Augmentation of the Antidepressant Action of Sertraline With Triiodothyronine (T3)and Reboxetine: Clinical Efficacy, Adverse Effects and Predictors of Response. - Full Text View

Sponsor:	Hadassah Medical Organization
Information provided by:	Hadassah Medical Organization
ClinicalTrials.gov Identifier:	NCT00421369

Purpose

In this project we aim to further refine indications for the use of the thyroid hormone - T3 for patients suffering from depression. We aim to identify a sub-group of patients who are more likely to respond to T3 and establish the time in the treatment course when T3 should be added. The results of this project could have significant, direct clinical implications.

Condition	Intervention
Major Depressive Disorder	Drug: sertraline Drug: triiodothyronine (T3) Drug: reboxetine

Study Type:	Interventional
Study Design:	Allocation: Non-Randomized Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	Augmentation of the Antidepressant Action of Sertraline With Triiodothyronine (T3)and Reboxetine: Clinical Efficacy, Adverse Effects and Predictors of Response.

Resource links provided by NLM:

MedlinePlus related topics: Antidepressants Depression Thyroid Diseases

Drug Information available for: Liothyronine sodium Sertraline hydrochloride Sertraline Reboxetine Reboxetine mesylate Triiodothyronine

U.S. FDA Resources

Further study details as provided by Hadassah Medical Organization:

Primary Outcome Measures:

treatment outcome defined categorically as Remission: A Hamilton Depression Scale (HAM-D) less or equal to 6.

Secondary Outcome Measures:

RESPONSE: Based on Hamilton Depression Scale (HAM-D)reduction of >50% from baseline to endpoint..
REMISSION: Based on the other rating scales applied in this project.
RESPONSE: Based on the other rating scales applied in this project.

Estimated Enrollment:	80
Study Start Date:	September 2007

Detailed Description:

The lifetime risk for major depressive disorder (MDD) is 15% in the general population. Current treatment approaches emphasize the achievement of remission. Remission implies virtual absence of depressive symptoms and is associated with better function and a better overall prognosis than response, which is usually defined as a 50% reduction in symptom severity. Sixty percent or more of patients treated optimally with antidepressants remain un-remitted and will need additional treatment. A potentially effective but under-exploited strategy to augment antidepressant effects is concurrent administration of the thyroid hormone, triiodothyronine (T3). We previously demonstrated the clinical efficacy and safety of T3 administered concurrently with the SSRI, sertraline, in the context of a randomized, double-blind placebo-controlled trial. Although all the patients were euthyroid, remission rates were significantly higher in the sertraline plus T3 group and were associated with significantly lower baseline T3 values and a significant decrease in serum thyroid stimulating hormone (TSH) values during the course of treatment.

The study aims to:

Delineate a sub-population of depressed patients treated with sertraline, who are more likely to respond to T3 augmentation on the basis of thyroid function and genetic variation in thyroid pathway genes.
Investigate the appropriate timing for the addition of T3.
Assess the efficacy of reboxetine, a specific noradrenaline reuptake inhibitor, as a further supplement to the treatment of un-remitted patients. The results of this study could have a significant, direct clinical impact on the pharmacological treatment of MDD.

Eligibility

Ages Eligible for Study:	18 Years to 70 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	Yes

Criteria

Inclusion Criteria:

Diagnosis of Major Depressive Episode (MDE) in the context MDD according to DSM-IV criteria, without psychotic features.
Hamilton Depression Scale (21 items, HAM-D) total >16 with item 1 (depressed mood) >2.
Age 18-70 years.
Male or female.
Competent and willing to give written informed consent.

Exclusion Criteria:

Clinical hyper- or hypothyroidism or any other thyroid illness.
Neurological or other medical illness that may impact upon the study or limit prescription of the study medications.
Significant suicidal risk [HAM-D item 3 (suicide) >2].
Comorbidity with any Psychotic Disorder, Bipolar Disorder, Post Traumatic Stress Disorder (PTSD), Eating Disorder.
Lifetime history of substance or alcohol dependence or of abuse in the preceding 12 months.
Treatment with the antidepressant, sertraline, in current episode.
More then one antidepressant trial or any augmentation treatment during current episode.
Length of current episode >12 months
Female subjects pregnant or lactating or not using adequate contraception.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00421369

Contacts

Contact: Rena Cooper-Kazaz, MD	00 972 2 6777184	crena@hadassah.org.il
Contact: Bernard Lerer, Prof.	00 972 2 6777185	lerer@cc.huji.ac.il

Locations

Israel
Hadassah Medical Organization	Recruiting
Jerusalem, Israel
Contact: Rena Cooper-Kazaz, MD 00 972 2 6777184 crena@hadassah.org.il
Principal Investigator: Rena Cooper-Kazaz, MD

Sponsors and Collaborators

Hadassah Medical Organization

Investigators

Principal Investigator:

Rena Cooper-Kazaz, MD

Hadassah Medical Organization

More Information

No publications provided

Responsible Party:	Dr. rena Cooper, HADASSAH MEDICAL ORGANIZATION
ClinicalTrials.gov Identifier:	NCT00421369 History of Changes
Other Study ID Numbers:	t3rbx-HMO-CTIL
Study First Received:	January 11, 2007
Last Updated:	June 22, 2011
Health Authority:	Israel: Israeli Health Ministry Pharmaceutical Administration

Keywords provided by Hadassah Medical Organization:

Major depressive disorder
Antidepressants
Triiodothyronine (T3)

Thyroid Function
Augmentation
Thyroid pathway genes

Additional relevant MeSH terms:

Depressive Disorder
Depression
Depressive Disorder, Major
Mood Disorders
Mental Disorders
Behavioral Symptoms
Antidepressive Agents
Sertraline
Reboxetine
Psychotropic Drugs
Central Nervous System Agents

Therapeutic Uses
Pharmacologic Actions
Serotonin Uptake Inhibitors
Neurotransmitter Uptake Inhibitors
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Serotonin Agents
Physiological Effects of Drugs
Adrenergic Uptake Inhibitors
Adrenergic Agents

ClinicalTrials.gov processed this record on February 09, 2012