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RecruitingMajor Depressive Disorder (MDD)

Pilot Study: Establishing Glutamatergic Changes in Rapid Antidepressant Effects of Ketamine

Eligible age

25–65 yrs

Accepts

All genders

Locations

1 state

Healthy volunteers

No

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About this study

In the treatment of Major Depressive Disorder (MDD), ketamine can produce rapid but short-lasting improvements in mood. In order to develop a new generation of treatments with rapid and sustained efficacy, a better understanding of the mechanism of action is urgently needed. One candidate mechanism is the modulation of synaptic strength mediated by glutamatergic activity as ketamine has been suggested to increase synaptic strength. Although determining how ketamine impacts the glutamatergic system is essential to isolating its mechanism of action, the invasive nature of most assessment methods has limited our ability to do so in humans. The proposed research aims to determine if changes in glutamatergic activity, reflecting the modulation of synaptic strength, underlie the antidepressant effects of ketamine. In this project, the investigators will utilize a novel measure of glutamate imaging, GluCEST, to assess changes in glutamatergic activity to assess synaptic strength following ketamine administration. Ten individuals (aged 25-65) with a DSM-V diagnosis of MDD will undergo baseline GluCEST imaging prior to and following ketamine infusion. Both clinician-administered and subjective mood measures will be collected. It is predicted that ketamine will improve mood and increase glutamatergic activity and synaptic strength. Results from this project have the potential to identify the modifiable mechanisms by which rapid antidepressants work which could ultimately stimulate the development of novel interventions that work through the modulation of glutamatergic activity.

Sponsor: University of Pennsylvania

You may qualify if…

  • 1. Age between 25 and 65 years;
  • 2. Current depression as assessed on the SCID;
  • 3. Treatment-resistant depression, as defined by failure of at least two previous antidepressant or mood stabilizing treatments within the current depressive episode. Failed antidepressant or mood stabilizing treatments can include pharmacotherapy for depression at an adequate dose for at least 8 weeks
  • 4. Able to comprehend English, as all questionnaires are in this language
  • 5. Ability to provide informed consent Ability to pass a comprehension assessment test related to effects of ketamine and trial objectives and criteria.

You may not qualify if…

  • 1. A sleep disorder other than insomnia, as determined by history;
  • 2. History of bipolar disorder, delirium, dementia, amnestic disorder, schizophrenia and other psychotic disorders as assessed on the SCID;
  • 3. Alcohol or drug abuse in the past year based upon the SCID or urine toxicology screen;
  • 4. A current smoker;
  • 4\) Any significant medical or neurological illness that impacts brain function or impedes participation; 5) History of head trauma with significant loss of consciousness; 6) Metallic implants, pacemakers or tattoos, or other contraindications to MRI; Claustrophobic, or intolerant of the scanner environment; 7) For women, pregnancy will exclude participation. 8) Untreated hypertension
  • Based on ketamine's known difficulties with induction of perceptual/psychomimetic symptoms, exclusion criteria for this study are as follows:
  • 1. Patients with a BMI over 40.
  • 2. Ongoing prescription of 4 mg lorazepam equivalents (total) daily, or morning dosing of any benzodiazepine at the time of assessment;

Where it's recruiting

Pennsylvania

Philadelphia

Source: ClinicalTrials.gov · NCT06788249 · last updated 2026-08-04

Pilot Study: Establishing Glutamatergic Changes in Rapid Antidepressan · TrialPath