Trends in U.S. Depression Prevalence From 2015 to 2020: The Widening Treatment Gap.
Renee D Goodwin, Lisa C Dierker, Melody Wu...
https://pubmed.ncbi.nlm.nih.gov/36272761/Actively Recruiting
Led by Theresa Jacob, PhD, MPH · Updated on 2026-04-24
40
Participants Needed
1
Research Sites
N/A
Total Duration
Researchers are evaluating the use of nebulized ketamine as a treatment for adults with moderate to severe depression in an inpatient psychiatric setting. This double-blind, randomized clinical trial compares nebulized ketamine with an active placebo, midazolam, to assess their effects on depressive symptoms. The study is designed to provide insights on whether inhaled ketamine can reduce depression when added to current medications and therapies. Participants will be randomly assigned to receive either nebulized ketamine at a dose calculated by body weight 1.5 mgkg or nebulized midazolam as an active comparator 0.03 mgkg. The study involves 4 to 5 visits depending on the treatment group, with dosing days requiring in-person attendance and monitoring for at least two hours. All other visits can be conducted remotely. Vital signs will be regularly collected during the observation period following dosing. Adults aged 18 and older diagnosed with moderate to severe major depressive disorder will be screened and enrolled. Throughout the 8 to 10 day study period, researchers will measure changes in depression using the Montgomery-sberg Depression Rating Scale MADRS and other scales assessing suicide ideation, dissociative effects, sedation, and agitation. Safety monitoring includes vital signs and side effect assessments. The study aims to capture both immediate and short-term effects of the treatments on depressive symptoms.
CONDITIONS
Nebulized Ketamine for the Treatment of Major Depressive Disorder
J
Jessica Poster, MD
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Theresa Jacob, PhD, MPH
Lead Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Nebulized ketamine | Nebulized midazolam (active comparator) |
|---|---|---|
| What it is | A rapid-acting antidepressant drug administered by inhalation using a nebulizer, with the dose calculated by body weight (1.5 mg/kg). | A sedative and anxiolytic drug given by inhalation through a nebulizer, dosed by body weight (0.03 mg/kg), serving as the active comparator. |
| Role in the trial | Evaluated for its potential to rapidly reduce symptoms of moderate to severe major depressive disorder. | Used as an active comparator to control for nonspecific effects and enable head-to-head assessment of ketamine's antidepressant potential. |
| Primary use or purpose | Investigated for rapid reduction of depressive symptoms in adults with moderate to severe major depressive disorder. | Serves as a comparator due to its sedative properties and absence of established antidepressant effect. |
| How it is given or performed | Participants inhale a personalized dose of ketamine through a nebulizer in a clinic setting. Dosage is based on body weight (1.5 mg/kg). | Midazolam is administered via nebulizer for inhalation under clinical supervision, with dosing determined by body weight (0.03 mg/kg). |
| Evidence status | Multiple trials, primarily with intravenous or intranasal routes, report rapid antidepressant effects for ketamine in treatment-resistant depression. Nebulized delivery is less studied, and this trial's results are not yet available. | Controlled trials confirm midazolam lacks significant antidepressant effect; it provides sedation and serves as a control for nonspecific effects in ketamine studies. |
| Important limitations | Nebulized administration for depression is experimental, and safety, dosing, and long-term effects are not fully established. Published studies focus mostly on intravenous and intranasal routes. | Midazolam offers no antidepressant effect and can cause sedation. Its use in this setting is for comparison rather than clinical benefit in depression. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - 8 to 10 days
Participants receive nebulized ketamine or midazolam as an adjunct to their current medications. Dosing visits require in-person attendance, with monitoring for at least two hours post-dose. Some visits may be completed remotely depending on the treatment arm.
4 to 5 visits, including dosing days with at least 2 hours of monitoring
Study Type
INTERVENTIONAL
Masking
TRIPLE
Allocation
RANDOMIZED
Model
CROSSOVER
Primary Purpose
TREATMENT
Number of Arms
2
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https://pubmed.ncbi.nlm.nih.gov/29202655/Theresa Jacob, PhD, MPH
Lead Sponsor