Ketamine + Mindfulness for Depression

Exclusion Criteria

• •All participants:
• •1. Presence of lifetime bipolar, psychotic, or autism spectrum; current problematic substance use (e.g., ongoing moderate-to-severe substance use disorder);
• •3. Changes made to treatment regimen within 4 weeks of baseline assessment.
• •4. Reading level \<6th grade as per patient self-report.
• •5. Patients who have received ECT in the past 2 months prior to Screening.
• •6. Current pregnancy or breastfeeding
• •7. Patients must be reasonable medical candidates for ketamine infusion, as determined by a physician co-investigator. Serious, unstable medical illnesses including respiratory \[obstructive sleep apnea, or history of difficulty with airway management during previous anesthetics\], cardiovascular \[including ischemic heart disease and uncontrolled hypertension\], and neurologic \[including history of severe head injury\] will be exclusions.
• •8. Clinically significant abnormal findings of laboratory parameters \[including urine toxicology screen for unreported drugs of abuse\], vitals, or ECG.
• •9. Uncontrolled or poorly controlled hypertension, as determined by a physician co-investigator's review of vitals collected during screening and any other relevant medical history/records.
• •10. Patients with one or more seizures without a clear and resolved etiology.
• •11. Patients starting hormonal treatment (e.g., estrogen) in the 3 months prior to Screening.
• •12. Past intolerance or hypersensitivity to ketamine.
• •13. Patients taking medications with known activity at the NMDA or AMPA glutamate receptor \[riluzole, amantadine, memantine, topiramate, dextromethorphan, D-cycloserine\], or the mu-opioid receptor \[opiate medications--morphine, oxycodone, heroin, fentanyl)\]. However, lamotrigine will not be a study exclusion given that it has been shown not to impact ketamine's safety profile or its antidepressant efficacy.
• •14. Patients taking any of the following medications: St John's Wort, theophylline, tramadol, metrizamide.
• •15. Patients who report meditating with mindfulness techniques \>1 hour weekly (on average) for the past 6 months or longer.