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NMDA Receptor FunctionGuaKetNCT01600885

The Effects of Ketamine and Guanfacine on Working Memory in Healthy Subjects

A study testing Guanfacine in people with NMDA Receptor Function, run by Yale University at 3 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of the study is 1. To establish the feasibility of fMRI studies of the interaction of guanfacine and ketamine. 2. To explore the possibility that guanfacine can ameliorate the negative effects of ketamine on task-related prefrontal activation. 3. Read more about this study

Who is it for?
Ages 21 to 45 yearsHealthy volunteers can take part
Conditions the study is for
NMDA Receptor Function
What is being tested?
Guanfacine
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
16 participants
Where
3 sitesUnited States
Study dates
Aug 2008to Dec 2014
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 21 to 45 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Age between 21 and 45, inclusive
  • Right-handed
  • Have at least a 12th grade education level or equivalent
  • Able to read and write English as a primary language
  • Willing to refrain from caffeine and alcohol use for one week prior to each MRI session.

Who cannot join

  • Abnormality on physical examination
  • A 12 lead ECG at screening has clinically significant abnormalities as determined by the physician reading the ECG
  • A positive pre-study urine drug screen or, at the study physicians' discretion on any drug screens given before the scans
  • Abnormality on clinical chemistry or hematology examination at the pre-study medical screening.
  • History of positive HIV or Hepatitis B.
  • Has received either prescribed or over-the-counter (OTC) centrally active medicine or herbal supplements within the week prior to the MRI scan.
Show all 24Show fewer
  • History of any substance abuse disorder meeting DSM-IV criteria with the exception of nicotine
  • Any history of DSM-IV Axis I psychiatric disorders,
  • Any history of major medical or neurological disorders
  • Any history indicating learning disability, mental retardation, or attention deficit disorder.
  • First-degree relative with Axis I DSM-IV disorder including substance abuse or dependence.
  • Any clinically significant abnormalities on screening electrocardiogram
  • Any history of head injury
  • Any evidence of psychosis-like symptoms, as indicated by elevated scores on the Perceptual Aberration-Magical Ideation (Chapman, Chapman et al. 1978; Eckblad, Chapman et al. 1983) and the revised Social Anhedonia scales(Eckblad, Chapman et al. unpublished)
  • A positive urine toxicology screen for illicit substance use or positive alcohol breathalyzer test conducted at screening interview and prior to each MRI session
  • Known sensitivity to ketamine.
  • Body circumference of 52 inches or greater.
  • History of claustrophobia
  • Any clinically significant impairment of color vision or visual acuity after correction available in the scanner.
  • 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
  • Pregnancy or breast-feeding would exclude potential participants and all female subjects will receive a urine pregnancy test at screening and before each MRI scan.
  • Donation of blood in excess of 500 mL within 56 days prior to dosing.
  • History of sensitivity to heparin or heparin-induced thrombocytopenia.
  • Blood pressure must be higher than 90/70. Pulse must be greater than 40 unless the participant is cleared by a study physician

Trial locations and contacts

3 sites in 1 country.

United States3 sites
  • Connecticut Mental Health Center

    New Haven, Connecticut, 06511

  • Yale Magnetic Resonance Research Center

    New Haven, Connecticut, 06520

  • Veterans Affairs Hospital

    West Haven, Connecticut, 06516

Other trials in United States

About this study

The purpose of the study is

  1. To establish the feasibility of fMRI studies of the interaction of guanfacine and ketamine.
  2. To explore the possibility that guanfacine can ameliorate the negative effects of ketamine on task-related prefrontal activation.
  3. To assess the strength of any interaction between guanfacine and ketamine.
Read the detailed description

Potential subjects will be interviewed over the phone and, if appropriate, will be scheduled for a screening session. Participants who meet study criteria will participate in two study sessions separated by at least two weeks. The sessions will be identical except on one day they will receive guanfacine and on the other, they will receive a placebo.

This study was initially completed in 2014. Upon analysis of the collected data, it was decided to add additional subjects and gather additional data to verify results seen in the collected data. The study was reopened and new data was added beginning in September 2016. Information about the study beginning in 2016 is available in a separate record.

Being tested
Guanfacine, Placebo
Keywords
Guanfacine, Ketamine, Functional Magnetic Resonance Imaging, Prefrontal Cortex Activity, Receptors, N-Methyl-D-Aspartate, Receptors, Adrenergic, alpha-2, Memory, Short-Term, Schizophrenia
Medical subject headings
Schizophrenia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • GuanfacineDrug

    Subjects will be given 3mg of guanfacine before the fMRI scan. Then when in the scanner, a bolus of ketamine (0.23mg/kg over 1 min) will be given during the visual fixation scan. Immediately after completion of the 1 min bolus, the participant will receive a steady state ketamine infusion of 0.58 mg/kg/hour and brain activation will be measured during a spatial working memory task. The entire scan will last approximately two and a half hours and the ketamine infusion will be up to one hour and 15 minutes.

  • PlaceboDrug

    Subjects will be given a placebo before the fMRI scan. Then when in the scanner, a bolus of ketamine (0.23mg/kg over 1 min) will be given during the visual fixation scan. Immediately after completion of the 1 min bolus, the participant will receive a steady state ketamine infusion of 0.58 mg/kg/hour and brain activation will be measured during a spatial working memory task. The entire scan will last approximately two and a half hours and the ketamine infusion will be up to one hour and 15 minutes.

Study groups in NCT01600885
Study groupRoleWhat they receive
Guanfacine then PlaceboActive comparatorDuring the first study session, the participant will receive guanfacine before undergoing a ketamine-infusion fMRI. During the second study session, at least two weeks later, the participant will receive a placebo before undergoing a ketamine-infusion fMRI.
Receives: Drug: Guanfacine; Drug: Placebo
Placebo then GuanfacineActive comparatorDuring the first study session, the participant will receive a placebo before undergoing a ketamine-infusion fMRI. During the second study session, at least two weeks later, the participant will receive guanfacine before undergoing a ketamine-infusion fMRI.
Receives: Drug: Guanfacine; Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percent Change in Amelioration of Ketamine-related Task Activation as Measured by Functional Magnetic Resonance Imaging in Inferior Parietal Lobule

    Scans will be analyzed for task-related prefrontal activation

    Difference Score: Percent Signal Change in Regions of Interest (ketamine - saline)

    Measured: Within 4 hours of dose administration, after up to 1.25 hours of ketamine infusion

  2. Percent Change in Amelioration of Ketamine-related Task Activation as Measured by Functional Magnetic Resonance Imaging in Middle Frontal Gyrus

    Difference Score: Percent Signal Change in Regions of Interest (ketamine - saline)

    Measured: Within 4 hours of dose administration, after up to 1.25 hours of ketamine infusion

  3. Percent Change in Amelioration of Ketamine-related Task Activation as Measured by Functional Magnetic Resonance Imaging in Superior Frontal Gyrus

    Difference Score: Percent Signal Change in Regions of Interest (ketamine - saline)

    Measured: Within 4 hours of dose administration, after up to 1.25 hours of ketamine infusion

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 May 2012 (estimated)
  2. Study startAug 2008
  3. Primary completionDec 2014
  4. Study completionDec 2014

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Basic science
Allocation
Randomised
Intervention model
Crossover
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
16 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01600885
Sponsor's protocol ID
0807004092
Acronym
GuaKet
Status last verified
Jul 2017
First submitted
15 May 2012
Last updated
21 Aug 2017
Data monitoring committee
No

Publications

  • Arnsten AF, Cai JX. Postsynaptic alpha-2 receptor stimulation improves memory in aged monkeys: indirect effects of yohimbine versus direct effects of clonidine. Neurobiol Aging. 1993 Nov-Dec;14(6):597-603. doi: 10.1016/0197-4580(93)90044-c.

    PubMed 7905189
  • Bjarnadottir M, Misner DL, Haverfield-Gross S, Bruun S, Helgason VG, Stefansson H, Sigmundsson A, Firth DR, Nielsen B, Stefansdottir R, Novak TJ, Stefansson K, Gurney ME, Andresson T. Neuregulin1 (NRG1) signaling through Fyn modulates NMDA receptor phosphorylation: differential synaptic function in NRG1+/- knock-outs compared with wild-type mice. J Neurosci. 2007 Apr 25;27(17):4519-29. doi: 10.1523/JNEUROSCI.4314-06.2007.

    PubMed 17460065
  • Brandt, J. The Hopkins Verbal Learning Test: development of a new memory test with six equivalent forms The Clinical Neuropsychologist 125-142, 1991

  • Buccafusco JJ. Neuropharmacologic and behavioral actions of clonidine: interactions with central neurotransmitters. Int Rev Neurobiol. 1992;33:55-107. doi: 10.1016/s0074-7742(08)60691-1. No abstract available.

    PubMed 1350577
  • Chapman LJ, Chapman JP, Raulin ML. Body-image aberration in Schizophrenia. J Abnorm Psychol. 1978 Aug;87(4):399-407. doi: 10.1037//0021-843x.87.4.399. No abstract available.

    PubMed 681612
  • Cho HS, D'Souza DC, Gueorguieva R, Perry EB, Madonick S, Karper LP, Abi-Dargham A, Belger A, Abi-Saab W, Lipschitz D, Bennet A, Seibyl JP, Krystal JH. Absence of behavioral sensitization in healthy human subjects following repeated exposure to ketamine. Psychopharmacology (Berl). 2005 Apr;179(1):136-43. doi: 10.1007/s00213-004-2066-5. Epub 2005 Jan 29.

    PubMed 15682309
  • da Silva TL, Pianca TG, Roman T, Hutz MH, Faraone SV, Schmitz M, Rohde LA. Adrenergic alpha2A receptor gene and response to methylphenidate in attention-deficit/hyperactivity disorder-predominantly inattentive type. J Neural Transm (Vienna). 2008;115(2):341-5. doi: 10.1007/s00702-007-0835-0. Epub 2008 Jan 16.

    PubMed 18200436
  • Driesen NR, Leung HC, Calhoun VD, Constable RT, Gueorguieva R, Hoffman R, Skudlarski P, Goldman-Rakic PS, Krystal JH. Impairment of working memory maintenance and response in schizophrenia: functional magnetic resonance imaging evidence. Biol Psychiatry. 2008 Dec 15;64(12):1026-34. doi: 10.1016/j.biopsych.2008.07.029. Epub 2008 Sep 27.

    PubMed 18823880
  • Eckblad M, Chapman LJ. Magical ideation as an indicator of schizotypy. J Consult Clin Psychol. 1983 Apr;51(2):215-25. doi: 10.1037//0022-006x.51.2.215. No abstract available.

    PubMed 6841765
  • Friedman JI, Adler DN, Temporini HD, Kemether E, Harvey PD, White L, Parrella M, Davis KL. Guanfacine treatment of cognitive impairment in schizophrenia. Neuropsychopharmacology. 2001 Sep;25(3):402-9. doi: 10.1016/S0893-133X(01)00249-4.

    PubMed 11522468
  • Glantz LA, Lewis DA. Dendritic spine density in schizophrenia and depression. Arch Gen Psychiatry. 2001 Feb;58(2):203. doi: 10.1001/archpsyc.58.2.203. No abstract available.

    PubMed 11177126
  • Glantz LA, Lewis DA. Decreased dendritic spine density on prefrontal cortical pyramidal neurons in schizophrenia. Arch Gen Psychiatry. 2000 Jan;57(1):65-73. doi: 10.1001/archpsyc.57.1.65.

    PubMed 10632234
  • Hahn CG, Wang HY, Cho DS, Talbot K, Gur RE, Berrettini WH, Bakshi K, Kamins J, Borgmann-Winter KE, Siegel SJ, Gallop RJ, Arnold SE. Altered neuregulin 1-erbB4 signaling contributes to NMDA receptor hypofunction in schizophrenia. Nat Med. 2006 Jul;12(7):824-8. doi: 10.1038/nm1418. Epub 2006 Jun 11.

    PubMed 16767099
  • Hunt RD, Arnsten AF, Asbell MD. An open trial of guanfacine in the treatment of attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 1995 Jan;34(1):50-4. doi: 10.1097/00004583-199501000-00013.

    PubMed 7860456
  • Jakala P, Riekkinen M, Sirvio J, Koivisto E, Kejonen K, Vanhanen M, Riekkinen P Jr. Guanfacine, but not clonidine, improves planning and working memory performance in humans. Neuropsychopharmacology. 1999 May;20(5):460-70. doi: 10.1016/S0893-133X(98)00127-4.

    PubMed 10192826

Questions about this trial

What is this clinical trial studying?

A study testing Guanfacine in people with NMDA Receptor Function, run by Yale University at 3 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 24 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 21 Aug 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 28 Oct 2014). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percent Change in Amelioration of Ketamine-related Task Activation as Measured by Functional Magnetic Resonance Imaging in Inferior Parietal Lobule (time frame: Within 4 hours of dose administration, after up to 1.25 hours of ketamine infusion). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01600885, which also lists 29 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Aug 2017.

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