Multiple Sclerosis Clinical Trial
Ketamine for Multiple Sclerosis Fatigue
Summary
The proposed study is a single-center, phase II, randomized, double-blind, parallel-group, active-placebo-controlled trial of intravenous low-dose ketamine in patients with MS fatigue.
Eligibility Criteria
Inclusion Criteria:
Subject must be a man or woman, 18 to 65 years of age, inclusive.
Subject must be medically stable based on physical examination, medical history, and vital signs
Subject must meet McDonald 2017 diagnostic criteria for multiple sclerosis based on the PI review of the medical records
Subject must complain from fatigue as one of their main symptoms and have a screening MFIS score equal or higher than the cutoff based on gender, age, and education displayed in Table-226
Subject must be ambulatory (able to walk at least 20 feet using bilateral assistance)
Subject must have internet and email access and ability to use a computer or tablet or smartphone
Subjects that are currently taking medication for alleviating fatigue (such as amantadine, modafinil and armodafinil, and amphetamine-like psychostimulants) at Screening are eligible to participate unless the medication is one of the disallowed therapies (Table 3). Subjects taking a fatigue medication at the Screening visit must have been receiving a stable dose for at least four weeks before the Screening visit and be willing to continue the medication at the same dose for the duration of the study.
Exclusion Criteria:
BDI-II score of more than 29 (indicating severe depression)
Having a known clear cause for secondary fatigue, such as untreated sleep apnea, untreated hypothyroidism, chronic liver disease, history of moderate to severe anemia (hemoglobin concentration of less than 9 gr/dl in men or less than 8 gr/dl in women).
Neurodegenerative disorders other than relapsing or progressive MS
Breastfeeding or pregnant
History of coronary artery disease or congestive heart failure
Uncontrolled hypertension at Screening (history of high blood pressure and screening systolic blood pressure >160 or diastolic blood pressure>100)
History of severe liver disease, including cirrhosis
Terminal medical conditions
Currently treated for active malignancy
Alcohol or substance abuse in the past year (except marijuana or other cannabinoids)
A history of intolerance or allergic or anaphylactic reaction to ketamine or midazolam
Clinically unstable medical or psychiatric disorders that require acute treatment as determined by the PI
History of severe or untreated coronary artery disease or history of congestive heart failure
History of prior ischemic or hemorrhagic stroke and cerebral vascular aneurysms.
History of recurrent seizures or epilepsy
Taking any disallowed therapy(ies), as noted in the protocol.
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