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    Clinical Trial Results:
    Investigation of antidepressant efficacy of oral ketamine treatment

    Summary
    EudraCT number
    2016-002068-14
    Trial protocol
    AT  
    Global end of trial date
    13 Oct 2021

    Results information
    Results version number
    v1(current)
    This version publication date
    13 Nov 2025
    First version publication date
    13 Nov 2025
    Other versions
    Summary report(s)
    Publication

    Trial information

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    Trial identification
    Sponsor protocol code
    KET_po
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02992496
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Medical University of Vienna
    Sponsor organisation address
    Spitalgasse 23, Vienna, Austria, 1090
    Public contact
    Dpt of Psychiatry and Psychotherapy, Medical University of Vienna, 0043 14040035680, biol-psychiatry@meduniwien.ac.at
    Scientific contact
    Dpt of Psychiatry and Psychotherapy, Medical University of Vienna, 0043 14040035680, biol-psychiatry@meduniwien.ac.at
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    05 Apr 2025
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    22 Apr 2021
    Global end of trial reached?
    Yes
    Global end of trial date
    13 Oct 2021
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To assess the antidepressant efficacy of oral ketamine in patients suffering from a major depressive episode in a double-blinded randomized and controlled study design.
    Protection of trial subjects
    Study risks were minimal and interventions were performed by trained clinical personnel. Side effects were monitored closely by standardized questionnaires.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    23 Jan 2017
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Austria: 47
    Worldwide total number of subjects
    47
    EEA total number of subjects
    47
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    47
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Patients suffering from a depressive episode were recruited from the in- and outpatient clinic of the Department of Psychiatry and Psychotherapy, Medical University of Vienna. Patients were recruited between 24.04.2017 and 07.04.2021.

    Pre-assignment
    Screening details
    Stable psychopharmacological treatment for 10 days (except benzodiazepines) was required. Initiation of a new antidepressant/mood-stabilising treatment within 4 weeks prior to participation was an exclusion criterion. History of ketamine treatment, psychosis, or substance abuse within the past 12 months were further exclusion criteria.

    Period 1
    Period 1 title
    overall trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator
    Blinding implementation details
    Randomization was performed by an independent researcher of our group not involved in the analysis or execution of the project. The randomization list was provided to the hospital pharmacy for preparation of the study medication. By using an active control treatment, unblinding due to unspecific drug effects was minimized. Further, adverse events were recorded by a different physician than the one responsible for assessment of depressive symptoms.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Ketamine
    Arm description
    Oral ketamine treatment 1mg/kg 6x over two weeks
    Arm type
    Experimental

    Investigational medicinal product name
    Ketamine hydrochloride
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Oral drops
    Routes of administration
    Oral use
    Dosage and administration details
    1mg/kg applied per-orally at six occasions over the period of 12 days

    Arm title
    Midazolam
    Arm description
    Oral midazolam treatment 0.03mg/kg 6x over two weeks
    Arm type
    Active comparator

    Investigational medicinal product name
    MIDAZOLAM HYDROCHLORIDE
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Oral solution
    Routes of administration
    Oral use
    Dosage and administration details
    0.03 mg/kg applied per-orally at six occasions over 12 days

    Number of subjects in period 1
    Ketamine Midazolam
    Started
    23
    24
    Completed
    23
    22
    Not completed
    0
    2
         Lost to follow-up
    -
    2

    Baseline characteristics

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    End points

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    End points reporting groups
    Reporting group title
    Ketamine
    Reporting group description
    Oral ketamine treatment 1mg/kg 6x over two weeks

    Reporting group title
    Midazolam
    Reporting group description
    Oral midazolam treatment 0.03mg/kg 6x over two weeks

    Primary: Depressive symptom score

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    End point title
    Depressive symptom score
    End point description
    Change in MADRS score compared between treatment arms
    End point type
    Primary
    End point timeframe
    baseline vs. 1 week after initiation of treatment
    End point values
    Ketamine Midazolam
    Number of subjects analysed
    23
    22
    Units: MADRS
        arithmetic mean (standard deviation)
    -7.695652 ( 10.87 )
    -5.772727 ( 9.24 )
    Statistical analysis title
    Mixed effects model for repeated measures
    Statistical analysis description
    An intention-to-treat analysis comprising all patients who received at least one dose was performed. A mixed effects model for repeated measures (baseline, 24 h, 7 days and 11 days after first dose) was calculated using maximum likelihood estimation. The intercept was allowed to vary randomly. Treatment group, time of visit and their interaction were included as fixed effects and subject as random effect.
    Comparison groups
    Ketamine v Midazolam
    Number of subjects included in analysis
    45
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    ≤ 0.05
    Method
    Mixed models analysis
    Confidence interval

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Administration of first dose until final examination scheduled at least 2 weeks after last dose
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    28.1
    Reporting groups
    Reporting group title
    Ketamine
    Reporting group description
    Oral ketamine treatment 1mg/kg 6x over two weeks

    Reporting group title
    Midazolam
    Reporting group description
    Oral midazolam treatment 0.03mg/kg 6x over two weeks

    Serious adverse events
    Ketamine Midazolam
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 23 (0.00%)
    0 / 22 (0.00%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Ketamine Midazolam
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    23 / 23 (100.00%)
    22 / 22 (100.00%)
    Cardiac disorders
    Palpitations
         subjects affected / exposed
    6 / 23 (26.09%)
    4 / 22 (18.18%)
         occurrences all number
    9
    7
    Chest pain
         subjects affected / exposed
    3 / 23 (13.04%)
    2 / 22 (9.09%)
         occurrences all number
    4
    2
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    18 / 23 (78.26%)
    8 / 22 (36.36%)
         occurrences all number
    29
    13
    Headache
         subjects affected / exposed
    7 / 23 (30.43%)
    3 / 22 (13.64%)
         occurrences all number
    10
    9
    Coordination abnormal
         subjects affected / exposed
    12 / 23 (52.17%)
    3 / 22 (13.64%)
         occurrences all number
    21
    6
    Tremor
         subjects affected / exposed
    2 / 23 (8.70%)
    0 / 22 (0.00%)
         occurrences all number
    2
    0
    Disturbance in attention
         subjects affected / exposed
    15 / 23 (65.22%)
    5 / 22 (22.73%)
         occurrences all number
    24
    10
    General disorders and administration site conditions
    Hyperhidrosis
         subjects affected / exposed
    7 / 23 (30.43%)
    4 / 22 (18.18%)
         occurrences all number
    9
    7
    Malaise
         subjects affected / exposed
    8 / 23 (34.78%)
    5 / 22 (22.73%)
         occurrences all number
    13
    8
    Ear and labyrinth disorders
    Tinnitus
         subjects affected / exposed
    3 / 23 (13.04%)
    3 / 22 (13.64%)
         occurrences all number
    5
    4
    Eye disorders
    Vision blurred
         subjects affected / exposed
    9 / 23 (39.13%)
    4 / 22 (18.18%)
         occurrences all number
    17
    8
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    5 / 23 (21.74%)
    1 / 22 (4.55%)
         occurrences all number
    10
    2
    Vomiting
         subjects affected / exposed
    1 / 23 (4.35%)
    0 / 22 (0.00%)
         occurrences all number
    1
    0
    Dry mouth
         subjects affected / exposed
    13 / 23 (56.52%)
    8 / 22 (36.36%)
         occurrences all number
    22
    12
    Constipation
         subjects affected / exposed
    2 / 23 (8.70%)
    1 / 22 (4.55%)
         occurrences all number
    3
    2
    Diarrhoea
         subjects affected / exposed
    1 / 23 (4.35%)
    1 / 22 (4.55%)
         occurrences all number
    2
    1
    Skin and subcutaneous tissue disorders
    Pruritus
         subjects affected / exposed
    1 / 23 (4.35%)
    1 / 22 (4.55%)
         occurrences all number
    1
    1
    Dry skin
         subjects affected / exposed
    4 / 23 (17.39%)
    2 / 22 (9.09%)
         occurrences all number
    4
    2
    Renal and urinary disorders
    Micturition urgency
         subjects affected / exposed
    5 / 23 (21.74%)
    2 / 22 (9.09%)
         occurrences all number
    6
    4
    Psychiatric disorders
    Restlessness
         subjects affected / exposed
    5 / 23 (21.74%)
    5 / 22 (22.73%)
         occurrences all number
    9
    9
    Anxiety
         subjects affected / exposed
    7 / 23 (30.43%)
    3 / 22 (13.64%)
         occurrences all number
    9
    4
    Apathy
         subjects affected / exposed
    7 / 23 (30.43%)
    8 / 22 (36.36%)
         occurrences all number
    11
    12
    Fatigue
         subjects affected / exposed
    12 / 23 (52.17%)
    11 / 22 (50.00%)
         occurrences all number
    19
    22

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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