Using Repetitive Transcranial Magnetic Stimulation (rTMS) for the Treatment of Bipolar Depression

This study is not yet open for participant recruitment.
Verified April 2012 by McGill University Health Center
Sponsor:
Information provided by (Responsible Party):
Pablo Cervantes, McGill University Health Center
ClinicalTrials.gov Identifier:
NCT01583023
First received: April 19, 2012
Last updated: NA
Last verified: April 2012
History: No changes posted
  Purpose

The purpose of this study is to evaluate whether repetitive transcranial magnetic stimulation (rTMS) treatment is an effective adjunct treatment to lithium and bupropion.


Condition Intervention Phase
Bipolar Disorder
Drug: Bupropion
Device: Repetitive Transcranial Magnetic Stimulation
Other: Placebo
Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Assessing the Efficacy of Left Repetitive Transcranial Magnetic Stimulation (rTMS) as an Adjunctive Treatment to Antidepressants for the Treatment of Bipolar Depression

Resource links provided by NLM:


Further study details as provided by McGill University Health Center:

Primary Outcome Measures:
  • Change in Montgomery-Asberg Depression Rating Scale (MADRS) from baseline at 6 weeks [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Change in Hamilton Depression Rating Scale (HAM-D 17) from baseline at 6 weeks [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]
  • Change in Beck Depression Inventory (BDI-II) from baseline at 6 weeks [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]
  • Change in Young Mania Rating Scale (YMRS) from baseline at 6 weeks [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 45
Study Start Date: June 2012
Estimated Study Completion Date: September 2013
Estimated Primary Completion Date: May 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Wellbutrin alone Drug: Bupropion
150mg daily for first week, 300mg daily thereafter for a total of 6 weeks
Other Name: Wellbutrin
Experimental: Placebo + rTMS Device: Repetitive Transcranial Magnetic Stimulation
Daily left DLPFC, at 110% motor threshold, with a frequency of 10 Hz. Stimulation will be applied in 5-second trains with a 10-second inter-train interval, for 30 trains per session. This treatment will be provided for the first 4 weeks of the study.
Other: Placebo
150mg daily first week, 300mg daily thereafter for a total of 6 weeks.
Experimental: Wellbutrin + rTMS Drug: Bupropion
150mg daily for first week, 300mg daily thereafter for a total of 6 weeks
Other Name: Wellbutrin
Device: Repetitive Transcranial Magnetic Stimulation
Daily left DLPFC, at 110% motor threshold, with a frequency of 10 Hz. Stimulation will be applied in 5-second trains with a 10-second inter-train interval, for 30 trains per session. This treatment will be provided for the first 4 weeks of the study.

  Eligibility

Ages Eligible for Study:   18 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Bipolar Disorder Type I or II subjects diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) in depressed phase
  • Age 18 to 65
  • Rating on the Montgomery-Asberg Depression Rating Scale (MADRS) score > 20
  • Rating on the Hamilton Rating Scale for Depression (HAMD-17) > 20
  • Rating on the Beck Depression Inventory (BDI-II) > 20
  • Rating on the Young Mania Rating Scale (YMRS ) < 8
  • Non-treated new depressive episode, at least 2 weeks in duration
  • If recently started on an antidepressant, subject must spend at least 4 weeks at a therapeutic dose before entering the study
  • Lithium monotherapy at a target dose of at least 0.7 mEq/L
  • If on psychotherapy, no less than 20 sessions in the last 6 months before initiation of rTMS

Exclusion Criteria:

  • History of any DSM-IV Axis I diagnosis other than BD Type I or II
  • Presence of any psychotic symptoms, characterized by a score of 3 or more on item 10 of the MADRS, a score of 6 on item 9 of the MADRS, or a score of 6 or more on item 8 of the YMRS
  • Comorbid active dependence or substance abuse (except nicotine)
  • Prior electroconvulsive therapy failure
  • Pacemaker, automatic implantable defibrillator or implantable pump
  • Aneurysm Clip
  • Heart/Vascular Clip
  • Prosthetic Valve
  • Metal Prosthesis
  • Pregnancy
  • Metal or metal fragments in the head
  • Personal or Family history of seizure disorder
  • Increased Intracranial pressure
  • History of stroke, meningitis/encephalitis, moderate to severe traumatic brain injury, neurosurgical procedure
  • Pharmacotherapy using any substances not mentioned in the inclusion criteria, except benzodiazepines (at a dose less than or equal to 1mg/day; Lorazepam is not allowed) and hypnotics
  • Previous treatment with Wellbutrin
  • Abnormal lab workup results
  • Subject currently enrolled in any detoxification program
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01583023

Contacts
Contact: Pablo Cervantes, MD 514-934-1934 ext 36109

Locations
Canada, Quebec
Allan Memorial Institute Not yet recruiting
Montreal, Quebec, Canada
Principal Investigator: Pablo Cervantes, MD            
Principal Investigator: Theodore Kolivakis, MD            
Principal Investigator: Nancy CP Low, MD            
Sub-Investigator: Alain Ptito, PhD            
Sponsors and Collaborators
McGill University Health Center
Investigators
Principal Investigator: Pablo Cervanes, MD McGill University Health Center
Principal Investigator: Theodore Kolivakis, MD McGill University Health Center
Principal Investigator: Nancy CP Low, MD McGill University Health Center
  More Information

No publications provided

Responsible Party: Pablo Cervantes, Director of the Mood Disorders Clinic, McGill University Health Center
ClinicalTrials.gov Identifier: NCT01583023     History of Changes
Other Study ID Numbers: RTMS-BD-1
Study First Received: April 19, 2012
Last Updated: April 19, 2012
Health Authority: Canada: Ethics Review Committee

Keywords provided by McGill University Health Center:
bipolar disorder
repetitive transcranial magnetic stimulation (rtms)
bupropion
lithium

Additional relevant MeSH terms:
Bipolar Disorder
Depression
Depressive Disorder
Affective Disorders, Psychotic
Mood Disorders
Mental Disorders
Behavioral Symptoms
Bupropion
Antidepressive Agents, Second-Generation
Antidepressive Agents
Psychotropic Drugs
Central Nervous System Agents
Therapeutic Uses
Pharmacologic Actions
Dopamine Uptake Inhibitors
Dopamine Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Neurotransmitter Uptake Inhibitors
Physiological Effects of Drugs

ClinicalTrials.gov processed this record on May 21, 2013