Effects of low dose intramuscular ketamine on depression ratings in depressed patients with cancer in palliative care

Open-label Stage 1 (single 1 mg/kg IM) and Stage 2 (repeated ~weekly 1 mg/kg IM for responders) followed by Stage 3 randomisation to single-dose 0.1, 0.5 or 1.0 mg/kg IM under double-blind conditions; primary outcome is change in MADRS over time.

Assessments include MADRS at baseline and 24 hours post-injection, proportion responding (>50% reduction) and remitting (MADRS <7), with additional measures including HADS and demoralisation scales.