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SuspendedNCT06419985Updated Jul 27, 2026

Ketamine HCl Prolonged Release Oral Tablets for CRPS

A Phase 2 interventional study of 80mg/day Ketamine HCl Prolonged Release and 160mg/day Ketamine HCl Prolonged Release in Complex Regional Pain Syndromes, sponsored by University of Southern California. Suspended at 1 site in United States. Open to participants aged 18 Years to 64 Years. Per ClinicalTrials.gov, last updated 2026-07-27.

Sponsored by University of Southern California · Phase 2, Interventional, and Treatment

Why this study was suspended
Difficulty clearing through the FDA
Phase
Phase 2
Study type
Interventional
Enrollment
65
Allocation
Not applicable
Ages
18 Years to 64 Years
Sex
All
01

Study summary

The purpose of this study is to evaluate the efficacy of Ketamine HCl Prolonged Release (PR) tablets in participants with pain due to complex regional pain syndrome (CRPS).

Additionally, this trial will explore the feasibility of the trial design through dosing compliance, clinical instruments for safety and quality of life measurements, and pharmacokinetic profile.

Read the detailed description

This study will enroll patients (age 18 to 64 years old) with history of CRPS (diagnosis greater than 6 months prior) at a single academic medical institution in the United States. All participants will be informed about the study and potential risks and will provided written informed consents prior to undergoing any study-related procedures.

Health status assessments including physical exams, blood work, urinalysis, EKG and questionnaires to assess quality of life and pain scale measurement will be conducted at the clinic visits. The participants will also keep a daily diary throughout the study to record pain levels, daily blood pressure and any additional pain medication needed.

There will be a total of 10 visits: a screening visit (day -28 to -7), clinic visits at day 1 (Baseline), week 2, week 4, week 8, and at the end of study (EOS) visit at 12 weeks. There will be additional telemedicine visits at week 1, week 3, week 5 and at the safety followup visit approximately 4 weeks after the EOS visit. There will also be followup phone call throughout the study to check on compliance and any adverse events.

All subjects will start with 40mg BID of Ketamine PR (80 mg/day) on the Baseline visit. The subjects are required to be observed in person for 6 hours following the first dose for any side effects using the Ketamine Side Effects Tools (KSET) - Baseline and Acute Treatment forms [From: Brooke Short et al. "Development of ketamine side effect tool (KSET) as a reference: J Affect Disord. 2020 April 01; 266: 615-620. doi:10.1016/j.jad.2020.01.120].

At an in person clinic visit 4 weeks after the Baseline visit, the dose may be increased to 80 mg BID (160 mg/day), using the same observation period as described at the Baseline visit. The study drug dosage will only be increased at this visit if the subject has not experienced adequate pain relief and has not experienced any adverse events.

Administration of the study drug will stop at the EOS visit (at 12 weeks after the Baseline visit).

Hemodynamic measurements, laboratory results, KSET - Followup form results and examination by the PI/Co-PI will be used throughout the study to assess possible adverse events (AEs). If the subject experiences any Grade 2 AEs, the PI/Co-PI will use clinical expertise and best judgement after determining the subject's level of distress and or discomfort to decide whether the subject will remain at the current dose, decrease the dose or discontinue study drug. If the subject experiences any Grade 3 Adverse Events (AEs), the study drug will be discontinued.

02

Conditions studied

  • Complex Regional Pain Syndromes

Keywords

  • CRPS
03

In context

Complex Regional Pain Syndromes

198 studies on the registry are indexed under Complex Regional Pain Syndromes; 55 are open to participants now.

This study's planned enrollment of 65 is above the median of 40 across 146 interventional studies indexed under Complex Regional Pain Syndromes.

Browse Complex Regional Pain Syndromes studies →

Lead sponsor

University of Southern California is the lead sponsor of 773 studies on the registry; 135 are open to participants now.

Of its 68 completed or terminated interventional studies of FDA-regulated products, 32 (47%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 64 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Male and female participants between 18 and 64 years of age, inclusive, at Screening Visit.
  2. Participants with a documented history of CRPS of at least 6 months at Visit 1.
  3. At least one sign in two of the categories of The Budapest Criteria for CRPS to support the diagnosis of CRPS.
  4. Stable individual regular standard treatment regimen for CRPS pain, i.e., no change in drug and non-drug treatments for at least 4 weeks prior to Screening Visit and anticipated to remain stable throughout the study.
  5. No surgery, denervation procedures or neural blockade within 1 month of Screening Visit.
  6. Participants on ketamine therapy at Screening Visit must agree to discontinue use for at least 14 days prior to the Baseline Observation Period.
  7. Agree to discontinue any prohibited medications within prior to 14 days of the Baseline Observation Period and for the duration of the study.
  8. Average daily CRPS pain intensity score in the affected limb of ≥5 and ≤9 on an 11-point (0-10) NRS averaged over 7 days prior to Baseline Visit (Visit 1). This will be based on completion of at least 5 daily pain diary entries during the week prior to Visit 1, with no more than one 24-hour pain intensity score of zero or more than one 24-hour pain intensity score of 10.
  9. Participants willing and able (e.g., mental and physical condition) to participate in all aspects of the trial, including use of medication, completion of subjective evaluations, attending scheduled clinic visits, completing telephone contacts, and compliance with protocol requirements as evidenced by providing signed written informed consent at Screening Visit.
  10. For persons of reproductive potential: use of highly effective contraception (females: barrier (condom, diaphragm, sponge, cervical cap) and/or oral, implantable rod, or intrauterine device birth control; males: barrier (condom)) for at least 1 month prior to screening and agreement to use such a method during study participation and for an additional 6 weeks after the end of study intervention administration.

Exclusion criteria

Exclusion Criteria:

  1. Known or suspected cardiovascular disease, arrythmias, and/or respiratory issues.
  2. Abnormal EKG results, abnormal blood pressure (SBP \<90 or ≥ 140; DBP \<50 or ≥ 90) and/or heart rates (\<50 or >110).
  3. Known or suspected psychotic illness or neurologic disease.
  4. Known or suspected elevated intraocular and/or intracranial pressure.
  5. Known or suspected renal or urologic conditions or symptoms (i.e., bladder pain syndrome, interstitial cystitis), and/or abnormal baseline urinalysis results.
  6. Known or suspected hyperthyroidism.
  7. Allergy, hypersensitivity, or intolerance to ketamine or any of the investigational product excipients.
  8. Participants receiving opioids ≥30 mg/day morphine milligram equivalents (MME), whether as part of their individual standard treatment regimen for CRPS pain or in context with any other indication, within the last two weeks prior to Visit 1.
  9. Positive urine screen for any of the following: cocaine, amphetamine, methamphetamine, PCP, opioids, THC (other than medication used for individual standard treatment of pain) at Visit 1.
  10. Known or suspected acute or chronic alcoholism, delirium tremens, or toxic psychosis.
  11. Meet DSM-5 criteria for current or past substance use disorder within the last 5 years for any psychoactive substances other than nicotine or caffeine.
  12. Known hepatic dysfunction or serious liver disease, including presence of aspartate aminotransferase (AST) levels ≥ 2 X upper limit of normal and/or alanine aminotransferase (ALT) levels ≥ 2 X upper limit of normal and/or total bilirubin ≥ 1.5 X upper limit of normal
  13. Abnormal urinalysis, urine culture or abnormal creatinine
  14. Evidence of moderate or severe renal impairment (CRCL \<60 ml/min) or participants with renal failure who are on any form of dialysis.
  15. Current or previous history of seizures.
  16. A positive pregnancy test/confirmed pregnancy test at the screening or baseline visit.
  17. If Ask Suicide-Screening Questionnaire (ASQ) is positive at Grade 2 (moderate), subject will be excluded.
  18. Any other condition of the patient that in the opinion of the investigator may compromise evaluation of the trial treatment or may jeopardize participant's safety, compliance or adherence to protocol requirements.
  19. Previous enrollment in this trial or participation in any other clinical trial within the past 30 days prior to enrollment.
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
65 participants (estimated)

Study arms

  • Experimental
    80mg Ketamine HCl PR

    One 40mg tablet of Ketamine HCl PR twice a day, which may be increased to two 40mg tablets Ketamine HCl PR twice a day at week 4 if subject does not experience adequate pain relief.

    Drug: 80mg/day Ketamine HCl Prolonged Release · Drug: 160mg/day Ketamine HCl Prolonged Release

Interventions

  • Drug80mg/day Ketamine HCl Prolonged Release

    Administration of Ketamine HCl Prolonged Release - 40mg BID

    Also known as: 80mg Ketamine PR

  • Drug160mg/day Ketamine HCl Prolonged Release

    Administration of Ketamine HCl Prolonged Release - 80mg BID

    Also known as: 160mg Ketamine PR

06

What researchers measure

Primary outcomes

  1. Average Daily Pain Numerical Rating Scale (ADP NRS)

    Average Daily Pain Numerical Rating Scale is a validated, self-reported instrument used to assess average pain intensity level over the past 24 hours. It uses an 11-point (0-10) scale, with 0 being "no pain" and 10 being "worst pain imaginable."

    Time frame: Day 1 to week 12

Secondary outcomes

  1. Patient-Reported Outcomes Measurement Information System-2 (PROMIS-29 Profile v2.1)

    The PROMIS-29 Profile v2.1 is a validated, self-reported instrument to measure functioning and well-being in 7 categories: physical function, anxiety, depression, fatigue, sleep disturbance, ability to participate in social roles and activities and pain interference. There are 4 questions in each of the 7 categories. Each question has five responses with a score from 1 to 5 (1 being best and 5 being worst). For each of these 7 categories, the lowest score is 4; the highest is 20.

    Time frame: Day 1 to week 12

  2. Complex Regional Pain Syndrome Severity Scale (CSS)

    The CSS Questionnaire assesses changes in Complex Regional Pain Syndrome (CRPS) severity by asking for the presence or absence (score of 1 or 0) of 16 clinically assessed signs and symptoms of CRPS. A higher score is worse, indicate greater CRPS severity (range 0-16).

    Time frame: Day 1 to week 12

  3. Patient Global Impression of Change (PGIC)

    Patient Global Impression of Change is a validated, self-reported instrument consisting of a 7-point scale (1 through 7) depicting a patient's rating of overall improvement since a certain point in time. The higher PGIC scores, the greater improvement. We will compare the scores at the end of Cycle 1 (1-4 weeks), 2 (4-8 weeks), and 3 (8-12 weeks).

    Time frame: Day 1 to week 12

  4. Maximum Plasma concentration [Cmax] of Ketamine

    Maximum Plasma concentration \[Cmax\] is the maximum concentration of the drug, Ketamine, in the body, measured in grams/Liter. Blood samples are obtained at Day 2, 4, and 7.

    Time frame: Day 1 to Day 7

  5. Time to Maximum Plasma concentration [Tmax] of Ketamine

    Time to Maximum Plasma concentration \[Tmax\] is the time it takes for the drug Ketamine, to reach maximum concentration (Cmax), measured in minutes. Blood samples are obtained at Day 2, 4, and 7.

    Time frame: Day 1 to Day 7

  6. Opioid sparing

    Participants will record any change in the amount (expressed as MME) and frequency of opioid medications used for treating CRPS pain.

    Time frame: Day 1 to week 12

  7. Medication sparing

    Participants will record daily use of rescue medication (expressed in mg and number of tablets) for treating CRPS pain. Acetaminophen (up to 3000mg/day) will be offered as rescue medication for breakthrough pain.

    Time frame: Day 1 to week 12

  8. Safety of Ketamine HCl PR oral tablets

    Number of participants with AEs, with abnormal vital signs, abnormal physical examination parameters; abnormal Electrocardiogram (EKG) parameters; abnormal laboratory parameters

    Time frame: Day 1 to 18 weeks

07

Study locations

1 site
  • Pain Center, Keck Medical Center of University of Southern California
    Los Angeles, California 90033, United States
08

References and documents

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 27, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06419985
Lead sponsor
University of Southern California
Responsible party
Steven Richeimer (Professor of Clinical Anesthesiology, University of Southern California) — Principal investigator
First posted
May 17, 2024
Start date
Jan 2027 (estimated)
Primary completion
Jan 2029 (estimated)
Completion
Jul 2029 (estimated)
Last update
Jul 27, 2026

Study contacts

Steven Richeimer, MD
principal investigator · Keck Medical Center of USC

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is suspended, as verified in Jul 2026. You cannot join it, but the record below documents what was studied.

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