International Study to Predict Optimised Treatment - in Depression
- Conditions
- Major Depressive Disorder
- Interventions
- Registration Number
- NCT00693849
- Lead Sponsor
- BRC Operations Pty. Ltd.
- Brief Summary
The aim of this study is to identify genetic, physical (brain) and psychological (cognitive) markers (or combinations of them) that predict specific response to a range of antidepressants treatment (Escitalopram, Venlafaxine, Sertraline) in patients diagnosed with major depressive disorder. This study is focused on outcomes which may impact on how "personalised medicine" is implemented in depression.
- Detailed Description
This is an open-label, randomised (effectiveness) study (ie. comparison of active treatments) to identify genetic markers, brain function, brain structure, and psychological and cognitive indicators (or a combination of markers) in MDD subjects versus healthy controls. Approximately 2,016 subjects with major depressive disorder (MDD) across multiple international sites (USA, Canada, UK, South Africa, New Zealand, The Netherlands and Australia) will be randomised to one of three approved and effective treatment arms:
Treatment A Escitalopram. Treatment B Sertraline. Treatment C Venlafaxine XR.
A group of matched healthy controls (n = 672) will also be enrolled.
Subjects will be asked to attend the testing facility on two separate occasions; for Pre-treatment (Pre-Tx) and at 8 weeks post initiation of treatment. The assessments/procedures at Pre-Tx and Week 8 include: Baseline a clinical work-up, blood collection for genetic analyses, cognitive testing and electrical brain functioning (EEG/ERP). Structural and functional data MRI data will be collected in ten percent (10%) of participants.
On Day 4 and Weeks 2, 4, 6, 12, 16, 24 and 52 Subjects will be contacted by phone and asked to complete 2 questionnaires via the internet.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 2688
- Meet DSM-IV criteria for primary diagnosis of MDD.
- HAM-D17 score of ≥ 16.
- 18-65 years age-range
- Subjects with English or Dutch literacy and fluency.
- Written, informed consent.
- Presence of suicidal ideations and/or tendencies (as determined by a score >12 on Section C, Suicidality, of the MINI Plus), Bipolar I-III, psychosis, primary eating disorders, Post Traumatic Stress Disorder (PTSD), Obsessive Compulsive Disorder (OCD), Post-Natal Depression as well as any Axis II personality disorders as diagnosed using the MINI Plus or by a health care professional.
- Pregnancy and women of child bearing potential who are not taking a medically accepted form of contraception and are at risk of becoming pregnant during the study.
- Breastfeeding.
- Known contra-indication or intolerance to the use of Escitalopram, Sertraline or Venlafaxine XR as defined in the product package insert for each drug (including previous treatment failure at the highest recommended dose).
- Use of any psychological or counselling therapy or antidepressant/CNS drug which cannot be washed out prior to participation and eliminated until after Week 8 or discontinuation.
- Use of any medication which is known to be contraindicated with Escitalopram, Sertraline, or Venlafaxine XR (refer to the product package insert for each drug).
- Known medical condition, disease or neurological disorder which might, in the opinion of investigator/s, interfere with the assessments to be made in the study or put subjects at increased risk when exposed to optimal doses of the drug treatment.
- History of head injury with loss of consciousness for at least 10 minutes.
- Recent/current substance dependence (as defined in Section K of the Mini Plus as per a 6 months period and/or alcoholism) in the past six months.
- Participation in an investigational study within four months of the baseline visit in which subjects have received an experimental drug/device that could affect the primary end points of this study.
- Subjects who, in the opinion of the investigator, have a severe impediment to vision, hearing and/or hand movement, which is likely to interfere with their ability to complete the test batteries.
- Subjects who, in the opinion of the investigator, are unable and/or unlikely to comprehend and follow the study procedures and instructions.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description C Venlafaxine-XR Venlafaxine-XR A Escitalopram Escitalopram B Sertraline Sertraline
- Primary Outcome Measures
Name Time Method To determine whether the genetic-brain-cognition function markers (or combination of markers) 'normalise' with acute drug treatment in MDD Week 8
- Secondary Outcome Measures
Name Time Method To determine whether markers of acute treatment prediction are also predictive of functional outcome over 6-12 months. 52-weeks
Trial Locations
- Locations (19)
Shanti Clinical Trials
🇺🇸Colton, California, United States
A.D.D. Treatment Center
🇺🇸Mission Viejo, California, United States
Veteran Affairs/Stanford University
🇺🇸Stanford, California, United States
Stanford University
🇺🇸Stanford, California, United States
Center for Healing the Human Spirit
🇺🇸Tarzana, California, United States
University of Missouri - St. Louis
🇺🇸Saint Louis, Missouri, United States
Brain Resource Center
🇺🇸New York, New York, United States
NeuroDevelopment Center
🇺🇸Providence, Rhode Island, United States
Brain Dynamics Centre
🇦🇺Westmead, New South Wales, Australia
Brain Health Lab
🇿🇦Johannesburg, Guatang, South Africa
University of Auckland
🇳🇿Auckland, New Zealand
Weill Cornell Medical College
🇺🇸White Plains, New York, United States
Swinburne University
🇦🇺Melbourne, Victoria, Australia
The Alfred Hospital
🇦🇺Melbourne, Victoria, Australia
University of Miami
🇺🇸Miami, Florida, United States
Skyland Behavioral Health Associates , P.A.
🇺🇸Asheville, North Carolina, United States
Ohio State University
🇺🇸Columbus, Ohio, United States
Flinders University
🇦🇺Adelaide, South Australia, Australia
Brainclinics Diagnostics B.V.
🇳🇱Nijmegen, Gelderland, Netherlands