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| ID | Type | Description | Link |
|---|---|---|---|
| 2014-002005-38 | EudraCT Number | ||
| ESKETINTRD1006 | Other Identifier | Janssen Research & Development, LLC |
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The purpose of this study is to evaluate the effect of esketamine compared to placebo on driving performance as assessed by the mean difference of standard deviation of lateral position (SDLP) from an on-road driving test in healthy participants.
This is a Phase 1, randomized (study medication assigned to participants by chance), double-blind (neither Investigator nor participant knows which treatment the participant receives), placebo-controlled (placebo is an inactive substance that is compared with a drug to test whether the drug has a real effect in a clinical trial), single-center, single-dose and 3-way crossover (the same medications provided to all participants but in different sequence) study of esketamine in healthy participants. Participants will be randomly assigned to 1 of 6 treatment sequences. The study will consist of 3 parts: Screening Phase (between 21 days and 1 day prior to the first dose administration), a 3-way crossover double-blind, single dose treatment Phase (45 days) and follow-up Phase (7 to 10 days after last dose administration). The maximum study duration for each participant will not exceed 7 weeks. Participants will receive either Treatment A (esketamine 84 milligram (mg) intranasal and 1 placebo capsule), Treatment B (placebo intranasal and 1 mirtazapine 30 mg capsule) or Treatment C (placebo intranasal and placebo capsule) in each treatment period. Driving performance will be assessed primarily by the mean difference of SDLP from an on road driving test. Participants' safety will be monitored throughout the study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sequence 1 (ABC) | Experimental | Participants will receive Treatment A (esketamine 84 milligram (mg) intranasally and 1 placebo capsule) in Period 1, Treatment B (placebo intranasally and 1 mirtazapine 30 mg capsule) in Period 2 and Treatment C (placebo intranasally and placebo capsule) in Period 3 with a washout interval of at least 6 days between treatment periods. |
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| Sequence 2 (BCA) | Experimental | Participants will receive Treatment B (placebo intranasally and 1 mirtazapine 30 mg capsule) in Period 1, Treatment C (placebo intranasally and placebo capsule) in Period 2 and Treatment A (esketamine 84 mg intranasally and 1 placebo capsule) in Period 3 with a washout interval of at least 6 days between treatment periods. |
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| Sequence 3 (CAB) | Experimental | Participants will receive Treatment C (placebo intranasally and placebo capsule) in Period 1, Treatment A (esketamine 84 mg intranasally and 1 placebo capsule) in Period 2 and Treatment B (placebo intranasally and 1 mirtazapine 30 mg capsule) in Period 3 with a washout interval of at least 6 days between treatment periods. |
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| Sequence 4 (CBA) | Experimental |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Esketamine | Drug | Esketamine 84 milligram (mg) [3*1 of spray in each nostril] will be administered intranasally on Day 1 in one of the treatment periods. |
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| Measure | Description | Time Frame |
|---|---|---|
| Standard Deviation of Lateral Position (SDLP) Assessed From an On-road Driving Test | The SDLP will be measured from a validated on-road driving test in a 100 kilometer (km) highway-driving lane. | 4 to 14 hours post-dose |
| Measure | Description | Time Frame |
|---|---|---|
| Standard Deviation of Speed (SDS) Assessed From an On-road Driving Test | The SDS will be measured from a validated on-road driving test in a 100 km highway-driving lane. | 4 to 14 hours post-dose |
| Mean Speed (MS) Assessed From an On-road Driving Test |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Janssen Research & Development, LLC Clinical Trial | Janssen Research & Development, LLC | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Leiden | Netherlands |
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| ID | Term |
|---|---|
| C000629870 | Esketamine |
| D000078785 | Mirtazapine |
| ID | Term |
|---|---|
| D003984 | Dibenzazepines |
| D006575 | Heterocyclic Compounds, 3-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
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Participants will receive Treatment C (placebo intranasally and placebo capsule) in Period 1, Treatment B (placebo intranasally and 1 mirtazapine 30 mg capsule) in Period 2 and Treatment A (esketamine 84 mg intranasally and 1 placebo capsule) in Period 3 with a washout interval of at least 6 days between treatment periods. |
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| Sequence 5 (ACB) | Experimental | Participants will receive Treatment A (esketamine 84 mg intranasally and 1 placebo capsule) in Period 1, Treatment C (placebo intranasally and placebo capsule) in Period 2 and Treatment B (placebo intranasally and 1 mirtazapine 30 mg capsule) in Period 3 with a washout interval of at least 6 days between treatment periods. |
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| Sequence 6 (BAC) | Experimental | Participants will receive Treatment B (placebo intranasally and 1 mirtazapine 30 mg capsule) in Period 1, Treatment A (esketamine 84 mg intranasally and 1 placebo capsule) in Period 2 and Treatment C (placebo intranasally and placebo capsule) in Period 3 with a washout interval of at least 6 days between treatment periods. |
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| Mirtazapine | Drug | Mirtazapine 30 mg capsule will be administered orally on Day 1 in one of the treatment periods. |
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| Placebo (Matched to Esketamine) | Drug | Placebo [3*1 in each nostril] will be administered intranasally on Day 1 in one of the treatment periods. |
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| Placebo (Matched to Mirtazapine) | Drug | Placebo capsule will be administered orally on Day 1 in one of the treatment periods. |
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The MS will be measured from a validated on-road driving test in a 100 km highway-driving lane.
| 4 to 14 hours post-dose |
| Mean Lateral Position (MLP) Assessed From an On-road Driving Test | The MLP will be measured from a validated on-road driving test in a 100 km highway-driving lane. | 4 to 14 hours post-dose |
| Subjective Driving Performance Score | Participants will indicate the perceived quality of their driving performance on a visual analog scale, which ranges from 0 ('I drove exceptionally poorly') to 20 ('I drove exceptionally well'). | After completion of driving test (4 to 14 hours post-dose) |
| Karolinska Sleepiness Scale (KSS) Score | The KSS is a participant-reported assessment used to rate sleepiness on a scale of 1 to 9, ranging from 1 (extremely alert) to 9 (very sleepy, great effort to keep awake, fighting sleep). | Pre-dose, 1, 2 hours and after completion of driving test (4 to 14 hours post-dose) |
| Columbia Suicide Severity Rating Scale (C-SSRS) Score | The C-SSRS is a low-burden measure of the spectrum of suicidal ideation and behavior developed to assess severity and track suicidal events providing a summary of both suicidal ideation and behavior to identify the level and type of suicidality present. | Up to 7 to 10 days after last dose administration |
| Brief Psychiatric Rating Scale (BPRS) Symptom Sub-Scale Score | The BPRS is an 18-item rating scale which is used to assess a range of psychotic and affective symptoms rated from both observation of the participant and the participant's own report. Only the 4-item positive symptom subscale (consisting of: suspiciousness/persecution, hallucinations, unusual thought content, and conceptual disorganization) will be used and each question is rated on a 7-point scale ranging from 0 (not present) to 6 (extremely severe). | Pre-dose, 1 and 2 hours post-dose |
| Clinician Administered Dissociative States Scale (CADSS) Score | The CADSS is an instrument for the measurement of present-state dissociative symptoms. The CADSS comprises 23 subjective items, divided into 3 components: Depersonalization, Derealization and Amnesia. Participant's responses are coded on a 5-point scale (0 = "Not at all" through to 4 = "Extremely"). | Pre-dose, 1 and 2 hours post-dose |
| Maximum plasma concentration (Cmax) | The Cmax is the maximum observed plasma concentration of esketamine or noresketamine. | Pre-dose, 0.5, 1, 3 and 4 hours post-dose |