Double-blind, randomised, parallel pilot study (n=20) comparing a 100-hour IV ketamine infusion plus clonidine versus a 40-minute IV ketamine infusion (plus clonidine and a 100-hour saline infusion) in adults with treatment-resistant major depressive disorder.
This pilot tests whether a higher-dose, longer-duration ketamine infusion (100 hours) plus clonidine provides more robust and longer-lasting antidepressant effects compared with the standard 40-minute ketamine infusion in treatment‑resistant major depressive disorder.
Adults (18–65) are randomised to two parallel arms; all receive clonidine pretreatment and monitoring during approximately 108-hour inpatient admission. Outcomes include depression severity (MADRS), safety labs, vitals, ECG, and adverse events with follow-up to assess durability of response.
100-hour IV ketamine infusion plus clonidine
100-hour continuous infusion (reported rate 0.00225 mg/kg/min).
Clonidine PO pretreatment and during infusion, up to 1 mg/day divided doses.
40-minute IV ketamine infusion following ~100-hour saline infusion; clonidine given to all participants
Standard 40-minute IV ketamine infusion (per protocol).
Clonidine PO pretreatment and during infusion, up to 1 mg/day divided doses.
100-hour IV saline placebo infusion.