Treatment of Mild to Moderate Depression Symptoms in Patients With Spinal Cord Injury
Recruitment status was Recruiting
This study proposes to test the efficacy of Venlafaxine HCI in reducing mild to moderate symptoms of depression among persons with Spinal Cord Injury (SCI). This study recruits either traumatic or non-traumatic injured persons with SCI living in the community.
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
|Official Title:||Treatment of Mild to Moderate Depression Symptoms in Patients With Spinal Cord Injury|
- The Patient Health Questionnaire-9 (PHQ-9) [ Time Frame: Assessed at baseline, weekly from weeks 1-5, week 9 at the end of treatment and then 3 months (week13) and after another 12 months (week26) ] [ Designated as safety issue: No ]This is a brief measure of depression taking 3-5 minutes to complete used to measure outcome and assess changes in mood during the study protocol times (before and after durg treatemnt). The PHQ-9 queries respondents about the occurrence of 9 symptoms of depression at baseline before the treatment started, and then by weeks 1-3,5,9, 13 (outcome), 14-16, 18, 20 and finally in week 26 (outcome) . The PHQ-9 has acceptable sensitivity and specificity.
- The Beck Scale for Suicide Ideation (BSS) [ Time Frame: same as PHQ-9 ] [ Designated as safety issue: Yes ]The BSS is used to assess the presence and severity of suicidal thoughts. Two items in particularly are used to assess safety during trial by assessing both active and passive suicidality.
- 16 item Quick Inventory of Depressive Symptomatology (QIDS- SR16) [ Time Frame: Baseline; weeks 13 and 26 ] [ Designated as safety issue: No ]It assesses depression symptoms across the nine DSM-IV criterion domians. It is a primary measure of the extent of depressive symptomatology.
- The SCI Pain Instrument (SCIPI) [ Time Frame: Baseline; weeks 13 and 26 ] [ Designated as safety issue: No ]is a 14 item instrument designed for assessment of both the intensity of pain as a sensory experience and the degree to which pain interferes with function.
- The Adherence and Side Effects Checklist [ Time Frame: Same as PHQ-9 ] [ Designated as safety issue: Yes ]Monitors medication adherence and keeps track of side effects of the study drug
- CAGE & Drug Use [ Time Frame: Same as PHQ-9 ] [ Designated as safety issue: Yes ]Is used to conduct safety monitoring with respect to subject using drugs and/or alcohol during treatment; and is also used to screen subjects eligible for the study.
- Generalized Anxiety Disorder-7 (GAD-7) [ Time Frame: Baseline; weeks 13 and 26 ] [ Designated as safety issue: No ]It is a 7 item measure to assess generalized anxiety and it is criterion refernced in relation to the DSM-IV. The GAD will be used as a secondary outcome measure.
- The Perceived Stress Scale (PSS) [ Time Frame: baseline, 13 and 26 weeks ] [ Designated as safety issue: No ]This is a 14 item measure to assess the degree to which life events are considered stressful.
- Life Experiences Survey - Disability (LES-D) [ Time Frame: baseline; 13 and 26 weeks ] [ Designated as safety issue: No ]This measures the nature of life events during the previous year; what happens to respondents and their perceptions.
- The Received Social Support and Social Undermining Scale (RSS/SU) [ Time Frame: baseline; 13 and 26 weeks ] [ Designated as safety issue: No ]The items concern how the significant people in the respondent's life nehave towards them.
- Measure of the Quality of the Environment [ Time Frame: baseline; 13 and 26 weeks ] [ Designated as safety issue: No ]It is a 26 item questionnaire of the perceived quality of environmental influences on community particpation.
- The Perceived Handicap Questionnaire (PHQ) [ Time Frame: baseline; 13 and 26 weeks ] [ Designated as safety issue: No ]It asks the respondents about their relative abilities in the areas of physical independence, mobility, occupation, social integration and economic self-sufficiency.
- Craig Handicap Assessment and Reporting Form - Short Form (CHART-SF) [ Time Frame: baseline; 13 and 26 weeks ] [ Designated as safety issue: No ]Only the Occupational scale of the CHART-SF will be used to measure types of productive activities after comminity re-entry.
- The SF-12 Health Status Questionnaire - 12 [ Time Frame: baseline; 13 and 26 weeks ] [ Designated as safety issue: No ]The SF-12 measures health related quality of life including items from various domains, physical, functional, psychological, pain, etc.
|Study Start Date:||June 2008|
|Estimated Study Completion Date:||August 2011|
|Estimated Primary Completion Date:||June 2011 (Final data collection date for primary outcome measure)|
Subjects will be provided with the medication starting at 37.5 mg and ending at 150 mg. for 13 weeks when they start titrating down back to 75mg at 13 weeks and 37.5 mg at 15 weeks. They receive no drugs from weeks 16th to 26ths when the study ends.There are 13 assessments and data collection points for this study. These include 3 face to face assessments at baseline, 13 weeks and 26 weeks. Additional contacts will be done via telephone calls.
Drug: Venlafaxine HCI
Starting dose is 37.5 mg and ending dose is 150 mg at 13 weeks. From weeks 13 to 26 subjects no longer will receive the drug
Other Name: Effexor XR
Placebo Comparator: B
Subjects will receive a placebo instead of medication with all other conditions being the same including placebo doses. The study drug or placebo will be dispensed following this same schedule by IDS eight times per study subject. This may vary slightly depending on response to treatment, etc.
Subjects will receive a placebo instead of drug for 6 months during the duration of treatment
The successes of psychological and pharmacological modes of intervention in treating depression, both alone and combined, are well documented in the literature. While a great deal of research has identified specific clinical indications for many antidepressants currently available in the general population, little is known about the clinical indications of these agents in SCI. This study is proposed to test the benefits of Venlafaxine HCI (Effexor XR) for reducing mild to moderate symptoms of depression among people with SCI. As a secondary outcome, this study will assess also the benefits of this medication in reducing severity of symptoms of pain, and enhancing subjects' perceived health and participation in the community. The intervention will last 12 weeks and there will be 13 assessments and data collection points. Data will be collected at 26 weeks also. Eight face to face contacts are anticipated.
|Contact: Linda Berlin, MA||(734) firstname.lastname@example.org|
|Contact: Linton Cuff, MA||(734) &email@example.com|
|United States, Michigan|
|University of Michigan Model SCI Care System||Recruiting|
|Ann Arbor, Michigan, United States, 48109-5491|
|Contact: Linda Berlin, MA 734-763-0971 firstname.lastname@example.org|
|Contact: Linton Cuff, MA (734) 763-0971 email@example.com|
|Principal Investigator: Denise Tate, Ph.D.|
|Principal Investigator: Anthony Chiodo, MD|
|Sub-Investigator: Gianna Rodriguez, MD|
|Sub-Investigator: Claire Kalpakjian, Ph.D.|
|Sub-Investigator: Marty Forchheimer, MPP|
|Sub-Investigator: Juan Lopez, MD|
|Sub-Investigator: Jon Kar Zubieta, MD, Ph.D.|
|Sub-Investigator: Michelle Meade, Ph.D.|
|Principal Investigator:||Anthony Chiodo, M.D.||University of Michigan Department of Physical Medicine and Rehabilitation|