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Prevention of Postpartum Depression: A Pilot Placebo-controlled Trial of Trazodone

Phase 1
Withdrawn
Conditions
Postpartum Depression
Interventions
Drug: Placebo
Registration Number
NCT05299398
Lead Sponsor
Verinder Sharma
Brief Summary

Postpartum depression is a serious illness that affects approximately 17% of women who have recently given birth. Untreated depression appears to have negative effects for both the mother and her baby. Postpartum depression is quite common among women with a history of depression. Sleeplessness is a common concern during pregnancy and after delivery, and it can also trigger depression in women with a history of depression. Antidepressants are the most commonly recommended drugs for prevention of postpartum depression; however, there is limited research to understand the effectiveness of the medications in preventing postpartum depression. Trazodone is a weak antidepressant, but it is commonly prescribed for sleeplessness due to physical or psychiatric disorders. We are planning a study to find out whether trazodone in a low dose is more effective than a sugar pill in preventing postpartum depression among women with histories of depression. We expect the results of our study will make it easier for healthcare providers to select the right medication for women who are at risk of developing depression after delivery and thus improve the mental health of mothers and well-being of their babies.

Detailed Description

Not available

Recruitment & Eligibility

Status
WITHDRAWN
Sex
Female
Target Recruitment
28
Inclusion Criteria

Healthy outpatients with a history of Major depressive disorder who are currently not on any psychotropic medications and who:

  1. are 18- 45 years old,
  2. are pregnant with gestation of 28-34 weeks,
  3. have been in full remission of depression for > 2 months (as per Diagnostic and Statistical Manual-5),
  4. are able to communicate in English,
  5. are capable of providing informed consent,
  6. are planning to deliver at Victoria Hospital in London Ontario, and
  7. live in London and the surrounding area, will be enrolled.
Exclusion Criteria
  1. current psychiatric disorder other than generalized anxiety,
  2. use of psychotropic medication over the previous 2 months,
  3. history of bipolar disorder or psychosis,
  4. high risk for suicide (actively suicidal or a score of ≥ 3 on item #3 on the Hamilton Depression Rating Scale-17 item [HDRS]),
  5. currently receiving psychotherapy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboPlacebo once daily for 24 weeks
TrazodoneTrazodoneTrazodone once daily for 24 weeks.
Primary Outcome Measures
NameTimeMethod
Occurrence of Major depressive episode27 weeks

Participants having a score of \>7 on the Hamilton Depression Rating Scale (Max 52) will be assessed using the Structured Clinical Interview for the Diagnostic and Statistical Manual for Mental Disorders- 5 (SCID-5) to establish recurrence of an major depressive episode. A higher score indicates recurrence of an MDE

Secondary Outcome Measures
NameTimeMethod
Time to occurrence of Major Depressive Episode (MDE)27 weeks

The time from childbirth until they develop MDE

Blood pressure27 weeks

The systolic and diastolic blood pressure will be measured in mmHG.

Body weight27 weeks

Body weight will be measured in kilograms

Side effects27 weeks

Side effects of Trazodone will be measured by the Frequency, Intensity, Burden of Side Effects Rating (FIBSER) scale

Development of mania symptoms27 weeks

Mania symptoms will be measured by the Young Mania Rating Scale. here are four items that are graded on a 0 to 8 scale (irritability, speech, thought content, and disruptive/aggressive behavior), while the remaining seven items are graded on a 0 to 4 scale. These four items are given twice the weight of the others. The score ranges from 0 to 60 where 60 indicates a worse outcome.

Electrocardiogram QT Interval27 weeks

test that checks the QT interval of the heart. This will let us know if the participants have heart abnormalities or if the medication has made changes to the heart of the participant.

Hamilton Depression Rating Scale24 weeks

The change in Hamilton Depression Rating Scale and Scale from baseline to 24 weeks to measure change in depressive symptoms. The score ranges from 0-53 where a higher score is a worse outcome.

Edinburgh Postnatal Depression24 weeks

The change in Edinburgh Postnatal Depression Scale from baseline to 24 weeks to measure the change in depressive symptoms. The scores range from 0 to 30 with 30 indicating more depression symptoms.

Maternal Functioning27 weeks

Maternal Functioning will be measured by Barkin Index of Maternal Functioning. The sum of the scores is calculated, ranging from 0 to 120. Where a score of 120 means perfect functioning. The different between the scores scores will be looked at and a more positive score (8 week score is greater than baseline score) is a better outcome.

Pulse27 weeks

Pulse will be measured in Beats per minute

Pill count27 weeks

Adherence to intervention

Retention rate27 weeks

The following criteria will be used to determine the success of the study: enrollment of 1 participant every 2 weeks, and recruitment of at least 60% of all patients considered eligible to participate in the study

Complete blood count (CBC)27 weeks

The CBC is a blood test to check the overall health of the participant

Thyroid Stimulating Hormone test27 weeks

a blood test that measures Thyroid Stimulating Hormone measured in the units mIU/L

Trial Locations

Locations (1)

Parkwood Institute Mental Health Care Building

🇨🇦

London, Ontario, Canada

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