[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"ketamine\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:ketamine":28},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,15,0,[8,49,74,121,147,180,208,236,277,305,335,361,386,416,437],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":13,"acronym":14,"eligibilityCriteria":15,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":18,"enrollmentInfo":19,"targetDuration":4,"studyType":22,"phases":23,"briefSummary":25,"conditions":26,"keywords":34,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":37,"lastUpdatePostDateStruct":38,"startDateStruct":41,"completionDateStruct":43,"leadSponsor":45,"locationsCount":48},"100622004","phase-4-safety-and-efficacy-of-esketamine---dexmedetomidine-combination-versus-dexmedetomidine-monotherapy-for-hyperactive-delirium-in-icu-patients-on-non-invasive-respiratory-support-seed-nirs-trial-study-protocol-of-a-randomized-controlled-trial-100622004",false,"NCT07377981","Safety and Efficacy of Esketamine - Dexmedetomidine Combination Versus Dexmedetomidine Monotherapy for Hyperactive Delirium in ICU Patients on Non-Invasive Respiratory Support (SEED-NIRS Trial): Study Protocol of a Randomized Controlled Trial","SEED-NIRS","Inclusion Criteria:\n\n1. Age ≥18 years and ≤80 years at the time of randomization;\n2. Hospitalized in the ICU (with an expected ICU stay \\>24 hours);\n3. Patients with hyperactive delirium: meeting criteria for Confusion Assessment Method for the ICU (CAM-ICU)\\[19\\] positivity (i.e., acute onset or fluctuating course plus inattention, and at least one secondary criterion-disorganized thinking or altered level of consciousness) and having agitation which is diagnosed if the Richmond Agitation-Sedation Scale (RASS) score\\[20\\] is superior or equal to +1. (The RASS and CAM-ICU are used to assess sedation and delirium levels. Hyperactive delirium is defined as CAM-ICU positive with RASS \\> +1);\n4. Receiving non-invasive respiratory support (eg. high-flow nasal cannula, CPAP, or non-invasive ventilation) at least for \\>24 hours.\n\nExclusion Criteria:\n\n1. Known or suspected allergy or Contraindications to any of the study drugs;\n2. Severe arrhythmias (e.g., ventricular fibrillation, second- or third-degree atrioventricular block, sick sinus syndrome, ventricular tachycardia, QTc interval ≥470 ms, severe bradycardia (heart rate \\\u003C40 beats per minute), etc.), or left ventricular ejection fraction (LVEF) \\\u003C30%;\n3. Recent administration of esketamine, dexmedetomidine or haloperidol within previous 72 hours.\n4. Pregnancy or lactation;\n5. Conditions that may affect efficacy assessment or cognitive function testing, such as blindness, deafness, aphasic, or coma patients;\n6. History of epilepsy or seizures;\n7. Patients with an estimated survival period of less than 48 hours as judged by the investigator;\n8. Neuropsychiatric conditions per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) that may introduce bias (e.g., active substance use disorder, psychosis, etc.), including alcoholism, drug abuse, or use of psychotropic medications;\n9. Patients receiving non-invasive respiratory support via a tracheostomy;\n10. Patients with untreated or inadequately treated hyperthyroidism;\n11. Severe hepatic insufficiency (Child-Pugh grade C);\n12. Severe renal dysfunction, defined as: chronic renal insufficiency with a glomerular filtration rate (GFR) ≤ 29 mL\u002Fmin\u002F1.73 m²; or subjects on long-term maintenance hemodialysis or peritoneal dialysis;\n13. A history of sleep disorders requiring medical intervention within the past month;\n14. Patients or their legally authorized representatives (family members) who are unable to cooperate or unwilling to provide written informed consent;\n15. Other conditions deemed unsuitable for inclusion by the investigators.","ALL","18 Years","80 Years",{"count":20,"type":21},388,"ESTIMATED","INTERVENTIONAL",[24],"PHASE4","This investigator-initiated, randomized, controlled, single-blind, superiority trial aims to assess the efficacy and safety of esketamine combined with dexmedetomidine for the management of agitation or delirium in intensive care unit (ICU) patients receiving non-invasive respiratory support. The primary endpoint is a clinically prioritized hierarchical composite endpoint within 28 days, including intubation or tracheostomy, delirium duration, and agitation duration.",[27,28,29,30,31,32,33],"Dexmedetomidine","Ketamine","Analgesia","Respiratory Therapy","Intensive Care Units (ICUs)","Agitation","Sedation and Analgesia",[35,29,32,27,28,31,30],"Sedation and analgesia","NOT_YET_RECRUITING","2026-06-30",{"date":39,"type":40},"2026-07-02","ACTUAL",{"date":42,"type":21},"2026-08-01",{"date":44,"type":21},"2029-01-01",{"name":46,"class":47},"The First Affiliated Hospital with Nanjing Medical University","OTHER",1,{"id":50,"slug":51,"hasResults":11,"nctId":52,"briefTitle":53,"officialTitle":53,"acronym":54,"eligibilityCriteria":55,"healthyVolunteers":11,"sex":16,"minAge":56,"maxAge":4,"enrollmentInfo":57,"targetDuration":4,"studyType":22,"phases":59,"briefSummary":60,"conditions":61,"keywords":64,"overallStatus":65,"whyStopped":4,"lastUpdateSubmitDate":66,"lastUpdatePostDateStruct":67,"startDateStruct":68,"completionDateStruct":70,"leadSponsor":72,"locationsCount":48},"100602205","phase-4-esketamine-versus-crisis-response-planning-versus-optimized-treatment-as-usual-for-suicide-prevention-a-pragmatic-controlled-trial-in-two-brazilian-cities-100602205","NCT07120477","Esketamine Versus Crisis Response Planning Versus Optimized Treatment as Usual for Suicide Prevention: A Pragmatic Controlled Trial in Two Brazilian Cities","SAVE","Inclusion Criteria:\n\n1. Age 14 years or older\n2. Presentation to a public emergency service (ED\u002FUEU) within the study municipality\n3. Recent suicide attempt within the past 30 days (actual, interrupted, or aborted attempt)\n4. Current severe suicidal ideation, defined as endorsement of items 4 or 5 on the Columbia-Suicide Severity Rating Scale (C-SSRS) screening version, indicating active suicidal ideation with specific plan and\u002For method, or active suicidal ideation with intent to act\n5. Residency in the catchment area of the study municipality (Indaiatuba, São Paulo, Brazil), enabling completion of follow-up assessments\n6. Ability to provide written informed consent (for participants aged 18 years or older) or written assent with written informed consent from a parent or legal guardian (for participants aged 14-17 years)\n7. No clinical decision for involuntary or voluntary hospitalization in a psychiatric inpatient unit following the index emergency department evaluation\n\nExclusion Criteria:\n\n1. Contraindications to esketamine, including: aneurysmal vascular disease, arteriovenous malformation, history of intracerebral hemorrhage, or known hypersensitivity to esketamine or ketamine\n2. Current pregnancy or breastfeeding (confirmed by rapid pregnancy test in the emergency setting for female participants of childbearing potential)\n3. Medical instability requiring intensive care unit (ICU) admission without feasible study follow-up\n4. Primary psychotic disorder (e.g., schizophrenia, schizoaffective disorder), current acute psychosis, or current acute manic episode precluding informed participation\n5. Severe substance use disorder compromising capacity for treatment adherence, as assessed by the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)\n6. Inability to maintain contact for follow-up assessments, including participants whose residential address is located outside the study municipality","14 Years",{"count":58,"type":21},468,[24],"Suicide is one of the leading causes of early death worldwide. In Brazil, suicide rates have been rising steadily over the past two decades, and most suicides occur in low- and middle-income countries where access to specialized care is limited. There is an urgent need for fast-acting, practical interventions that can be delivered in public emergency settings. Two promising approaches have emerged: esketamine, a medication that can rapidly reduce suicidal thoughts within hours, and Crisis Response Planning (CRP), a brief session in which a trained clinician works with the person to create a personalized written plan for managing future suicidal crises.\n\nThe goal of this clinical trial is to learn if esketamine or Crisis Response Planning (CRP), each added to enhanced treatment as usual (eTAU), can prevent future suicide-related events compared to eTAU alone in adolescents and adults aged 14 years or older who recently attempted suicide or have severe suicidal thoughts. The main questions it aims to answer are:\n\nDoes a single esketamine infusion plus eTAU lower the risk of a new suicide-related event compared to eTAU alone over 12 months? Does a single session of Crisis Response Planning plus eTAU lower the risk of a new suicide-related event compared to eTAU alone over 12 months? Which approach leads to faster or more lasting improvements in suicidal thoughts, depression, anxiety, sleep, well-being, hopelessness, and quality of life? Are these interventions feasible, acceptable, and cost-effective within a public health system?\n\nResearchers will compare three groups to see which approach works best to prevent suicide attempts, suicide-related hospitalizations, and suicide deaths over one year.\n\nA total of 468 participants will be randomly assigned in equal numbers (156 per group) to one of three groups:\n\nEsketamine group: receive a single intravenous esketamine infusion (0.50 mg\u002Fkg given over 40 minutes) in a monitored medical setting with continuous heart rate, blood pressure, and oxygen monitoring, plus eTAU. A physician will be present throughout. Participants will be observed for up to 24 hours before discharge.\n\nCrisis Response Planning group: complete one 20-to-45-minute session with a trained clinician to build a personal crisis plan that includes warning signs, coping strategies, reasons for living, support contacts, and emergency resources. Participants will leave with a written and digital copy of their plan, plus eTAU.\n\nEnhanced treatment as usual (eTAU) group: receive standard emergency care, safety counseling about access to lethal means, connection to the local mental health network (including Psychosocial Care Centers and primary care), and a scheduled psychiatric follow-up appointment within 7 days.\n\nParticipants will:\n\nComplete health questionnaires about suicidal thoughts, depression, anxiety, sleep, well-being, hopelessness, and quality of life at 11 time points over one year (at enrollment, 24 hours, 7 days, 2 weeks, 4 weeks, 8 weeks, 16 weeks, 24 weeks, 32 weeks, 40 weeks, and 1 year) Provide a blood sample at the start of the study for exploratory analyses of biological markers that may be related to treatment response Use a smartphone app to report their mood, thoughts, and emotions four times a day for four weeks after enrollment Be monitored for safety and adverse events throughout the entire study period\n\nThe study takes place in the public emergency network of Indaiatuba, São Paulo, Brazil (population approximately 256,000), and is designed to reflect real-world clinical conditions. Participants who experience a new suicide-related event during the study will be offered an open-label rescue treatment combining esketamine and Crisis Response Planning, and will continue to be followed for the remainder of the year. The study also includes an evaluation of how well these interventions can be adopted and sustained within Brazil's public mental health system, including assessments of acceptability, feasibility, and cost-effectiveness.",[62,28,63],"Suicide Prevention","Crisis Response Plan",[62,28,63],"RECRUITING","2026-06-28",{"date":37,"type":40},{"date":69,"type":40},"2026-06-01",{"date":71,"type":21},"2029-12",{"name":73,"class":47},"University of Sao Paulo",{"id":75,"slug":76,"hasResults":11,"nctId":77,"briefTitle":78,"officialTitle":78,"acronym":4,"eligibilityCriteria":79,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":80,"enrollmentInfo":81,"targetDuration":4,"studyType":83,"phases":4,"briefSummary":84,"conditions":85,"keywords":106,"overallStatus":65,"whyStopped":4,"lastUpdateSubmitDate":111,"lastUpdatePostDateStruct":112,"startDateStruct":114,"completionDateStruct":116,"leadSponsor":118,"locationsCount":48},"100551600","natural-history-of-depression-bipolar-disorder-and-suicide-risk-100551600","NCT06462196","Natural History of Depression, Bipolar Disorder and Suicide Risk","* INCLUSION CRITERIA:\n\nIn order to be eligible to participate in this study, an individual must meet all of the following criteria:\n\n* Signed consent for Protocol 01-M-0254: The Evaluation of Patients with Mood and Anxiety Disorders and Healthy Volunteers\n* Age 18 years or older\n* Able to provide informed consent\n* Able to read and write English\n\nEXCLUSION CRITERIA:\n\n* Unstable medical conditions in the opinion of the investigator that would preclude participation in outpatient or inpatient treatment.\n* Pregnancy\n* Participation in the Protocol 01-M-0254: The Evaluation of Patients with Mood and Anxiety Disorders and Healthy Volunteers, as a healthy volunteer.\n* Participants with a history of DSM-IV substance or alcohol abuse or dependence, or DSM-5 substance use disorder (except for caffeine, nicotine, or cannabis), or moderate to severe alcohol use disorder, within the preceding three months. In addition, participants who are currently using drugs (except for caffeine, nicotine, or cannabis) must not have used illicit substances or known drugs of abuse in the two weeks prior to consent and must have a negative drug urine test (except for prescribed benzodiazepines or stimulants) prior to enrolling in the study. Cannabis use is exclusionary if the use is daily, or if participants are unable to abstain during the study, or if function of daily life is impaired by use as determined by a clinician.","120 Years",{"count":82,"type":21},500,"OBSERVATIONAL","Mood disorders, such as depression and bipolar disorder, are difficult to treat. One reason is that there are no objective ways to measure how these disorders affect the body and respond to different treatments. In this study, researchers want to perform tests on people undergoing clinical care for mood disorders. The purpose is to understand the experience of receiving treatment for depression, bipolar disorder, and suicide risk. We also hope that this study will help us to predict which medications will improve thoughts of suicide.\n\nPeople 18 years or older who are receiving treatment for depression, bipolar disorder, or suicide risk may take part in this study. Participants must have also been enrolled in protocol 01-M-0254.\n\nThis study will be conducted at the NIH Clinical Center in Bethesda, MD. The study typically lasts up to 12 weeks, but may last longer if a participant s treatment continues past that time.\n\nParticipants will have weekly interviews and questionnaires while they are being treated for their mood disorder. Other tests are optional and include psychological testing, blood draws, sleep tests, and imaging scans. These will be done at the start and the end of research participation.",[86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,28,101,102,103,104,105],"Behavioral Symptoms","Suicide","Self-Injurious Behavior","Sensory System Agents","Analgesics","Peripheral Nervous System Agents","Physiological Effects of Drugs","Anesthetics, Dissociative","Anesthetics, General","Anesthetics","Central Nervous System Depressants","Excitatory Amino Acid Antagonists","Excitatory Amino Acid Agents","Neurotransmitter Agents","Molecular Mechanisms of Pharmacological Action","Depression, Unipolar","Depressive Symptoms","Treatment Resistant Depression","Major Depressive Disorder","Depression, Bipolar",[107,87,104,108,109,110,103],"Neurobiology","Bipolar Disorder","Biomarkers","Suicide Risk","2026-06-26",{"date":113,"type":40},"2026-06-29",{"date":115,"type":40},"2024-09-09",{"date":117,"type":21},"2030-06-01",{"name":119,"class":120},"National Institute of Mental Health (NIMH)","NIH",{"id":122,"slug":123,"hasResults":11,"nctId":124,"briefTitle":125,"officialTitle":126,"acronym":127,"eligibilityCriteria":128,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":129,"enrollmentInfo":130,"targetDuration":4,"studyType":22,"phases":132,"briefSummary":133,"conditions":134,"keywords":4,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":139,"lastUpdatePostDateStruct":140,"startDateStruct":141,"completionDateStruct":143,"leadSponsor":145,"locationsCount":48},"100645335","phase-4-biomarker-guided-antidepressant-selection-100645335","NCT07680140","Biomarker-Guided Antidepressant Selection","Biomarker-Guided Antidepressant Selection for Treatment-Resistant Depression","BioSelect","Inclusion Criteria:\n\n1. Provision of signed and dated informed consent form\n2. Adults of all genders aged 18-70 at the time of screening\n3. Diagnosis of Major Depressive Disorder (by DSM-5 criteria)\n4. Depressive symptoms of at least moderate severity (GRID HDRS-17 score \\>= 14 or as determined by a study clinician)\n5. Failed at least 1 prior trial of standard first-line treatment for MDD per the modified Antidepressant Treatment History form, the Maudsley Staging Method, and APA Practice Guidelines (e.g., SSRI, SNRI, CBT) OR initiated and discontinued a trial of a first-line treatment for MDD (e.g. could not tolerate side effects, etc.)\n6. Not currently taking antidepressants OR on a stable dose of antidepressant for at least 1month prior to screening and plans to remain off antidepressants OR on this stable dose for the duration of participation\n7. Current medication regimen is compatible with safe participation in the trial in the assessment of a study clinician\n8. Access to psychiatric care before, during, and after completion of the study\n9. For females of reproductive potential: agreement to use effective contraception for at least 1 month prior to screening and agreement to use such a method during study participation\n10. Proficiency in English sufficient to complete assessments and follow study procedure instructions\n11. Stated willingness to comply with all study procedures and availability for the duration of the study\n\nExclusion Criteria:\n\n1. Imminent risk of suicide\n2. Presence of primary psychiatric diagnosis other than MDD (e.g., post-traumatic stress disorder, obsessive-compulsive disorder, MDD with psychotic features, primary psychotic illness, bipolar I or II disorder)\n3. History of epilepsy or a history of seizures that would influence the participant's risk for TMS-evoked seizures; history of any condition \u002F concurrent medication that could notably lower seizure threshold in the estimation of a study clinician\n4. Met criteria for any clinically significant substance use disorder (by DSM-V criteria) with active substance misuse in the 6 months prior to screening\n5. Lifetime history of PCP\u002Fketamine abuse\n6. History or presence of significant neurological disorder that may be contributing to current depressive symptoms in the judgment of a study clinician (e.g., traumatic brain injury, stroke, Parkinson's disease or other movement disorder, epilepsy)\n7. Presence of medical contraindications to ketamine, including liver function tests \\> 2.5x normal limit, recent myocardial infarction, congestive heart failure \\> stage 2, angina pectoris, clinically significant bradycardia or tachycardia at the baseline assessment, or uncontrolled hypertension\n8. MRI contraindication, including presence of ferromagnetic foreign metal bodies or implants, implanted or conductive ferromagnetic objects in or near the head (e.g., stents, deep brain stimulators, vagus nerve stimulators, aneurysm coils, ocular implants, cochlear implants), and ferromagnetic permanent make-up that may undergo heating in an MRI scanner\n9. Individuals who are nursing, pregnant, or contemplating pregnancy within the length of study participation\n10. Abnormal bloodwork that may be contributing to depressive symptoms in the estimation of a study clinician (e.g. indicators of clinically significant hypothyroidism, kidney failure, liver failure, etc.)\n11. History or presence of any disorder or medical condition that, in the opinion of the study team, may compromise, interfere, or limit the individual's ability to complete the intervention or study procedures","70 Years",{"count":131,"type":21},27,[24],"Depression is one of the leading causes of disability worldwide. Common treatments like antidepressant medications and talk therapy work well for some people, but many others do not improve, even after trying multiple treatments.\n\nThis study will investigate two alternative treatment options for people whose depression has not responded to standard treatments: repetitive transcranial magnetic stimulation (rTMS), a non-invasive form of brain stimulation, and ketamine, a fast-acting medication. It can be difficult to decide between these interventions in clinical practice, and selecting between them often comes down to patient preference and trial and error. This study is working to optimize the selection approach: using biological and behavioral markers to match each person to identify biomarkers that may predict response to rTMS or ketamine. Investigators believe that differences in how individuals respond to rTMS versus ketamine are partly explained by differences in how their brains are organized, and that these differences can be measured and used to guide intervention decisions. This is an early-stage pilot study designed to test whether this biomarker-based approach is practical and acceptable to patients. Investigators will evaluate how well a combination of brain imaging and clinical data can predict, at the individual level, who is likely to respond to rTMS versus ketamine. The ultimate goal is to develop a reliable, scalable tool that helps clinicians make faster and more informed intervention decisions, reducing the time people with treatment-resistant depression spend searching for an antidepressant that works.",[135,136,137,28,138],"Depression - Major Depressive Disorder","Treatment-resistant Depression (TRD)","rTMS","fMRI","2026-06-25",{"date":39,"type":40},{"date":142,"type":21},"2026-07",{"date":144,"type":21},"2028-12",{"name":146,"class":47},"Weill Medical College of Cornell University",{"id":148,"slug":149,"hasResults":11,"nctId":150,"briefTitle":151,"officialTitle":152,"acronym":4,"eligibilityCriteria":153,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":129,"enrollmentInfo":154,"targetDuration":4,"studyType":22,"phases":156,"briefSummary":158,"conditions":159,"keywords":166,"overallStatus":65,"whyStopped":4,"lastUpdateSubmitDate":172,"lastUpdatePostDateStruct":173,"startDateStruct":175,"completionDateStruct":177,"leadSponsor":179,"locationsCount":48},"100555424","phase-2-investigation-of-the-antidepressant-effects-of-2r6r-hnk-an-enhancer-of-synaptic-glutamate-release-in-treatment-resistant-depression-100555424","NCT06511908","Investigation of the Antidepressant Effects of (2R,6R)-HNK, an Enhancer of Synaptic Glutamate Release, in Treatment-Resistant Depression","An Investigation of the Antidepressant Effects of (2R,6R)-HNK, an Enhancer of Synaptic Glutamate Release, in Treatment-Resistant Depression","* INCLUSION CRITERIA:\n\nIn order to be eligible to participate in this study, an individual must meet all of the following criteria:\n\n1. Ability of participant to understand and willingness to sign a written informed consent document. To verify this, participants must score \\>= 80% on the consent quiz.\n2. Stated willingness to comply with all study procedures and availability for the duration of the study.\n3. 18 to 70 years of age.\n4. All participants must have undergone a screening assessment under protocol 01-M-0254.\n5. Participants must fulfill DSM-IV or DSM-5 criteria for MDD, single episode or recurrent without psychotic features, based on clinical assessment and confirmed by a structured diagnostic interview (SCID-P). Participants must be experiencing a current major depressive episode lasting at least two weeks.\n6. Participants must have an initial score of \\>= 20 on the MADRS and a YMRS score of \\\u003C12 within one week of study entry and upon entry into Phase II.\n7. Ability to take intravenous medication and be willing to adhere to the (2R,6R)-HNK regimen.\n8. Participants must have a current or past history of lack of response to at least one adequate antidepressant trial (may be from the same chemical class), with at least one in the current major depressive episode, operationally defined using the modified Antidepressant Treatment History Form (ATHF); non-response to an adequate trial of ECT or TMS would count as an adequate antidepressant trial.\n9. For individuals of reproductive potential: use of highly effective contraception starting at the time of enrollment and agreement to use such a method during study participation and for an additional four weeks after the end of Study Phase II.\n10. For males of reproductive potential: use of condoms or other methods from the time of enrollment to ensure effective contraception with partner, and for an additional 90 days after the end of Phase II.\n11. Agreement to adhere to Lifestyle Considerations throughout study duration.\n12. Medically healthy, or with stable, treated, chronic medical conditions (provided any medications are not excluded)\n\nEXCLUSION CRITERIA:\n\nAn individual who meets any of the following criteria will be excluded from participation in this study:\n\n1. Current use of disallowed concomitant medications or transcranial magnetic stimulation (TMS) two weeks prior to the start of Phase II.\n2. Treatment with a reversible monoamine oxidase inhibitor (MAOI) four weeks prior to the start of Phase II.\n3. Treatment with fluoxetine, aripiprazole, or brexpiprazole five weeks prior to the start of Phase II.\n4. Treatment with clozapine or electroconvulsive therapy (ECT) four weeks prior to the start of Phase II.\n5. Ongoing treatment with moderate or strong CYP3A4\u002F5 inhibitors or inducers\n6. Lifetime history of deep brain stimulation.\n7. Previous antidepressant non-response to ketamine or esketamine (full course).\n8. No structured psychotherapy will be permitted during the total duration of the study. Participants unable or unwilling to stop psychotherapy will be unable to participate in the study.\n9. Pregnancy or lactation.\n10. Current psychotic features or a diagnosis of schizophrenia or any other psychotic disorder as defined in the DSM-IV or DSM-5.\n11. Participants with a history of DSM-IV substance or alcohol abuse or dependence, or DSM-5 substance use disorder (except for caffeine, nicotine, or cannabis), or moderate to severe alcohol use disorder, within the preceding three months. In addition, participants who are currently using drugs (except for caffeine, nicotine, or cannabis) must not have used illicit substances or known drugs of abuse in the two weeks prior to screen and must have a negative drug urine test (except for prescribed benzodiazepines or stimulants) prior to starting Phase II. Cannabis use is exclusionary if the use is daily, or if participants are unable to abstain during the study, or if function of daily life is impaired by use as determined by a clinician. Due to the interactions between cannabis and SSRIs, frequent cannabis use during previous antidepressant treatment will result in that treatment being considered a failed trial for eligibility purposes.\n12. Participants with a DSM-IV or DSM-5 Axis II diagnosis of borderline or antisocial personality disorder.\n13. Participants with a history of head injury that resulted in loss of consciousness exceeding five minutes (for the imaging component of the study).\n14. No serious, unstable medical illnesses including but not limited to the following body systems and organs or those that in the judgment of the Principal Investigator pose a risk to the participant's ability to safely participate in the study: Hepatic diseases (e.g. active viral hepatitis infection or cirrhosis of the liver, any liver disease with Child-Pugh score \\>=5), cardiovascular disease (including ischemic heart disease, coronary artery disease, congestive heart failure, poorly controlled hypertension due to risk of further blood pressure elevation and increase in demand on cardiac function from study drug), renal\u002Furologic (e.g chronic kidney disease or acute kidney injury, history of bladder dysfunction due to theoretical risk of ketamine-induced cystitis, moderate to severe renal impairment of any etiology), endocrinologic (including uncontrolled diabetes due to association with progressive abnormality of the microvasculature and nervous system), or neurologic disease (e.g. elevated intraocular pressure or history of or presence of diseases that are associated with elevated intracranial pressure).\n15. Participants with unstable clinical hyperthyroidism or hypothyroidism.\n16. Participants with one or more seizures without a clear and resolved etiology.\n17. Clinically significant abnormal laboratory tests specifically defined by:\n\n    * Alkaline phosphatase (Alk Phos) \\> 150 U\u002FL\n    * Alanine aminotransferase (ALT) \\> 55 U\u002FL\n    * Aspartate aminotransferase (AST) \\> 34 U\u002FL\n    * Total bilirubin (TB) \\> 1.2 mg\u002FdL\n    * Direct bilirubin (DB) \\> 0.5 mg\u002FdL\n    * 25-hydroxyvitamin D \\\u003C 20 ng\u002FmL\n    * Folate \\\u003C 2ng\u002FmL\n    * Vitamin B12 \\\u003C 200 pg\u002FmL\n18. Moderate to severe renal impairment with body surface area corrected eGFR \\\u003C60mL\u002Fmin.\n19. Participants who, in the Principal Investigator's judgment, pose a current serious suicidal or homicidal risk.\n20. Positive HIV test.\n21. Contraindications to MRS (metal in body, claustrophobia, etc. for imaging)\n22. Participants with COVID-19 or suspected COVID-19\n23. Inability to read and understand English. Non- English speakers will not be eligible as most of the required monitoring and rating instruments are not validated in languages other than English.",{"count":155,"type":21},50,[157],"PHASE2","Background:\n\nMajor depressive disorder (MDD) is a serious mental illness that can put people at risk of self-harm and death. Many drugs are used to treat MDD, but it can take a long time for them to be effective. Researchers want to know if a faster-acting drug, (2R,6R)-hydroxynorketamine (HNK), can better treat the symptoms of MDD.\n\nObjective:\n\nTo test a study drug (HNK) in people with MDD.\n\nEligibility:\n\nPeople aged 18 to 70 years with MDD. They must have had a screening assessment under protocol 01-M-0254.\n\nDesign:\n\nParticipants will be tapered off their current MDD drugs over 2 to 5 weeks. They will stay off of the drugs for up to 2 weeks prior to starting the study medication and procedures. They will have a physical exam with blood tests. They will have tests of their heart function, mood, and thinking. They will answer questions about their symptoms. They may choose to have imaging scans and scans of their brain activity.\n\nHNK is given through a tube attached to a needle inserted into a vein. Participants will receive infusions on this schedule:\n\nThey will receive 4 infusions over 2 weeks. They will stay in the clinical center overnight after each infusion or for the duration of the study.\n\nThey will receive no drugs for 2 to 3 weeks.\n\nThey will have 4 more infusions over 2 weeks, with overnight stays after each or for the duration of the study.\n\nOne set of 4 infusions will be the HNK. The other set of 4 infusions will be a placebo. A placebo looks just like the real drug but contains no medicine. Participants will not know when they are getting the HNK or placebo.\n\n...",[87,160,28,100,99,98,92,161,162,163,164,165,86],"Depressive Disorder, Treatment-Resistant","Depressive Disorder, Major","Depressive Disorder","Depression","Mental Disorders","Mood Disorders",[104,28,109,167,168,169,107,170,171],"Neuropharmacology","Magnetic Resonance Imaging","Magnetoencephalography","Glutamate","Hydroxynorketamine","2026-06-13",{"date":174,"type":40},"2026-06-16",{"date":176,"type":40},"2024-11-06",{"date":178,"type":21},"2027-07-01",{"name":119,"class":120},{"id":181,"slug":182,"hasResults":11,"nctId":183,"briefTitle":184,"officialTitle":185,"acronym":186,"eligibilityCriteria":187,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":188,"targetDuration":190,"studyType":83,"phases":4,"briefSummary":191,"conditions":192,"keywords":194,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":199,"lastUpdatePostDateStruct":200,"startDateStruct":202,"completionDateStruct":204,"leadSponsor":206,"locationsCount":48},"100642150","outcomes-registry-after-ketamine-infusions-for-chronic-pain-a-longitudinal-evaluation-100642150","NCT07648771","Outcomes Registry After Ketamine Infusions for Chronic Pain: A Longitudinal Evaluation","Nationwide Observational Registry of Patient Outcomes Following Ketamine Infusion Therapy for Chronic Pain","ORACLE","Inclusion Criteria:\n\n* Planning to receive an intravenous ketamine infusion for the treatment of chronic pain\n\nExclusion Criteria:\n\n* Unable to read or understand English questionnaires",{"count":189,"type":21},800,"16 Weeks","Ketamine is an anesthetic drug that is sometimes used to relieve chronic pain. The goal of this observational study is to learn about how patients respond to ketamine infusions for chronic pain.\n\nNote: This study does not provide ketamine - instead, this study uses surveys to follow patients who are already scheduled to receive ketamine infusions as part of their regular medical care.\n\nWe will also follow a second group of patients who were recommended ketamine infusions by their doctor but were denied insurance coverage for this treatment. These participants will complete the same surveys for up to 16 weeks, starting from when their treatment was originally scheduled. Comparing this group to patients who received ketamine will help researchers better understand ketamine's effects and how insurance denials affect chronic pain patients.",[193,28],"Chronic Pain",[195,196,197,198,28,193,29],"Observational","Registry","Longitudinal","Surveys","2026-06-12",{"date":201,"type":40},"2026-06-15",{"date":203,"type":21},"2026-08",{"date":205,"type":21},"2034-12",{"name":207,"class":47},"Stanford University",{"id":209,"slug":210,"hasResults":11,"nctId":211,"briefTitle":212,"officialTitle":213,"acronym":214,"eligibilityCriteria":215,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":216,"enrollmentInfo":217,"targetDuration":4,"studyType":22,"phases":218,"briefSummary":219,"conditions":220,"keywords":222,"overallStatus":65,"whyStopped":4,"lastUpdateSubmitDate":226,"lastUpdatePostDateStruct":227,"startDateStruct":229,"completionDateStruct":231,"leadSponsor":233,"locationsCount":235},"100643335","phase-2-subanesthetic-ketamine-infusions-for-depressive-symptoms-in-intensive-care-unit-patients-100643335","NCT07639359","Subanesthetic Ketamine Infusions for Depressive Symptoms in Intensive Care Unit Patients","Ketamine In Depression - Intensive Care Unit Trial (KID-ICU): A Phase II Randomized, Double-Blind, Placebo-Controlled Multicenter Study of Ketamine Infusion for Depressive Symptoms in Intensive Care Unit Patients","KID-ICU","\\*\\*Inclusion Criteria:\\*\\*\n\n* Age 18 to 99 years.\n* Male or female.\n* Admission to an intensive care unit for 6 or more days at the time of screening.\n* Moderate to severe depressive symptoms, defined as a Patient Health Questionnaire-9 score of 10 or greater at screening.\n* Ability to provide informed consent.\n\n\\*\\*Exclusion Criteria:\\*\\*\n\n* History of psychosis or hallucinations, as assessed by review of the electronic medical record and patient interview during screening.\n* History of prolonged QT interval.\n* History of dementia.\n* History of major depressive disorder before the current intensive care unit admission.\n* History of psychiatric diagnosis, including dissociative disorder, primary psychotic disorder, mania with psychosis, pervasive developmental disorder, cognitive disorder, or anorexia nervosa.\n* Known allergy to ketamine or diphenhydramine.\n* History of increased intracranial pressure, hypertensive hydrocephalus, or increased intraocular pressure.\n* Hemodynamic instability at the time of screening, defined as peripheral oxygen saturation \\\u003C95%, systolic blood pressure \\\u003C90 mmHg or \\>180 mmHg, heart rate \\\u003C50 or \\>120 beats\u002Fmin, or respiratory rate \\\u003C10 or \\>30 breaths\u002Fmin.\n* Patient refusal to participate or to provide informed consent.\n* Pregnancy, postpartum period within 2 months, or breastfeeding.\n* Presence of intracranial mass or vascular lesion.\n* Altered mental status precluding informed consent.\n* Body weight \\>115 kg or \\\u003C45 kg.\n* Active psychosis.\n* Current treatment with medications that may interfere with the N-methyl-D-aspartate receptor system, including lamotrigine, acamprosate, memantine, riluzole, or lithium.\n* Current treatment with aminophylline or theophylline.\n* Active substance withdrawal or use of hallucinogens, including cannabis, in the past month, as determined by clinical interview and urine drug screening.","99 Years",{"count":155,"type":21},[157],"\\*\\*Brief Summary\\*\\*\n\nDepressive symptoms are frequent among patients admitted to the intensive care unit (ICU) and may be associated with worse clinical outcomes, reduced participation in care, lower treatment adherence, and increased mortality. Conventional antidepressants, including selective serotonin reuptake inhibitors (SSRIs), have limited utility in this setting because of their delayed onset of action, incomplete efficacy, and potential drug interactions in medically complex patients.\n\nKetamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has emerged as a rapid-acting antidepressant when administered at subanesthetic doses. Preliminary evidence suggests that intravenous ketamine may improve mood-related symptoms within a short time frame and may have an acceptable safety profile in selected critically ill patients.\n\nThe KID-ICU trial (Ketamine In Depression - Intensive Care Unit) is a Phase II randomized, double-blind, placebo-controlled multicenter trial designed to evaluate the efficacy and safety of subanesthetic intravenous ketamine infusions for moderate-to-severe depressive symptoms in adult ICU patients. Eligible participants are adults who have been admitted to the ICU for 6 or more days and have moderate-to-severe depressive symptoms, defined as a Patient Health Questionnaire-9 (PHQ-9) score of 10 or greater.\n\nParticipants will be randomized in a 1:1 ratio to receive either intravenous ketamine at 0.5 mg\u002Fkg, with a maximum dose of 60 mg per day, administered over 40 to 60 minutes on 2 consecutive days, or placebo with normal saline in an identical presentation. The primary efficacy outcome is the change in PHQ-9 score from baseline to Day 30 after the last infusion. Safety outcomes include prespecified hemodynamic, neuropsychiatric, and treatment-discontinuation events during and after infusion. Secondary outcomes include anxiety and depression symptoms assessed with the Hospital Anxiety and Depression Scale (HADS), clinical severity and improvement assessed with Clinical Global Impression scales, intensive care unit and hospital length of stay, and mortality.\n\nA total of 50 participants will be enrolled across intensive care unit sites at Hospital Italiano de Buenos Aires. Psychiatric and clinical follow-up will be provided to all participants regardless of treatment assignment.",[221,28],"Depression Disorder",[223,224,225],"ketamine","intensive care","depression","2026-06-05",{"date":228,"type":40},"2026-06-10",{"date":230,"type":40},"2026-05-14",{"date":232,"type":21},"2027-10-01",{"name":234,"class":47},"Hospital Italiano de Buenos Aires",2,{"id":237,"slug":238,"hasResults":11,"nctId":239,"briefTitle":240,"officialTitle":241,"acronym":4,"eligibilityCriteria":242,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":243,"enrollmentInfo":244,"targetDuration":4,"studyType":22,"phases":246,"briefSummary":248,"conditions":249,"keywords":263,"overallStatus":65,"whyStopped":4,"lastUpdateSubmitDate":268,"lastUpdatePostDateStruct":269,"startDateStruct":271,"completionDateStruct":273,"leadSponsor":275,"locationsCount":48},"100573936","phase-3-nebulized-ketamine-for-the-treatment-of-major-depressive-disorder-100573936","NCT06752759","Nebulized Ketamine for the Treatment of Major Depressive Disorder","Nebulized Ketamine for the Treatment of Major Depressive Disorder in an Inpatient Setting: A Midazolam-controlled Randomized Controlled Trial","Inclusion Criteria:\n\n* All individuals 18 years and older with a Montgomery-Asberg Depression Rating Scale score (MADRS) ≥ 20\n* Must have a diagnosis of moderate to severe Major Depressive Disorder (MDD)\n* Structured Clinical Interview for DSM-5 (SCID-5) will be performed to confirm MDD diagnosis\n\nExclusion Criteria:\n\n* Adult patients with an allergy to Ketamine\n* Adult patients with an allergy to Midazolam\n* Individuals with a history of mania\u002Fhypomania or diagnosis of bipolar disorder\n* Patients on lithium and\u002For lamotrigine therapy\n* Recent or current homicidal ideation with an intent to act\n* MDD with psychotic features or current or past diagnosis of a psychotic disorder\n* No substance use disorder in the preceding 3 months except nicotine or caffeine or a positive urine screen for substances (except cannabis)\n* Diagnosis of obsessive-compulsive disorder, antisocial personality disorder, borderline personality disorder, posttraumatic stress disorder, intellectual disability, altered mental status, pregnant or breastfeeding patients,\n* Patients on \\> 2 medications for hypertension\n* Patients with uncontrolled hypertension (BP \\>140 mm Hg systolic and\u002For \\>90 mm Hg diastolic on two separate readings at the time of screening)\n* Body weight of \\> 150kg\n* Patients with history of congestive cardiac failure\n* Day of presentation, patients with unstable vital signs (systolic blood pressure \\\u003C90 or\\>160 mm Hg, pulse rate \\\u003C50 or \\>150 beats\u002Fmin, and respiration rate \\\u003C10 or \\>30 breaths\u002Fmin)\n* Consumption of opioids within 24 hours of drug administration\n* Acutely intoxicated patients will also be excluded","88 Years",{"count":245,"type":21},40,[247],"PHASE3","This is a double-blind active placebo controlled clinical trial for individuals with moderate to severe depression. The purpose of this study is to assess if nebulized ketamine can reduce depressive symptoms.",[250,251,28,252,91,253,99,254,89,255,256,257,258,259,260,261,262],"Severe Depression","Moderate Depression","Midazolam","Central Nervous System Agents","Physiologic Effects of Drugs","Analgesics, Non-Narcotic","Anti-Inflammatory Agents, Non-Steroidal","Depressive Symptom","Hypnotics and Sedatives","Anti-anxiety Agents","Tranquilizing Agents","Psychotropic Drugs","Anesthetics Agent",[264,265,28,252,91,89,93,266,267],"Maimonides Medical Center","Psychiatry","Nebulized Medications for depression","GABA Agents","2026-04-21",{"date":270,"type":40},"2026-04-24",{"date":272,"type":40},"2024-10-16",{"date":274,"type":21},"2027-09-30",{"name":276,"class":47},"Theresa Jacob, PhD, MPH",{"id":278,"slug":279,"hasResults":11,"nctId":280,"briefTitle":281,"officialTitle":282,"acronym":4,"eligibilityCriteria":283,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":284,"targetDuration":4,"studyType":83,"phases":4,"briefSummary":286,"conditions":287,"keywords":293,"overallStatus":65,"whyStopped":4,"lastUpdateSubmitDate":295,"lastUpdatePostDateStruct":296,"startDateStruct":298,"completionDateStruct":300,"leadSponsor":302,"locationsCount":48},"100610009","induction-agent-choice-with-early-mortality-and-prognostic-outcomes-in-critically-ill-patients-100610009","NCT07222007","Induction Agent Choice With Early Mortality and Prognostic Outcomes in Critically Ill Patients","Association of Induction Agent Choice With Early Mortality and Prognostic Outcomes in Critically Ill Patients: A Large-Scale Retrospective Cohort Analysis","Inclusion Criteria:\n\n* Age ≥ 18 years\n* Admission to the surgical ICU for critical care\n* Administration of one of the studied induction agents\n* Availability of complete clinical data\n\nExclusion Criteria:\n\n* Age \\\u003C 18 years\n* Absence of documented induction agent administration\n* Incomplete or missing medical records",{"count":285,"type":21},4,"The aim of this retrospective cohort study is to compare the safety and efficacy of induction agents for tracheal intubation in critically ill adult patients.",[288,289,290,291,292,28],"Critically Ill","Intubation Complication","Oxygenation","Airway Management","Propofol",[294],"intubation, critically ill patients, airway management","2026-04-11",{"date":297,"type":40},"2026-04-14",{"date":299,"type":21},"2026-04-18",{"date":301,"type":21},"2026-07-01",{"name":303,"class":304},"Zeliha Alicikus","OTHER_GOV",{"id":306,"slug":307,"hasResults":11,"nctId":308,"briefTitle":309,"officialTitle":310,"acronym":4,"eligibilityCriteria":311,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":18,"enrollmentInfo":312,"targetDuration":4,"studyType":22,"phases":314,"briefSummary":316,"conditions":317,"keywords":322,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":326,"lastUpdatePostDateStruct":327,"startDateStruct":329,"completionDateStruct":331,"leadSponsor":333,"locationsCount":48},"100630652","intraoperative-ketamine-for-chronic-postoperative-pain-after-open-heart-surgery-100630652","NCT07490457","Intraoperative Ketamine for Chronic Postoperative Pain After Open-Heart Surgery","Effect of Intraoperative Ketamine Administration on Postoperative Chronic Pain in Patients Undergoing Open Cardiac Surgery","Inclusion Criteria:\n\n* ASA II-III,\n* Patients scheduled for elective on-pump open cardiac surgery via median sternotomy.\n\nExclusion Criteria:\n\n* Emergency surgery requirement\n* Need for reoperation\n* Requirement for postoperative re-intubation\n* History of opioid use\n* Preoperative diabetic neuropathy or autonomic dysfunction\n* Hepatic or renal dysfunction\n* History of neuropathic pain\n* Neurocognitive disorders such as psychosis or dementia\n* Use of antidepressants or antipsychotics\n* Body mass index (BMI) \\> 40",{"count":313,"type":21},100,[315],"NA","The goal of this interventional study is to determine whether a single intraoperative IV dose of ketamine can reduce postoperative chronic and acute pain and postoperative opioid requirements in adult patients undergoing open-heart surgery under general anesthesia. The main questions it aims to answer are:\n\nPrimary outcome: Does a single-dose intraoperative IV ketamine reduce the presence and severity of pain at 3 and 6 months after surgery ? Secondary outcomes: Does it reduce acute postoperative pain scores, opioid consumption, and other recovery-related outcomes in the early postoperative period ? Researchers will compare a single-dose IV ketamine arm to a placebo arm to see if ketamine decreases chronic pain incidence at 3 and 6 months and improves acute pain\u002Fopioid-related outcomes.\n\nParticipants will:\n\nBe randomized to receive either a single IV bolus of ketamine or placebo during surgery.\n\nUndergo standard general anesthesia and open cardiac surgery per protocol. Have postoperative pain assessed using Numeric Rating Scale (NRS) at extubation, 0, 3, 6, 12, 24, and 48 hours.\n\nHave opioid and additional analgesic use recorded, time to first rescue analgesic noted, and ICU\u002Fhospital length of stay tracked.\n\nBe evaluated for ICU delirium (CAM-ICU) and complete Quality of Recovery-15, Brief Pain Inventory-Short Form, and Pain Self-Efficacy questionnaires.\n\nBe followed up at 3 and 6 months for assessment of chronic postoperative pain.",[318,193,319,320,28,321],"Cardiac Anaesthesia","Post Operative Pain, Chronic","Post Operative Pain, Acute","Pain",[323,223,324,325],"Postoperative chronic pain","Open-heart surgery","Intraoperative ketamine","2026-03-18",{"date":328,"type":40},"2026-03-24",{"date":330,"type":21},"2026-04-15",{"date":332,"type":21},"2027-05",{"name":334,"class":304},"Bursa City Hospital",{"id":336,"slug":337,"hasResults":11,"nctId":338,"briefTitle":339,"officialTitle":340,"acronym":4,"eligibilityCriteria":341,"healthyVolunteers":11,"sex":16,"minAge":342,"maxAge":4,"enrollmentInfo":343,"targetDuration":4,"studyType":22,"phases":344,"briefSummary":345,"conditions":346,"keywords":4,"overallStatus":65,"whyStopped":4,"lastUpdateSubmitDate":353,"lastUpdatePostDateStruct":354,"startDateStruct":356,"completionDateStruct":358,"leadSponsor":359,"locationsCount":48},"100612024","ketamine-lidocaine-versus-ketamine-fentanyl-for-induction-of-anesthesia-in-patients-with-left-ventricular-systolic-dysfunction-undergoing-elective-coronary-artery-bypass-100612024","NCT07248202","Ketamine-lidocaine Versus Ketamine-fentanyl for Induction of Anesthesia in Patients With Left Ventricular Systolic Dysfunction Undergoing Elective Coronary Artery Bypass","A Comparison Between the Effect of Ketamine-lidocaine Versus Ketamine-fentanyl for Induction of Anesthesia on Cerebral Perfusion Guided by Near Infra-red Spectroscopy in Patients With Coronary Artery Disease and Left Ventricular Systolic Dysfunction Undergoing Elective Coronary Artery Bypass Graft Surgery: (A Randomized Controlled Study)","Inclusion Criteria:\n\n* patients with coronary artery disease\n* with moderate to severe left ventricular dysfunction (ejection fraction \\\u003C 40%),\n* scheduled for elective CABG surgery\n\nExclusion Criteria:\n\n* associated chronic stroke, TIA , carotid occlusive disease( due to abnormal vasomotor activity), patients with known neurological impairment (cerebral infarction , dementia ), significant carotid artery stenosis ,\n* valvular heart disease,\n* persistent arrhythmias,\n* congestive cardiac failure,\n* on mechanical ventilation,\n* intra-aortic balloon pump,\n* emergency surgery,\n* and those with known allergy to any of the study's drugs,\n* severe systemic non-cardiac disease and\n* patients with baseline NIRS reading \\\u003C 60%\n* Patients with dementia or visual or auditory impairment","21 Years",{"count":245,"type":21},[315],"This study compares ketamine\u002Ffentanyl versus ketamine\u002Flidocaine in term of their impact on cerebral perfusion during CABG. No prior data address these effects, and the goal is to identify the induction regimen that better preserves cerebral oxygenation.",[347,348,349,350,28,351,352],"Coronary Artery Disease (CAD)","Left Ventricular (LV) Systolic Dysfunction","Induction Anesthesia","Coronary Bypass Graft Surgery","Fentanyl","Lidocaine","2026-03-15",{"date":355,"type":40},"2026-03-17",{"date":357,"type":40},"2025-12-01",{"date":142,"type":21},{"name":360,"class":47},"Cairo University",{"id":362,"slug":363,"hasResults":11,"nctId":364,"briefTitle":365,"officialTitle":365,"acronym":4,"eligibilityCriteria":366,"healthyVolunteers":11,"sex":16,"minAge":367,"maxAge":368,"enrollmentInfo":369,"targetDuration":4,"studyType":22,"phases":371,"briefSummary":372,"conditions":373,"keywords":4,"overallStatus":36,"whyStopped":4,"lastUpdateSubmitDate":377,"lastUpdatePostDateStruct":378,"startDateStruct":380,"completionDateStruct":382,"leadSponsor":384,"locationsCount":4},"100620646","role-of-opioid-free-anaesthesia-in-elderly-patients-undergoing-elective-coronary-artery-bypass-graft-surgeries-with-cardiopulmonary-bypass-in-enhanced-recovery-after-surgeries-100620646","NCT07360327","Role of Opioid Free Anaesthesia in Elderly Patients Undergoing Elective Coronary Artery Bypass Graft Surgeries With Cardiopulmonary Bypass in Enhanced Recovery After Surgeries","Inclusion Criteria:\n\n* Age group: above 65 years old of both sex. Undergoing an elective coronary artery bypass graft surgeries with cardiopulmonary bypass.\n\nExclusion Criteria:\n\n* Past or ongoing history of drug abuse.\n* Psychiatric disease and cognitive disorders.\n* Inability to perform the confusion assessment method for the intensive care unit (CAM-ICU) test.\n* EF\\\u003C40 %.\n* 1st or 2nd degree Heart block.\n* HR \\\u003C50 bpm.\n* Allergy from drugs used in this study.\n* Use of a left ventricular assist device, IAB or ECMO pri","65 Years","90 Years",{"count":370,"type":21},60,[315],"The introduction of synthetic opioids in 1960 to general anesthesia together with sedative hypnotics and muscle relaxants allowed the appearance of the concept of multimodal balanced anesthesia. Although they help in achieving hemodynamic stability during anesthesia of open heart surgeries, their administration consequences are neither scarce nor benign to the patient. Perioperative opioids are associated with increased incidence of respiratory depression, prolonged mechanical ventilation, nausea and vomiting, prolonged sedation, Postoperative ileus (POI), urine retention, Postoperative cognitive dysfunction (POCD), immune depression and hyperalgesia (Beloeil et al., 2018).\n\nCoronary artery bypass graft surgery with cardiopulmonary bypass (CPB) is particularly vulnerable to the above-mentioned complications. Indeed, some of the side effects of this surgery overlap with the adverse effects of opioids. Postoperative pulmonary complications are observed in up to 50% of patients (Fisscher et al., 2022) and POCD or delirium in 4-54% according to studies (Bhushan et al., 2021). Whereas major gastrointestinal complications are estimated to occur in around 3% of patients, essentially acute pancreatitis, postoperative ileus (Marsoner et al., 2019).\n\nOpioid-free anesthesia (OFA) strategies have emerged to avoid intraoperative opioid use. It is based on the fact that a sympathetic reaction evidenced by hemodynamic changes in an anesthetised patient does not systematically reflect pain. In addition, a sleeping patient will not recall pain, while hormonal stress and sympathetic and inflammatory reactions can be controlled by therapeutic classes",[374,27,28,375,376],"CABG","Opioid Free Anesthesia","Opioid Based Anesthesia","2026-01-14",{"date":379,"type":40},"2026-01-22",{"date":381,"type":21},"2026-01-01",{"date":383,"type":21},"2026-12-01",{"name":385,"class":47},"Ain Shams University",{"id":387,"slug":388,"hasResults":11,"nctId":389,"briefTitle":390,"officialTitle":391,"acronym":4,"eligibilityCriteria":392,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":368,"enrollmentInfo":393,"targetDuration":4,"studyType":22,"phases":395,"briefSummary":396,"conditions":397,"keywords":406,"overallStatus":65,"whyStopped":4,"lastUpdateSubmitDate":408,"lastUpdatePostDateStruct":409,"startDateStruct":411,"completionDateStruct":412,"leadSponsor":414,"locationsCount":48},"100606900","anesthesia-techniques-neuroprotection-and-surgical-field-in-fess-under-controlled-hypotension-100606900","NCT07181564","Anesthesia Techniques, Neuroprotection and Surgical Field in FESS Under Controlled Hypotension","FUNCTIONAL ENDOSCOPIC NASAL AND SINUS SURGERY AND ANESTHESIA: Study of Hemodynamic Parameters During General Anesthesia Compared to the Surgical Field, as Well as Assessment of Cerebral Ischemia Intraoperatively by Measurement of S100B Protein and Specific Neuronal Enolase (NSE).","Inclusion Criteria :\n\nAdult patients (≥18 years old). Scheduled for F.E.S.S (Functional endoscopic sinus surgery ) under general anesthesia.\n\nAble to provide informed consent\n\nExclusion Criteria:\n\nEmergency surgery. ASA physical status IV-V. Severe hepatic or renal dysfunction. Known allergy or contraindication to study drugs. Pregnant or lactating women. unable to provide informed consent\n\nPatients unwilling or unable to provide consent.",{"count":394,"type":21},150,[315],"This prospective, randomized controlled trial investigates the effect of four different anesthetic maintenance techniques on surgical field conditions, hemodynamic stability, and neuroprotection during functional endoscopic sinus surgery (FESS) performed under controlled hypotension. Patients are randomly assigned to receive either total intravenous anesthesia with propofol-remifentanil, propofol-remifentanil with adjunct ketamine and magnesium, sevoflurane-remifentanil, or sevoflurane-remifentanil with adjunct ketamine and magnesium. Primary outcomes include serum biomarkers of neuronal injury (S100B and neuron-specific enolase, NSE) measured perioperatively, as well as surgical field visibility and intraoperative bleeding scores. Secondary outcomes include recovery profile and postoperative pain.",[398,399,400,401,402,403,404,405,28],"Magnesium Sulfate","Remifentanil","S 100beta","S100 Beta Protein, Human","Neuron-Specific Enolase","Brain Ischemia","Sevoflurane Anaesthesia","Propofol\u002FRemifentanil",[407],"\"Anesthesia\", \"Controlled Hypotension\", \"FESS\", \"S100B\", \"Neuron-Specific Enolase\"","2025-09-11",{"date":410,"type":40},"2025-09-18",{"date":408,"type":40},{"date":413,"type":21},"2026-03-20",{"name":415,"class":47},"University General Hospital of Patras",{"id":417,"slug":418,"hasResults":11,"nctId":419,"briefTitle":420,"officialTitle":421,"acronym":4,"eligibilityCriteria":422,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":367,"enrollmentInfo":423,"targetDuration":4,"studyType":22,"phases":424,"briefSummary":425,"conditions":426,"keywords":4,"overallStatus":65,"whyStopped":4,"lastUpdateSubmitDate":430,"lastUpdatePostDateStruct":431,"startDateStruct":433,"completionDateStruct":434,"leadSponsor":436,"locationsCount":48},"100590369","intraoperative-combination-of-ketamine-and-magnesium-sulfate-infusions-on-postoperative-analgesia-in-open-rhinoplasty-100590369","NCT06966518","Intraoperative Combination of Ketamine and Magnesium Sulfate Infusions on Postoperative Analgesia in Open Rhinoplasty","Effectiveness of Intraoperative Combination of Ketamine and Magnesium Sulfate Infusions on Postoperative Analgesia in Patients Undergoing Open Rhinoplasty: A Randomized Controlled Trial","Inclusion Criteria:\n\n* Age from 18 to 65 years.\n* Both sexes.\n* American Society of Anesthesiologists (ASA) physical status I - II.\n* Scheduled for rhinoplasty under general anesthesia.\n\nExclusion Criteria:\n\n* Receiving analgesic or any medications since 48 hours before the surgery.\n* Drug addiction.\n* Cardiovascular disease.\n* Respiratory disease, renal, liver, metabolic and neurological disease.\n* Pregnancy or breast feeding.\n* Asthma.",{"count":155,"type":21},[315],"The study aims to evaluate the effectiveness of intraoperative combination of ketamine and magnesium sulfate infusions on postoperative analgesia in patients undergoing open rhinoplasty.",[427,28,398,428,429],"Intraoperative","Postoperative Analgesia","Rhinoplasty","2025-05-12",{"date":432,"type":40},"2025-05-13",{"date":430,"type":40},{"date":435,"type":21},"2025-10-01",{"name":385,"class":47},{"id":438,"slug":439,"hasResults":11,"nctId":440,"briefTitle":441,"officialTitle":442,"acronym":4,"eligibilityCriteria":443,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":444,"targetDuration":4,"studyType":22,"phases":446,"briefSummary":447,"conditions":448,"keywords":449,"overallStatus":65,"whyStopped":4,"lastUpdateSubmitDate":452,"lastUpdatePostDateStruct":453,"startDateStruct":455,"completionDateStruct":457,"leadSponsor":459,"locationsCount":48},"100306705","phase-4-ect-with-ketamine-anesthesia-vs-high-intensity-ketamine-with-ect-rescue-for-treatment-resistant-depression-100306705","NCT03272698","ECT with Ketamine Anesthesia Vs High Intensity Ketamine with ECT Rescue for Treatment-Resistant Depression","A Prospective Randomized Controlled Trial of Electroconvulsive Therapy with Ketamine Anesthesia (Standard Therapy) and High Intensity Ketamine with Electroconvulsive Therapy Rescue for Treatment-Resistant Depression - EAST HIKER Trial","Inclusion Criteria:\n\n* Montgomery Asberg Depression Rating Scale (MADRS) score of greater than 20) planned for ECT therapy.\n* Subjects must meet clinical criteria for TRD defined as failure to respond to at least 2 standard-of-care drug therapies of adequate treatment duration.\n\nExclusion Criteria:\n\n* Subjects will be ineligible if they cannot provide informed consent\n* American Society of Anesthesiology physical status score of four or greater\n* Implanted medical device with electronic parts (e.g. pacemaker, defibrillator, intrathecal pump, spinal cord stimulator, deep brain stimulator)\n* Schizoaffective disorder\n* Women of child-bearing potential will be asked to undergo a commercial urine pregnancy screening test. Those who refuse or screen positive will be excluded.\n* Allergic to any of the study drugs or their carrier components\n* Any serious physical condition prior to randomization deemed by the attending psychiatrist or consulting anesthetist to be a contraindication to ECT such as cardiovascular disease (including untreated hypertension), respiratory disease, cerebrovascular disease, intracranial hypertension (including glaucoma), or seizures.",{"count":445,"type":21},62,[24],"To determine if an high intensity ketamine with ECT rescue (HIKER) approach for treatment resistant depression will: 1) reduce patient suffering by hastening disease remission, 2) have fewer side effects, 3) reduce the need for ECT, and 4) be preferred by most patients. Half of participants will be randomized to the HIKER arm and receive high intensity ketamine treatment for eight consecutive days, and the other half will be assigned to the ECT with ketamine anesthesia (EAST) arm and receive 8 ECT treatments (2-3 treatment\u002Fweek)",[103,28],[223,450,451],"treatment-resistant depression","electroconvulsive therapy","2025-01-20",{"date":454,"type":40},"2025-01-23",{"date":456,"type":40},"2017-09-01",{"date":458,"type":21},"2025-12-31",{"name":460,"class":47},"University of Saskatchewan"]