positive Affect Scale (CPAS)Day 339.7619048 units on a scaleStandard Deviation 22.5319878
Ketamine 1.0mgClinical Positive Affect Scale (CPAS)Day 021.2500000 units on a scaleStandard Deviation 14.6785737
Ketamine 1.0mgClinical Positive Affect Scale (CPAS)Day 337.4500000 units on a scaleStandard Deviation 18.7096232
Ketamine 1.0mgClinical Positive Affect Scale (CPAS)Day 133.0000000 units on a scaleStandard Deviation 16.264265
Midazolam 0.045mgClinical Positive Affect Scale (CPAS)Day 124.4444444 units on a scaleStandard Deviation 15.2053482
Midazolam 0.045mgClinical Positive Affect Scale (CPAS)Day 021.2631579 units on a scaleStandard Deviation 12.1052886
Midazolam 0.045mgClinical Positive Affect Scale (CPAS)Day 333.3750000 units on a scaleStandard Deviation 15.8445574
Comparison: Ketamine 0.1 mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.4995% CI: [-0.94, 23.29]Mixed Models Analysis
Comparison: Ketamine 0.2 mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 195% CI: [-10.19, 12.93]Mixed Models Analysis
Comparison: Ketamine 0.5 mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.0395% CI: [5.31, 27.77]Mixed Models Analysis
Comparison: Ketamine 1.0 mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.8295% CI: [-2.81, 20.16]Mixed Models Analysis
Comparison: Ketamine 0.1 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 195% CI: [-8.83, 19.05]Mixed Models Analysis
Comparison: Ketamine 0.2 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 195% CI: [-19.87, 6.59]Mixed Models Analysis
Comparison: Ketamine 0.5 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 195% CI: [-5.26, 20.53]Mixed Models Analysis
Comparison: Ketamine 1.0 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 195% CI: [-8.31, 17.91]Mixed Models Analysis
Secondary

Clinician-Administered Dissociative States Scale (CADSS) Scores During Infusion

The CADSS is a 23-item self-report scale for the assessment of dissociative states. It is a reliable, valid self-report instrument. The severity of each dissociative symptom ranges from 0 (not present) to 4 (extreme). The total score is calculated by summing across items, with a total possible range of 0-92. The CADSS was administered right before infusion, and 40, 80 minute and 120 minutes after the start of infusion. The timeframe is at this moment.

Time frame: Day 0/baseline at 0, 40, 80, and 120 minutes

ArmMeasureGroupValue (MEAN)Dispersion
Ketamine 0.1mgClinician-Administered Dissociative States Scale (CADSS) Scores During InfusionMinute 403.0000000 units on a scaleStandard Deviation 5.0758946
Ketamine 0.1mgClinician-Administered Dissociative States Scale (CADSS) Scores During InfusionMinute 00.1111111 units on a scaleStandard Deviation 0.4714045
Ketamine 0.1mgClinician-Administered Dissociative States Scale (CADSS) Scores During InfusionMinute 800.4444444 units on a scaleStandard Deviation 0.7838234
Ketamine 0.1mgClinician-Administered Dissociative States Scale (CADSS) Scores During InfusionMinute 1200.0555556 units on a scaleStandard Deviation 0.2357023
Ketamine 0.2mgClinician-Administered Dissociative States Scale (CADSS) Scores During InfusionMinute 1200 units on a scaleStandard Deviation 0
Ketamine 0.2mgClinician-Administered Dissociative States Scale (CADSS) Scores During InfusionMinute 800.1000000 units on a scaleStandard Deviation 0.4472136
Ketamine 0.2mgClinician-Administered Dissociative States Scale (CADSS) Scores During InfusionMinute 404.0500000 units on a scaleStandard Deviation 4.2608993
Ketamine 0.2mgClinician-Administered Dissociative States Scale (CADSS) Scores During InfusionMinute 00.1000000 units on a scaleStandard Deviation 0.4472136
Ketamine 0.5mgClinician-Administered Dissociative States Scale (CADSS) Scores During InfusionMinute 00 units on a scaleStandard Deviation 0
Ketamine 0.5mgClinician-Administered Dissociative States Scale (CADSS) Scores During InfusionMinute 1200.1363636 units on a scaleStandard Deviation 0.6396021
Ketamine 0.5mgClinician-Administered Dissociative States Scale (CADSS) Scores During InfusionMinute 800.7727273 units on a scaleStandard Deviation 2.1141658
Ketamine 0.5mgClinician-Administered Dissociative States Scale (CADSS) Scores During InfusionMinute 4014.2727273 units on a scaleStandard Deviation 9.6076644
Ketamine 1.0mgClinician-Administered Dissociative States Scale (CADSS) Scores During InfusionMinute 00.1000000 units on a scaleStandard Deviation 0.3077935
Ketamine 1.0mgClinician-Administered Dissociative States Scale (CADSS) Scores During InfusionMinute 4024.6842105 units on a scaleStandard Deviation 17.7108022
Ketamine 1.0mgClinician-Administered Dissociative States Scale (CADSS) Scores During InfusionMinute 801.8000000 units on a scaleStandard Deviation 2.9664794
Ketamine 1.0mgClinician-Administered Dissociative States Scale (CADSS) Scores During InfusionMinute 1200.6500000 units on a scaleStandard Deviation 1.5985191
Midazolam 0.045mgClinician-Administered Dissociative States Scale (CADSS) Scores During InfusionMinute 1200.5789474 units on a scaleStandard Deviation 0.9015905
Midazolam 0.045mgClinician-Administered Dissociative States Scale (CADSS) Scores During InfusionMinute 00.4210526 units on a scaleStandard Deviation 1.01739326
Midazolam 0.045mgClinician-Administered Dissociative States Scale (CADSS) Scores During InfusionMinute 402.6842105 units on a scaleStandard Deviation 3.5127171
Midazolam 0.045mgClinician-Administered Dissociative States Scale (CADSS) Scores During InfusionMinute 801.1578947 units on a scaleStandard Deviation 1.833732
Secondary

Montgomery-Asberg Depression Rating Scale (MADRS)

The MADRS is a 10-item clinician-rated scale measuring depression severity. Symptoms are rated on a 7-point scale, where 0 = not present, and 1-6 represent increasing severity. Values 2, 4, and 6 have specific anchoring text (e.g., 2=Difficulties in starting activities. 4=Difficulties in starting simple routine activities which are carried out with effort, 6=Complete lassitude. Unable to do anything without help.) Values 1, 3, and 5 do not have specific text. The possible scale range is 0-60, where higher values represent higher severity. In this study, the MADRS was used to rate symptoms occurring in the past 3 days.

Time frame: A baseline assessment was made on Day 0, preceding infusion (i.e., treatment). Outcome assessments were made on days 3, 5, 7, 14, and 30. The primary endpoint for this study was Day 3. Thus, the outcome measure table provides data on Days 0 and 3.

Population: Several subjects dropped out of the study in between Day 0, Day 1 and Day 3.

ArmMeasureGroupValue (MEAN)Dispersion
Ketamine 0.1mgMontgomery-Asberg Depression Rating Scale (MADRS)Day 033.8333333 units on a scaleStandard Deviation 5.9334545
Ketamine 0.1mgMontgomery-Asberg Depression Rating Scale (MADRS)Day 319.6666667 units on a scaleStandard Deviation 10.8144524
Ketamine 0.2mgMontgomery-Asberg Depression Rating Scale (MADRS)Day 034.4500000 units on a scaleStandard Deviation 8.4571676
Ketamine 0.2mgMontgomery-Asberg Depression Rating Scale (MADRS)Day 322.6315789 units on a scaleStandard Deviation 11.7294052
Ketamine 0.5mgMontgomery-Asberg Depression Rating Scale (MADRS)Day 031.5909091 units on a scaleStandard Deviation 3.9359042
Ketamine 0.5mgMontgomery-Asberg Depression Rating Scale (MADRS)Day 314.7619048 units on a scaleStandard Deviation 8.9883523
Ketamine 1.0mgMontgomery-Asberg Depression Rating Scale (MADRS)Day 317.1000000 units on a scaleStandard Deviation 11.5708345
Ketamine 1.0mgMontgomery-Asberg Depression Rating Scale (MADRS)Day 032.6500000 units on a scaleStandard Deviation 5.8873191
Midazolam 0.045mgMontgomery-Asberg Depression Rating Scale (MADRS)Day 033.6315789 units on a scaleStandard Deviation 7.0884141
Midazolam 0.045mgMontgomery-Asberg Depression Rating Scale (MADRS)Day 324.8333333 units on a scaleStandard Deviation 10.5286723
Comparison: Ketamine 0.1 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were four pairwise comparisons of interest (see Analysis 1-4), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.3395% CI: [-12.44, 2.14]Mixed Models Analysis
Comparison: Ketamine 0.2 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were four pairwise comparisons of interest (see Analysis 1-4), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.5395% CI: [-9.03, 4.72]Mixed Models Analysis
Comparison: Ketamine 0.5 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were four pairwise comparisons of interest (see Analysis 1-4), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.0295% CI: [-16.56, -3.15]Mixed Models Analysis
Comparison: Ketamine 1.0 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were four pairwise comparisons of interest (see Analysis 1-4), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.0895% CI: [-14.52, -0.93]Mixed Models Analysis
Secondary

Number of Participants Reporting Suicidal Ideation/Behavior on the Columbia Suicide Severity Rating Scale (C-SSRS)

The Columbia Suicide Severity Rating Scale (C-SSRS): The C-SSRS is a low-burden measure of the spectrum of suicidal ideation and behavior that was developed in the National Institute of Mental Health Treatment of Adolescent Suicide Attempters Study to assess severity and track suicidal events through any treatment. It is a clinical interview providing a summary of both ideation and behavior that can be administered during any evaluation or risk assessment to identify the level and type of suicidality present. The C-SSRS can also be used during treatment to monitor for clinical worsening or improvement. It contains 5 rating scale questions (yes/no) for suicidal ideation increasing severity and 5 rating scale questions (yes/no) for suicidal behavior of increasing severity. The time frame is for both lifetime and the past six months for the Baseline/Screening scale and since the last visit for the Since Last Visit scale.

Time frame: Screening Visit and Days 0, 1, 3, 5, 7, 14 and 30 combined

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Ketamine 0.1mgNumber of Participants Reporting Suicidal Ideation/Behavior on the Columbia Suicide Severity Rating Scale (C-SSRS)Screening: # with suicidal ideation/behavior17 Participants
Ketamine 0.1mgNumber of Participants Reporting Suicidal Ideation/Behavior on the Columbia Suicide Severity Rating Scale (C-SSRS)Follow-Up: # with suicidal ideation/behavior15 Participants
Ketamine 0.2mgNumber of Participants Reporting Suicidal Ideation/Behavior on the Columbia Suicide Severity Rating Scale (C-SSRS)Screening: # with suicidal ideation/behavior15 Participants
Ketamine 0.2mgNumber of Participants Reporting Suicidal Ideation/Behavior on the Columbia Suicide Severity Rating Scale (C-SSRS)Follow-Up: # with suicidal ideation/behavior9 Participants
Ketamine 0.5mgNumber of Participants Reporting Suicidal Ideation/Behavior on the Columbia Suicide Severity Rating Scale (C-SSRS)Screening: # with suicidal ideation/behavior17 Participants
Ketamine 0.5mgNumber of Participants Reporting Suicidal Ideation/Behavior on the Columbia Suicide Severity Rating Scale (C-SSRS)Follow-Up: # with suicidal ideation/behavior10 Participants
Ketamine 1.0mgNumber of Participants Reporting Suicidal Ideation/Behavior on the Columbia Suicide Severity Rating Scale (C-SSRS)Follow-Up: # with suicidal ideation/behavior6 Participants
Ketamine 1.0mgNumber of Participants Reporting Suicidal Ideation/Behavior on the Columbia Suicide Severity Rating Scale (C-SSRS)Screening: # with suicidal ideation/behavior14 Participants
Midazolam 0.045mgNumber of Participants Reporting Suicidal Ideation/Behavior on the Columbia Suicide Severity Rating Scale (C-SSRS)Screening: # with suicidal ideation/behavior17 Participants
Midazolam 0.045mgNumber of Participants Reporting Suicidal Ideation/Behavior on the Columbia Suicide Severity Rating Scale (C-SSRS)Follow-Up: # with suicidal ideation/behavior13 Participants
Secondary

Number of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by Treatment

1. CBC 2. Chemistry (Total bilirubin, AST, ALT, GGT, ALK Phosphatase, Creatinine, BUN/Urea, Glucose, Uric Acid) Testing was performed by study site laboratories and used institutional normal lab value ranges.

Time frame: Day 3 and Early Termination Visit (approximately 3 weeks following intervention)

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Ketamine 0.1mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentChemistry Remaining Tests0 Participants
Ketamine 0.1mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentChemistry ALT(SGPT)0 Participants
Ketamine 0.1mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentCBC0 Participants
Ketamine 0.1mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentChemistry AST(SGOT)0 Participants
Ketamine 0.1mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentChemistry Total Bilirubin0 Participants
Ketamine 0.2mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentChemistry Remaining Tests0 Participants
Ketamine 0.2mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentChemistry Total Bilirubin1 Participants
Ketamine 0.2mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentChemistry AST(SGOT)1 Participants
Ketamine 0.2mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentCBC0 Participants
Ketamine 0.2mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentChemistry ALT(SGPT)1 Participants
Ketamine 0.5mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentChemistry Total Bilirubin0 Participants
Ketamine 0.5mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentChemistry ALT(SGPT)0 Participants
Ketamine 0.5mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentChemistry AST(SGOT)0 Participants
Ketamine 0.5mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentChemistry Remaining Tests0 Participants
Ketamine 0.5mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentCBC0 Participants
Ketamine 1.0mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentCBC0 Participants
Ketamine 1.0mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentChemistry ALT(SGPT)0 Participants
Ketamine 1.0mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentChemistry Remaining Tests0 Participants
Ketamine 1.0mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentChemistry Total Bilirubin0 Participants
Ketamine 1.0mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentChemistry AST(SGOT)0 Participants
Midazolam 0.045mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentChemistry Total Bilirubin0 Participants
Midazolam 0.045mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentChemistry Remaining Tests0 Participants
Midazolam 0.045mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentChemistry ALT(SGPT)0 Participants
Midazolam 0.045mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentCBC0 Participants
Midazolam 0.045mgNumber of Participants With Abnormal and Clinically Significant CBC and Chemistry Labs by TreatmentChemistry AST(SGOT)0 Participants
Secondary

Snaith-Hamilton Pleasure-Scale (SHAPS)

The SHAPS is a 14-item self-report scale to measure hedonic tone. Items (e.g., I would enjoy reading a book, magazine, or newspaper.) are rated on a 4-point scale (1=strongly disagree, 2=disagree, 3=agree, 4=strongly agree). Either of the 'disagree' responses scores 1 point, and either of the 'agree' responses scores 0 points, for a total scale range of 0-14. Higher scores indicate greater inability to experience pleasure. Patients were asked to rate their experience of the past 24 hours.

Time frame: A baseline assessment was made on Day 0, preceding infusion (i.e., treatment). Outcome assessments were made on days 1, 3, 5, 7, 14, and 30. The primary endpoint for this study was Day 3. Thus, the outcome measure table provides data on Days 0, 1 and 3

Population: Several subjects dropped out of the study in between Day 0, Day 1 and Day 3.

ArmMeasureGroupValue (MEAN)Dispersion
Ketamine 0.1mgSnaith-Hamilton Pleasure-Scale (SHAPS)Day 07.2222222 units on a scaleStandard Deviation 3.9040786
Ketamine 0.1mgSnaith-Hamilton Pleasure-Scale (SHAPS)Day 33.5333333 units on a scaleStandard Deviation 3.3777987
Ketamine 0.1mgSnaith-Hamilton Pleasure-Scale (SHAPS)Day 13.9375000 units on a scaleStandard Deviation 4.2812576
Ketamine 0.2mgSnaith-Hamilton Pleasure-Scale (SHAPS)Day 15.7368421 units on a scaleStandard Deviation 4.2536534
Ketamine 0.2mgSnaith-Hamilton Pleasure-Scale (SHAPS)Day 07.5500000 units on a scaleStandard Deviation 3.913203
Ketamine 0.2mgSnaith-Hamilton Pleasure-Scale (SHAPS)Day 36.3888889 units on a scaleStandard Deviation 4.5262488
Ketamine 0.5mgSnaith-Hamilton Pleasure-Scale (SHAPS)Day 12.22727273 units on a scaleStandard Deviation 3.5748036
Ketamine 0.5mgSnaith-Hamilton Pleasure-Scale (SHAPS)Day 06.5909091 units on a scaleStandard Deviation 3.2316749
Ketamine 0.5mgSnaith-Hamilton Pleasure-Scale (SHAPS)Day 33.0000000 units on a scaleStandard Deviation 3.7815341
Ketamine 1.0mgSnaith-Hamilton Pleasure-Scale (SHAPS)Day 07.3500000 units on a scaleStandard Deviation 4.1961762
Ketamine 1.0mgSnaith-Hamilton Pleasure-Scale (SHAPS)Day 33.6500000 units on a scaleStandard Deviation 4.8370826
Ketamine 1.0mgSnaith-Hamilton Pleasure-Scale (SHAPS)Day 14.3000000 units on a scaleStandard Deviation 4.5664682
Midazolam 0.045mgSnaith-Hamilton Pleasure-Scale (SHAPS)Day 15.0000000 units on a scaleStandard Deviation 4.6272848
Midazolam 0.045mgSnaith-Hamilton Pleasure-Scale (SHAPS)Day 06.4736842 units on a scaleStandard Deviation 3.7471237
Midazolam 0.045mgSnaith-Hamilton Pleasure-Scale (SHAPS)Day 34.2500000 units on a scaleStandard Deviation 3.8384024
Comparison: Ketamine 0.1 mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 195% CI: [-3.99, 1.56]Mixed Models Analysis
Comparison: Ketamine 0.2 mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.1795% CI: [-1.9, 3.43]Mixed Models Analysis
Comparison: Ketamine 0.5 mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.395% CI: [-5.32, -0.16]Mixed Models Analysis
Comparison: Ketamine 1.0 mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 195% CI: [-3.35, 1.93]Mixed Models Analysis
Comparison: Ketamine 0.1 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 195% CI: [-3.25, 2.66]Mixed Models Analysis
Comparison: Ketamine 0.2 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.3995% CI: [-0.06, 5.59]Mixed Models Analysis
Comparison: Ketamine 0.5 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 195% CI: [-3.91, 1.58]Mixed Models Analysis
Comparison: Ketamine 1.0 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 195% CI: [-3.22, 2.35]Mixed Models Analysis
Secondary

Symptoms of Depression Questionnaire (SDQ)

The SDQ is a 44-item self-report scale, which aims to measure depression more comprehensively by including the assessment of symptoms in the anxiety-depression spectrum, including symptoms of irritability, anger attacks, and anxiety. Items are rated on an 6-point Likert scale, where participants are asked to rate if a specific symptom (e.g. How has your mood been over the past 24 hours?) is normal for him or her (score = 2), what is better than normal (score = 1), and what is worse than normal (scores = 3-6). The total scale score is calculated by averaging across the items, resulting in a possible range from 1 to 6. Higher scores indicate greater depression severity. When rating, patients were asked to consider their symptoms during the past 24 hours.

Time frame: A baseline assessment was made on Day 0, preceding infusion (i.e., treatment). Outcome assessments were made on days 1, 3, 5, 7, 14, and 30. The primary endpoint for this study was Day 3. Thus, the outcome measure table provides data on Days 0, 1 and 3

Population: Several subjects dropped out of the study in between Day 0, Day 1 and Day 3.

ArmMeasureGroupValue (MEAN)Dispersion
Ketamine 0.1mgSymptoms of Depression Questionnaire (SDQ)Day 03.5164141 units on a scaleStandard Deviation 0.5081856
Ketamine 0.1mgSymptoms of Depression Questionnaire (SDQ)Day 12.5752843 units on a scaleStandard Deviation 0.7091841
Ketamine 0.1mgSymptoms of Depression Questionnaire (SDQ)Day 32.5106061 units on a scaleStandard Deviation 0.715812
Ketamine 0.2mgSymptoms of Depression Questionnaire (SDQ)Day 32.7828283 units on a scaleStandard Deviation 0.7398734
Ketamine 0.2mgSymptoms of Depression Questionnaire (SDQ)Day 03.4636364 units on a scaleStandard Deviation 0.5416735
Ketamine 0.2mgSymptoms of Depression Questionnaire (SDQ)Day 12.9096195 units on a scaleStandard Deviation 0.712391
Ketamine 0.5mgSymptoms of Depression Questionnaire (SDQ)Day 32.5573593 units on a scaleStandard Deviation 0.9017779
Ketamine 0.5mgSymptoms of Depression Questionnaire (SDQ)Day 12.3109504 units on a scaleStandard Deviation 0.6315677
Ketamine 0.5mgSymptoms of Depression Questionnaire (SDQ)Day 03.5392562 units on a scaleStandard Deviation 0.5838397
Ketamine 1.0mgSymptoms of Depression Questionnaire (SDQ)Day 12.6113636 units on a scaleStandard Deviation 0.500567
Ketamine 1.0mgSymptoms of Depression Questionnaire (SDQ)Day 32.5909091 units on a scaleStandard Deviation 0.5736341
Ketamine 1.0mgSymptoms of Depression Questionnaire (SDQ)Day 03.4113636 units on a scaleStandard Deviation 0.4336652
Midazolam 0.045mgSymptoms of Depression Questionnaire (SDQ)Day 32.8751353 units on a scaleStandard Deviation 0.6668931
Midazolam 0.045mgSymptoms of Depression Questionnaire (SDQ)Day 12.9200573 units on a scaleStandard Deviation 0.646421
Midazolam 0.045mgSymptoms of Depression Questionnaire (SDQ)Day 03.4264507 units on a scaleStandard Deviation 0.471977
Comparison: Ketamine 0.1 mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.7495% CI: [-0.79, 0.08]Mixed Models Analysis
Comparison: Ketamine 0.2 mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 195% CI: [-0.37, 0.45]Mixed Models Analysis
Comparison: Ketamine 0.5 mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.0295% CI: [-1.01, -0.21]Mixed Models Analysis
Comparison: Ketamine 1.0 mg/kg vs. midazolam at Day 1:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.895% CI: [-0.72, 0.1]Mixed Models Analysis
Comparison: Ketamine 0.1 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.8895% CI: [-0.83, 0.18]Mixed Models Analysis
Comparison: Ketamine 0.2 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 195% CI: [-0.53, 0.44]Mixed Models Analysis
Comparison: Ketamine 0.5 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.8895% CI: [-0.79, 0.15]Mixed Models Analysis
Comparison: Ketamine 1.0 mg/kg vs. midazolam at Day 3:~As estimated by the repeated measures fixed effects model with DAY (0, 1, 3), GROUP (5 groups as specified above), and the DAY\*GROUP interaction effect. Because there were eight pairwise comparisons of interest (see Analysis 1-8), we used Holm's method to protect family-wise error rate in the presence of multiple testing.p-value: 0.8895% CI: [-0.76, 0.19]Mixed Models Analysis

Source: ClinicalTrials.gov · Data processed: Mar 5, 2026