Examining The Effect Of Ketamine On Glutamate/Glutamine Cycling

Study Overview
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Brief Summary
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This study is looking at the mechanisms underlying the behavioral effects of ketamine in healthy and depressed individuals.

Official Title
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Examining The Effect Of Ketamine On Glutamate/Glutamine Cycling

Conditions
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Depression

Intervention / Treatment
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* Drug: Ketamine


Participation Criteria
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Eligibility Criteria
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Healthy Group Inclusion Criteria: Male or female between the ages of 21-65 years. Able to provide written informed consent. Able to read and write English. Exclusion Criteria: Personal or first-degree family member with history of mood, anxiety, or psychotic axis I DSM-IV disorders confirmed after comprehensive psychiatric evaluation. Any history of serious medical or neurological illness. Any signs of major medical or neurological illness on examination or as a result of ECG screening or laboratory studies. Lifetime history of psychoactive substance or alcohol dependence or substance or alcohol abuse (other than nicotine or caffeine abuse), or drinking more that 5 drinks/week during the last year. Abnormality on physical examination. A positive pre-study (screening) urine drug screen or, at the study physician's discretion on any drug screens given before the scans. Pregnant or lactating women or a positive urine pregnancy test for women of child-bearing potential at screening or prior to any imaging day. Subjects who test positive for HIV or viral hepatitis (hepatitis B and/or C) Has received either prescribed or over-the-counter (OTC) centrally active medicine or herbal supplements within the week prior to the MRI scan. Any history indicating learning disability, mental retardation, or attention deficit disorder. Known sensitivity to ketamine. Body circumference of 52 inches or greater. Body weight of 280 pounds or greater. History of claustrophobia. Presence of cardiac pacemaker or other electronic device or ferromagnetic metal foreign bodies in vulnerable positions as assessed by a standard pre-MRI screening questionnaire. Donation of blood in excess of 500 mL within 56 days prior to dosing. History of sensitivity to heparin or heparin-induced thrombocytopenia. Resting blood pressure lower than 90/60 or higher than 150/90,or resting heart rate lower than 45/min or higher than 100/min. Depression Group Inclusion Criteria: Male or female between the ages of 21-65 years. Able to provide written informed consent. Current MDD Single Episode (296.2x) or Recurrent (296.3x), as determined by the Structured Clinical Interview for DSM-IV (SCID) patient edition Montgomery Asberg Depression Rating Scale (MADRS) score of 18 or higher at baseline and start of first 13C-MRS. Quick Inventory of Depressive Symptoms - Self-Report (QIDS-SR16) score of 19 or higher at baseline and start of first 13C-MRS. No psychotropic medications for 2 or more weeks (4 weeks for Fluoxetine) prior to first 13C-MRS. Be able to understand and speak English. Exclusion Criteria: Patients with a history of DSM-IV-TR diagnosis of bipolar disorder or schizophrenia or schizoaffective disorder or currently exhibiting psychotic features associated with their depression; dementia or suspicion thereof, is also exclusionary. First-degree family member with history of schizophrenia or any other psychotic disorder. Serious suicide or homicide risk, as assessed by evaluating clinician; A serious suicide risk will be considered an inability to control suicide attempts, imminent risk of suicide in the investigator's judgment, or a history of serious suicidal behavior, which is defined using the Columbia-Suicide Severity Rating Scale (C-SSRS) as either (1) one or more actual suicide attempts in the 3 years before study entry with the lethality rated at 3 or higher, or (2) one or more interrupted suicide attempts with a potential lethality judged to result in serious injury or death. Substance abuse or dependence during the 12 months prior to screening. Any history of serious medical or neurological illness. Any signs of major medical or neurological illness. Abnormality on physical examination. A subject with a clinical abnormality may be included only if the study physician considers the abnormality will not introduce additional risk factors and will not interfere with the study procedure. A positive pre-study (screening) urine drug screen or on any drug screens given before the scans. Pregnant or lactating women or a positive urine pregnancy test for women of childbearing potential at screening or prior to any imaging day. Any history indicating learning disability, or mental retardation. Known sensitivity to ketamine. Body weight of 280 pounds or greater. History of claustrophobia. Presence of cardiac pacemaker or other electronic device or ferromagnetic metal foreign bodies in vulnerable positions as assessed by a standard pre-MRI screening questionnaire. Donation of blood in excess of 500 mL within 56 days prior to dosing. History of sensitivity to heparin or heparin-induced thrombocytopenia. Resting blood pressure lower than 90/60 or higher than 150/90,or resting heart rate lower than 45/min or higher than 100/min.

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Non-Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Healthy<br>Healthy participants will receive ketamine in the scan | Drug: Ketamine<br> <br> |
| Experimental: Depressed<br>Depressed participants will receive ketamine in the scan | Drug: Ketamine<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Glutamate Metabolism |  | 40-75 minutes |