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Trial registered on ANZCTR
Registration number
ACTRN12620000361909p
Ethics application status
Not yet submitted
Date submitted
5/03/2020
Date registered
13/03/2020
Date last updated
13/03/2020
Date data sharing statement initially provided
13/03/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
Ketamine and spider phobia replication study
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Scientific title
Replication study of ketamine in phobic participants using virtual reality stimuli
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Secondary ID [1]
300719
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none
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
This replication study is a follow up to ACTRN12619001504101 with changes to the dosing regimen and additional outcome measure.
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Health condition
Health condition(s) or problem(s) studied:
spider phobia
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Condition category
Condition code
Mental Health
314781
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Anxiety
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants with DSM 5 specific spider phobia will receive one of 2 randomized study treatments separated by one week. Participants will be administered single oral doses of 1.5 mg/kg ketamine and 0.02mg/kg midazolam (the psychoactive control) liquid added to 50mls orange juice. The order of the doses is randomized.
One hour after dosing participants will be exposed to images of spiders using a Virtual Reality
(VR) headset. We are using commercially available spider exposure software (https://store.steampowered.com/app/485270/Arachnophobia/) which has 5 levels. Lower levels have less spiders, that are contained in a glass jar. Higher levels have more spiders, more movement, and they are uncontained. Progression from lower to higher levels is under control of the participant, who can stop the simulation at any time.
Resting EEG will be recorded predose, during the VR simulation, at 70 minutes and 48-72 hours post dose.
We will monitor ratings of anxiety using a 100mm Visual Analog Scale (0mm = no anxiety, 100mm = worst anxiety) and physiological measures of anxiety including heart rate.
Participants will also complete the Fear Questionnaire (FQ) item 18 - which measures level of phobic avoidance.
The maximum duration of vR stimulation per visit is up to 5 minutes.
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Intervention code [1]
317041
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Treatment: Drugs
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Comparator / control treatment
0.02 mg/kg of midazolam will be used as the psychoactive control. The order of dosing will be determined using computer-generated random code, using a balanced randomisation.
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Control group
Active
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Outcomes
Primary outcome [1]
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change in anxiety ratings
Fear Questionnaire Item 18
100 mm Visual Analogue Scale
Heart rate
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Assessment method [1]
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Timepoint [1]
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-30 mins post dose FQ item 18, VAS, HR;
-60 mins FQ item 18, VAS, HR.
After the VR spider presentation ( 60 mins post-dose using 5 exposure levels);
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Secondary outcome [1]
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Completion of Fear Questionnaire (FQ) item 18 - phobic avoidance
We are assessing the level of phobic avoidance by asking participants to complete Item 18 of the FQ.
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Assessment method [1]
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Timepoint [1]
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predose
30 mins post dose
60 mins post dose
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Secondary outcome [2]
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How many of the 5 exposure levels to spiders using VR participants are able to complete
This outcome is assessed by study personnel who can see on the dual monitor how many levels of the simulation the participants complete - and how long they remain at each level.
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Assessment method [2]
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Timepoint [2]
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60 mins post dose
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Eligibility
Key inclusion criteria
1.Capable of understanding and signing an informed consent
2.Aged >18 years on the day of consent.
3.Must meet criteria for DSM5 specific phobia, and have a Fear of Spiders Questionnaire score >95 to participate.
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Minimum age
18
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1.Female participants who are or intend to become pregnant, or are lactating
2.Participants who, in the opinion of the investigator, do not understand the information and procedures of the study, or would not be compliant with them (in particular the study restrictions and risks involved).
3.Any participant for whom the investigator believes, for any reason, that participation would not be an acceptable risk.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Prof Glue will create the random codes. Study personnel involved with recruitment, dosing, data collection and analysis will not have access to the random codes until the databases are locked.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer generated random code, using a balanced randomization
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
6/04/2020
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Actual
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Date of last participant enrolment
Anticipated
9/11/2020
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Actual
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Date of last data collection
Anticipated
7/12/2020
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Actual
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Sample size
Target
12
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Otago
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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University of Otago
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Address [1]
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PO Box 56 Dunedin 9054
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Country [1]
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New Zealand
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Primary sponsor type
University
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Name
University of Otago
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Address
PO Box 56 Dunedin 9054
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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N/A
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Address [1]
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N/A
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Country [1]
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
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Southern Health and Disability Ethics Committee
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Ethics committee address [1]
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Ministry of Health
PO bOx 5013
Wellington 6011
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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23/03/2020
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Approval date [1]
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Ethics approval number [1]
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Summary
Brief summary
We hypothesise that Ketamine could be used therapeutically to manage phobic situations that interfere with health or business activities (e.g. needle phobic patients getting medical/dental procedures; aeroplane/flight phobic patients needing to travel by air).
The purpose of the study is to evaluate the effect of oral doses of ketamine and the active control, midazolam, on anxiety ratings in participants with spider phobia.
Images of spiders will be presented to participants at 60 minutes via a virtual reality (VR) headset. 5 spider encounters will be presented that vary in terms of size, activity level and proximity of the VR spider to the participant.
Resting EEG will be recorded predose, during the VR spider simulation, and at 70 mins, after the spider simulation exercise is completed.
Changes in anxiety and phobia ratings, plus heart rate will be obtained pre-dose, at 30 mins and immediately after each VR spider exposure at 60 mins..
This study is a replication study of ACTRN12619001504101.
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Trial website
N/A
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Trial related presentations / publications
N/A
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Public notes
This study is a replication study of ACTRN12619001504101.. The primary differences are
1. There are 2 dose periods instead of 3
2. We have added in resting EEG predose, at 60 mins during the VR presentation, at 70 mins and 48-72 hours post dose.
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Contacts
Principal investigator
Name
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Prof Paul Glue
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Address
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Department of Psychological Medicine
Dunedin School of Medicine
University of Otago
PO Box 56
Dunedin 9054
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Country
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New Zealand
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Phone
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+64 3 470 9451
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dr Shona Neehoff
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Address
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Department of Psychological Medicine
Dunedin School of Medicine
University of Otago
PO Box 56
Dunedin 9054
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Country
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New Zealand
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Phone
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+64 3 470 9451
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Prof Paul Glue
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Address
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Department of Psychological Medicine
Dunedin School of Medicine
University of Otago
PO Box 56
Dunedin 9054
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Country
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New Zealand
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Phone
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+64 3 470 9451
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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