Recruiting

Slow Wave Induction by Propofol to Eliminate Depression (SWIPED) Stage II

ClinicalTrials.gov IDNCT06867549

PhasePHASE2

Enrollment70

SponsorWashington University School of Medicine

Age60 Years

SexALL

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Conditions studied

Depression

About this study

The investigators hypothesize that brief behavioral therapy and targeted propofol infusion in depressed geriatric patients will augment subsequent slow wave sleep and improve clinical and cognitive outcomes. The team will recruit 70 participants for a double-blinded placebo controlled randomized controlled trial. Two propofol infusions, 2-6 days apart, will be administered, targeting either a low propofol dose arm (minimal EEG slow waves, brain effect-site concentration 1-2 mcg/ml) or moderate dose propofol arm (maximal induction of EEG slow waves, brain effect site concentration of \>2.5 mcg/ml). The pharmacologic intervention will be paired with 3-4 sessions of Brief Behavioral Therapy for Insomnia for all participants. To minimize bias, there will be no specific gender or ethnic background consideration for enrollment. This will be a single site investigation at Washington University Medical Center.

Interventions

Drug: Propofol — Targeted propofol infusion in TRD patients will induce sedation. Dosage of propofol is determined based upon EEG markers and treatment arm.
Diagnostic Test: Electroencephalography (EEG) — EEG will be recorded during propofol infusion and during overnight sleep. Sleep EEG data will be acquired for a minimum of one night prior to the first sedation session, providing a baseline measure. Additional overnight sleep recordings will be performed on day of sedation and subsequent nights.
Behavioral: Brief Behavioral Therapy for Insomnia — Trained staff will provide evaluation and up to 3 follow up appointments of BBTI for all participants. These will be done remotely to assess behavioral approaches to improve overall sleep habits.

Primary outcomes

Change in SWS duration (Pre-infusion and on the nights of propofol infusions)

Eligibility information

Inclusion Criteria: * Provision of signed and dated informed consent form * Stated willingness to comply with all study procedures and availability for the duration of the study * Age 60 or greater * English speaking (as an interpreter will not be readily available should a participant need to convey any safety concerns during the propofol infusion sessions or require guidance on conducting at-home sleep recordings) * Depression (non-responsive to at least one adequate trial of oral antidepressants for current episode). Exclusion Criteria: * Presence of symptomatic coronary artery disease * Presence of marked congestive heart failure/cardiomyopathy(NYHA \> Class III, LVEF \<40%, greater than mild RV systolic dysfunction) * Prior reaction to propofol * Resting heart rate \< 50 bpm * Treatment with Electroconvulsive therapy/Transcranial Magnetic Stimulation/vagal nerve stimulation within 6 weeks * Body mass index \> 35 * C-SSRS of 4 or greater (active suicidal ideation with some intent and with/without a specific plan) * MoCA score \< 23 (at least mild dementia) * Schizophrenia * Bipolar disorder * Non-prescribed use of amphetamines, opioids, cocaine, or phencyclidine; Urine THC \> 150 ng/ml * Intake of \> 14 beers/week (or equivalent) * Anesthetic exposure in the past 4 weeks * Concurrent use of benzodiazepines \> 2 mg/day lorazepam or equivalent, trazodone \> 50 mg/day, or gabapentin \> 600mg/day.

Study locations

Washington University School of Medicine/Barnes-Jewish Hospital, St Louis, Missouri 63110 United States

Before you participate: Varda Clinical is an independent discovery tool, not the study sponsor or a medical provider. Eligibility can only be determined by the official study team. Discuss potential risks and benefits with a qualified healthcare professional.

Source: ClinicalTrials.gov. Record last refreshed by Varda Clinical: 2026-10-03.