Neurobiology of Non-Specific and Specific Treatment Responses in Major Depression
试验速览
- 阶段
- 3 期
- 状态
- 撤回
- 试验地点
- 1
- 主要终点
- depression score
研究概览
简要总结
The primary study intent is to examine biological mechanisms associated with acute and chronic treatment responses in major depressive disorder (MDD). It is hypothesized that treatment responsiveness, representing endogenous opioid system function, will be associated with acute improvements in mood state over a 10-week treatment trial in MDD. Potential (bio) markers of treatment effects will be tested against psychophysical responses to placebo and active treatments.
详细描述
Volunteers will be randomized to receive placebo pills or a commercially available SNRI for 10 weeks. Volunteers will undergo imaging with structural and functional MRI and PET with [11C]carfentanil to determine baseline μOR BPND and changes in BPND measures during acute i.v. medication administration at the time of scanning before and after the 10-week treatment period.
To elicit the activation of µ-opioid-mediated neurotransmission in the scanner, we utilize the introduction of medication (active or inactive) 1mL into an intravenous port every 4 minutes, 15 sec per infusion, starting 45 minutes after radiotracer administration, until scan completion. Participants are made aware that the study drug will be administered at the time a computer-generated human voice recording reads a second-by-second count of the infusion timing (15 sec).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 55 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Meet DSM V criteria for Major Depressive Episode, single episode or recurrent, for at least a month;
- •Unmedicated for at least 10 half-lives of the previous AD used;
- •Willing to limit the introduction of any new treatments during the study;
- •18 - 55 years of age;
- •Right handed;
- •Capable of giving written informed consent;
- •Hamilton Depression Rating Scale (17-item HDRS, not including atypical features) >15 at screening and randomization;
排除标准
- •Major medical illness (e.g., cancer, HIV, Hepatitis C, etc.) or concurrent, untreated, or symptomatic medical illnesses, including acute or ongoing pain, autoimmune or inflammatory disease;
- •Use of narcotic analgesics within the last 6 months or regular use of sleeping aids (including benzodiazepines and related compounds), more than twice a week;
- •Recent history of substance abuse (within the last 6 months) or history of substance dependence (lifetime);
- •Other comorbid psychiatric illnesses, such as Bipolar Disorder, Obsessive Compulsive Disorder, Panic Disorder, any psychosis, or Axis II diagnoses. Generalized Anxiety and Social Anxiety Disorders will NOT be considered exclusionary given their common association with MDD
- •Concurrent participation in other therapeutic trials;
- •Pregnancy/nursing;
- •Ongoing treatment with medications with psychotropic properties;
- •Contraindications to PET or MRI methods;
- •Impairments, activities or situations that would prevent completion of the study protocol;
- •Prior non-response to duloxetine;
- •Active suicidal ideation.
- •Urine screens positive for opioids or any substances of abuse.
- •Allergy to fentanyl (because of structural similarity to the radiotracer [11C]carfentanil to be employed in the study).
研究组 & 干预措施
Placebo
10 weeks of placebo once daily for 1 week, then twice daily therafter.
干预措施: Placebo (Drug)
Interventional
10 weeks of duloxetine beginning at 30 mg per day for week 1, then 60 mg / day thereafter.
干预措施: Duloxetine (Drug)
结局指标
主要结局
depression score
时间窗: 10 weeks
HRSD-17 score
mu-opioid receptor binding capacity
时间窗: 10 weeks
derived from PET scans
次要结局
未报告次要终点