Status:

RECRUITING

Ketamine-Assisted Recovery for Methamphetamine Use Disorder & HIV

Lead Sponsor:

Nicky Mehtani, MD, MPH

Collaborating Sponsors:

San Francisco Department of Public Health

California HIV/AIDS Research Program

Conditions:

Methamphetamine Use Disorder

Eligibility:

All Genders

18-69 years

Phase:

PHASE2

Brief Summary

The goal of this clinical trial is to learn whether it is possible to use intramuscular (IM) ketamine in combination with psychotherapy to treat moderate-to-severe methamphetamine use disorder (MeUD) ...

Detailed Description

This is a single-arm pilot feasibility trial (N=12) of 3 doses of ketamine hydrochloride (0.50-0.75 mg/kg IM) administered approximately once weekly, in combination with 7 sessions of manualized psych...

Eligibility Criteria

Inclusion

  • Age 18-69
  • Moderate or severe methamphetamine use disorder
  • Interest in reducing or stopping methamphetamine use
  • Insured by MediCal, MediCare, or Healthy San Francisco
  • Used methamphetamine ≥7 out of the 30 days prior to screening OR enrolled in a residential drug treatment program
  • Have a diagnosis of HIV OR taken PrEP over the last 90 days OR engaged in ≥1 risk behavior for HIV acquisition/transmission over the last 90 days (i.e., anal sex under the influence of methamphetamine, condomless sex with a partner of serodiscordant or unknown HIV status, or any shared use of injection drug supplies)
  • English speaking
  • Permanently housed for ≥30 days OR enrolled in residential drug treatment for ≥5 days
  • Have a text-capable cell phone or access to email (if not enrolled in residential treatment)
  • Able and willing to provide informed consent and adhere to visit schedule
  • If necessary, willing to be contacted on a daily basis by one of the therapists for 7 days after each ketamine session
  • Prior to scheduled ketamine sessions, agree: (a) abstain from using methamphetamine and cocaine for ≥48 hours, (b) abstain from using non-prescribed opioids, cannabis products, benzodiazepines, or alcohol for ≥24 hours, (c) consume no more than a modest quantity (e.g., 1 cup) of caffeine (e.g., coffee or tea) in the morning; (d) continue usual regimen of routinely prescribed opioid-based medications throughout trial; and (e) continue any routine behavioral or pharmacologic mental health interventions as usual outside of the trial
  • Female-born participants of child-bearing potential with male-born partners and male-born participants with female-born partners of child-bearing potential must agree to use highly effective contraception for at least 1 month prior to and 2 months after ketamine administration

Exclusion

  • Significant prior use of ketamine for non-anesthetic purposes, as determined by the investigators
  • Cognitive impairment sufficient to impede the ability to complete study tasks
  • Lifetime history of intracranial hemorrhage
  • Has an intracranial mass
  • Had a stroke in the past 12 months
  • Had a seizure in the past 6 months
  • Has current psychosis or any lifetime history of schizophrenia or schizoaffective disorder
  • Engaged in a contingency management program during study
  • Taking any prohibited medications
  • If receiving any medication that may cause blunting of responses or diminished affect, such as antipsychotics, exclusion will be as per the evaluation of the PI and study staff
  • Active suicidal ideation with intent
  • Baseline hypertension (≥150 SBP or ≥90 DBP) after repeated measurements
  • History of aneurysmal vascular disease, dissection or arteriovenous malformation
  • Had a cardiac arrest or myocardial infarction in the past 12 months
  • QTc \>450 msec on 12-lead EKG (Bazett's formula)
  • Has a clinically significant arrhythmia
  • Meets any of the following laboratory parameters: ALT ≥3x ULN, AST ≥3x ULN, total bilirubin ≥1.5x ULN, eGFR \<30mL/min by CKD-EPI or currently on dialysis
  • Pregnant, breastfeeding, or unwilling to use birth control during the study
  • Pending legal proceedings with a high risk for incarceration during the study
  • Taken another investigational drug in the past 30 days
  • Has any physical or mental health condition which, per the clinical judgment of the investigators, interferes with safe study participation or adherence to study procedures

Key Trial Info

Start Date :

March 4 2025

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

June 1 2026

Estimated Enrollment :

12 Patients enrolled

Trial Details

Trial ID

NCT06538285

Start Date

March 4 2025

End Date

June 1 2026

Last Update

April 4 2025

Active Locations (1)

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San Francisco Department of Public Health

San Francicso, California, United States, 94102