A randomized controlled trial of the effect of anesthetic dose during electroconvulsive therapy for major depression

2024-519407-99-00 Therapeutic use (Phase IV) Authorised, recruitment pending

Status Authorised, recruitment pending · 1 EU/EEA countries · 4 sites

Overview

Sponsor-declared trial summary

Phase Therapeutic use (Phase IV)
Status Authorised, recruitment pending
Participants planned 210
Countries 1
Sites 4

Major depressive disorder

The main objective of this trial is to to test if the reduction of depressive symptoms after six electroconvulsive therapy (ECT) sessions is larger in patients anesthetized with a low thiopental dose compared to patients anesthetized with a high thiopental dose during ECT.

Key facts

Sponsor
Karolinska Institutet
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male and Female
Therapeutic area
Psychiatry and Psychology [F] - Mental Disorders [F03]
Decision date (initial)
2025-03-27
Transition trial
No
Low-intervention
Yes
Rare-disease indication
No
Vulnerable population
No

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Dose response, Efficacy

The main objective of this trial is to to test if the reduction of depressive symptoms after six electroconvulsive therapy (ECT) sessions is larger in patients anesthetized with a low thiopental dose compared to patients anesthetized with a high thiopental dose during ECT.

Secondary objectives 1

  1. Secondary research questions: Does seizure duration differ between the low and high thiopental dose groups? Are there significant differences in the cognitive side effects experienced within a week after ECT between the low and high thiopental dose groups, and do these side effects persist to a different extent after six months between the two groups? Are there differences in the total number of ECT sessions in a series between the low and high thiopental dose groups? Does the duration of hospital stay differ between the low and high thiopental dose groups? Are there differences in the occurrence of awareness during anesthesia between the low and high thiopental dose groups? Are there differences in the risk of Major Depressive Disorder (MDD) relapse within a year after ECT between the low and high thiopental dose groups?

Conditions and MedDRA coding

Major depressive disorder

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 1

  1. • age 18 years and above • hospitalized patients with an ongoing major depressive episode within MDD

Exclusion criteria 1

  1. • postpartum depression • schizophrenia • psychotic syndrome • bipolar disorder • patients for whom the anesthesiologist deems that a high anesthetic dose is inappropriate due to a somatic condition. • patients under compulsory psychiatric care according to the Swedish Act on Compulsory Psychiatric Care (Lagen om psykiatrisk tvångsvård) • patients who do not speak or understand Swedish or English sufficiently to provide informed consent or complete study assessments

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

  1. Change in MADRS score after six ECT sessions with a low thiopental dose compared to a high thiopental dose for anesthesia during ECT for MDD

Secondary endpoints 1

  1. • Seizure duration in the low versus high thiopental dose group • Cognitive side effects within a week after ECT and after six months • The total number of ECT sessions in a series in the low versus high thiopental dose group • Length of hospital stay in the low versus high thiopental dose group • Awareness during anesthesia in the low versus high thiopental dose group • The risk for MDD relapse within a year after ECT in the low versus high thiopental dose group

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 1

Pentocur 1 g pulver till injektionsvätska, lösning

PRD10107228 · Product

Active substance
Thiopental Sodium
Substance synonyms
THIOPENTONE SODIUM
Pharmaceutical form
SOLUTION FOR INJECTION
Route of administration
INTRAVENOUS
Max daily dose
5.50 mg/kg milligram(s)/kilogram
Max total dose
6.00 g gram(s)
Max treatment duration
3 Week(s)
Authorisation status
Authorised
ATC code
N01AF03 — THIOPENTAL
Marketing authorisation
61069
MA holder
ABCUR AB
MA country
Sweden
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Karolinska Institutet

Sponsor organisation
Karolinska Institutet
Address
Nobels Vag 6
City
Solna
Postcode
171 65
Country
Sweden

Scientific contact point

Organisation
Karolinska Institutet
Contact name
Mikael Tiger

Public contact point

Organisation
Karolinska Institutet
Contact name
Mikael Tiger

Locations

1 EU/EEA country · 4 investigational sites

By country

CountryMS statusPlanned subjectsSites
Sweden Authorised, recruitment pending 210 4
Rest of world 0

Investigational sites

Sweden

4 sites · Authorised, recruitment pending
Region Stockholm – SLSO
S:t Görans sjukhus, Norra Stockholms psykiatri, SLSO, Region Stockholm, Solnavagen 1 E, S:t Matteus, Stockholm
Region Oerebro Laen
Allmänpsykiatrin, Universitetssjukhuset Örebro, Region Örebro län, Sodra Grev Rosengatan, 701 85, Orebro
Region Stockholm – SLSO
Psykiatri Nordväst, Danderyds sjukhus, Solnavagen 1 E, S:t Matteus, Stockholm
Sahlgrenska University Hospital-Vaestra Goetalandsregionen
Psykiatri Affektiva, Sahlgrenska sjukhuset, Bla Straket 5, Goteborgs Annedal, Goteborg

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 6 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) Protocol TIDE version 6 6
Protocol (for publication) Protocol TIDE version 6 clean 250312 6
Recruitment arrangements (for publication) forfarande-for-rekrytering-och-samtyckesprocess TIDE 1
Subject information and informed consent form (for publication) Forskningspersonsinformation 241211 TIDE 1
Summary of Product Characteristics (SmPC) (for publication) Pentocur powder for solution for injection ENG SmPC_09001bee83624e64 1
Synopsis of the protocol (for publication) Protocol synopsis Swedish TIDE 1

Application history

1 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2024-12-18 Sweden Acceptable
2025-03-27
2025-03-27