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rEEG Guided Pharmacotherapy of Subjects With Depression Treatment Failure

Not Applicable
Completed
Conditions
Depressive Disorder
Interventions
Other: Star*D algorithm
Other: rEEG-guided therapy
Registration Number
NCT00437827
Lead Sponsor
MYnd Analytics
Brief Summary

This study is testing a process (rEEG)for selecting the most appropriate medication(s) to treat a patient's depression versus a control group being treated according to a standardized method, the modified Star\*D Algorithm. Qualified subjects will be randomized to the experimental (rEEG guided) group, or the control group and treated for 12 weeks. Medications utilized in this study are currently marketed. All visits, physical exam, rEEG, labs, rating scales and medications are provided at no cost to the patient.

Detailed Description

This study is testing a process (rEEG)for selecting the most appropriate medication(s) to treat a patient's depression versus a control group being treated according to a standardized method, the modified Star\*D Algorithm. Qualified subjects will be randomized to the experimental (rEEG guided) group, or the control group and treated for 10 weeks. Medications utilized in this study are currently marketed. All visits, physical exam, rEEG, labs, rating scales and medications are provided at no cost to the patient.

To qualify for entry into the study, patients must be:

1. 18 years of age or older.

2. Diagnosis of Major Depressive Disorder. Subjects may meet criteria for both melancholic and atypical depression.

3. Have failed 1 or more SSRIs, or have failed 2 or more antidepressants in at least 2 drug classes.

And patients must not have:

1. History of: closed head injury with unconsciousness, craniotomy, cerebral metastases, cerebrovascular accident; no current diagnosis of seizure disorder, bipolar disorder, schizophrenia, dementia, mental retardation, substance abuse, or major depression with psychotic features; or use of depot neuroleptics in last 12 months.

2. Known pregnancy and/or lactation, or intent to become pregnant during this study.

Medications that can be used in this study are:

Anti-depressants: fluoxetine, sertraline, paroxetine, desipramine, imipramine, nortriptyline,amitriptyline, clomipramine, bupropion, venlafaxine

Stimulants \& MAO Inhibitors: moclobemide, tranylcypromine, selegiline, methylphenidate, dextroamphetamine, dexlevoamphetamine, pemoline, lamotrigine, topiramate

Benzodiazepines: lorazepam, clonazepam, alprazolam

Anti-convulsants: carbamazepine, lithium, divalproex, gabapentin

Beta Blockers: metoprolol, propranolol, atenolol

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
120
Inclusion Criteria
  1. 18 years of age or older.
  2. Diagnosis of Major Depressive Disorder validated by SCID. Subjects may meet criteria for both melancholic and atypical depression per this protocol.
  3. Have failed three or more antidepressant regimens during the current depressive episode with minimum daily dose(s) as defined in the Medication History for Depression Case Report Form and for a minimum duration of treatment of at least 4 weeks. For purposes of the Study, augmentation will be considered a separate regimen.
  4. Able to stop all medications for 5 half-lives of the medication(s), with the exception of hormones, thyroid, hydrochlorthiazide and Ambien. See Appendix II for a list of the half-lives of medications.
Exclusion Criteria
  1. History of: closed head injury with unconsciousness, craniotomy, cerebral metastases, cerebrovascular accident; no current diagnosis of seizure disorder, bipolar disorder, schizophrenia, dementia, mental retardation, substance abuse, or major depression with psychotic features; or use of depot neuroleptics in last 12 months.

  2. Participation in any other therapeutic drug study evaluating a treatment for depression within 60 days preceding inclusion, unless drug(s) half-life is known.

  3. Known pregnancy and/or lactation, or intent to become pregnant during this study.

  4. Doesn't qualify via rEEG analysis due to:

    • Potential physiologic abnormality
    • Low abnormality in comparison to current rEEG database
    • No strong prediction by rEEG analysis for any particular medication class

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
1Star*D algorithmEach subject in this arm will receive depression therapy similar to that used by the Star\*D study - a major depression study conducted in the United States (Sequenced Treatment Alternatives to Relieve Depression (STAR\*D) trial. Am J Psychiatry 2006; 163:1905-1917)
2rEEG-guided therapyEach subject in this arm will receive therapy based upon an individualized rEEG report which provides one or more treatment options with the highest probability of success.
Primary Outcome Measures
NameTimeMethod
Two group comparison of QIDS-SR16 and Q-LES-Q-SFafter 12 weeks of treatment
Secondary Outcome Measures
NameTimeMethod
Two group comparison of MADRS, Clinical Global Improvement and Severity.after 12 weeks of therapy

Trial Locations

Locations (13)

Hawaii Clinical Research Center

🇺🇸

Honolulu, Hawaii, United States

Stanford University

🇺🇸

Stanford, California, United States

Harvard Medical School - Cambridge Hospital

🇺🇸

Cambridge, Massachusetts, United States

Shanti Research and Clinical Trials

🇺🇸

San Bernardino, California, United States

McClean Hospital/Harvard

🇺🇸

Belmont, Massachusetts, United States

Elite Clinical Trials

🇺🇸

Wildomar, California, United States

Cornell University

🇺🇸

New York City, New York, United States

Behavioral Research Specialists

🇺🇸

Glendale, California, United States

Alpha Behavioral Care, P.A.

🇺🇸

Summit, New Jersey, United States

Rush University

🇺🇸

Chicago, Illinois, United States

University of California - Irvine

🇺🇸

Irvine, California, United States

Univ of TX Health Science Center

🇺🇸

San Antonio, Texas, United States

Radiant Research

🇺🇸

Denver, Colorado, United States

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