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Brain Energy Metabolism in Individuals With Major Depressive Disorder Receiving Escitalopram

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ClinicalTrials.gov Identifier: NCT00183677
Recruitment Status : Completed
First Posted : September 16, 2005
Results First Posted : January 4, 2017
Last Update Posted : January 4, 2017
Sponsor:
Information provided by (Responsible Party):
David Mischoulon, MD, Massachusetts General Hospital

Tracking Information
First Submitted Date  ICMJE September 13, 2005
First Posted Date  ICMJE September 16, 2005
Results First Submitted Date  ICMJE September 22, 2011
Results First Posted Date  ICMJE January 4, 2017
Last Update Posted Date January 4, 2017
Study Start Date  ICMJE July 2003
Actual Primary Completion Date June 2009   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: November 4, 2016)
Responder and Remission Status (%), Based on the Depression Rating Scale Score [ Time Frame: Measured at Week 12 ]
The Hamilton Depression Rating Scale, 17 items (HAMD-17, range 0-52) was used to measure changes in depression severity from baseline to endpoint. Clinical Responder status was defined as > 50% improvement (i.e., reduction) in HAMD-17 score from baseline to endpoint. Clinical Remission status was defined as HAMD-17 score < 8 at endpoint (week 12 visit).
Original Primary Outcome Measures  ICMJE
 (submitted: September 13, 2005)
  • Score on the depression rating scale; measured at Week 12
  • Brain energy metabolism; measured at Week 2 and Week 12
Change History Complete list of historical versions of study NCT00183677 on ClinicalTrials.gov Archive Site
Current Secondary Outcome Measures  ICMJE Not Provided
Original Secondary Outcome Measures  ICMJE Not Provided
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Brain Energy Metabolism in Individuals With Major Depressive Disorder Receiving Escitalopram
Official Title  ICMJE Biochemical Brain Changes Correlated With the Antidepressant Effect of Escitalopram: A Magnetic Resonance Spectroscopic Imaging Study
Brief Summary This study will evaluate changes in brain energy metabolism due to treatment with escitalopram in people with major depressive disorder.
Detailed Description

Major depressive disorder (MDD) is a severe form of depression. MDD can significantly interfere with an individual's thoughts, behavior, mood, and physical health. People who suffer from MDD often experience feelings of worthlessness; they may feel hopeless and may be unable to cope with problems in their life. In addition, they often experience sleep disruption, loss of appetite, and chronic pain.

Antidepressant medications are often prescribed for treating MDD; however, 30% to 40% of individuals fail to respond adequately to medication. Preliminary research has shown that lower levels of brain energy metabolism are often associated with MDD. No studies have yet shown whether there is a difference in brain energy metabolism between individuals who respond well to antidepressants versus those who do not. Escitalopram is an antidepressant medication often used to treat MDD. It causes a calming effect and reduces anxiety by increasing the amount of serotonin in the brain. This study will compare the changes in brain energy metabolism due to treatment with escitalopram in individuals with MDD. In turn, these findings may aid in understanding the relationship between brain energy metabolism and depression, and may guide future antidepressant trials.

This 12-week study will enroll individuals diagnosed with MDD, as well as healthy individuals. During Weeks 1 through 4, participants with MDD will receive 10 mg of escitalopram on a daily basis. If a participant does not respond well to the medication, as determined by the study clinician, the dose may be increased to 20 mg per day for Weeks 5 through 8. If a participant continues to not respond to the medication after 8 weeks, the dose may be increased to 30 mg per day for Weeks 9 through 12. Study visits will occur every other week throughout the 12 weeks. Laboratory tests, physical examinations, and vital sign measurements will be performed at each study visit. Outcome measurements will include depression levels as assessed by standardized psychological tests and questionnaires, as well as brain energy metabolite levels as assessed by magnetic resonance spectroscopy (MRS) and magnetic resonance imaging (MRI) scans. The MRS and MRI scans will occur at baseline, Week 2, and Week 12; the entire scanning procedure will last 70-80 minutes. Following the end of the study, all participants will be offered follow-up medical care for 3 months. Participants who responded well to escitalopram will be offered continued treatment with the drug, while those who did not respond well to escitalopram will be offered treatment with another antidepressant.

Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 4
Study Design  ICMJE Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE Depression
Intervention  ICMJE Drug: Escitalopram
Escitalopram 10 to 30 mg per day for 12 weeks
Other Name: Lexapro
Study Arms  ICMJE Experimental: Escitalopram
Participants will receive open treatment with escitalopram.
Intervention: Drug: Escitalopram
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Completed
Actual Enrollment  ICMJE
 (submitted: November 4, 2016)
97
Original Enrollment  ICMJE
 (submitted: September 13, 2005)
125
Actual Study Completion Date  ICMJE June 2009
Actual Primary Completion Date June 2009   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

For depressed subjects:

  • Meets DSM-IV diagnostic criteria for major depressive disorder
  • Score of greater than 16 on the Hamilton Depression Rating scale (17 items) at study entry
  • Agrees to use an effective form of contraception throughout the study

For healthy volunteers:

  • Not currently taking any medications
  • No lifetime history of major neurological, medical, psychiatric disorder, or head injury
  • Agrees to use an effective form of contraception throughout the study

Exclusion Criteria:

  • Current suicidal ideation that may make study participation unsafe
  • Current serious or unstable medical illness (e.g., cardiovascular, kidney, liver, respiratory, endocrine, neurologic, or blood-related disease)
  • History of seizure disorder
  • History of or current DSM-IV diagnosis of any of the following psychiatric illnesses within 12 months of study entry: organic mental disorder, schizophrenia, schizoaffective disorder, delusional disorder, psychotic disorders not otherwise specified, bipolar disorder, mood congruent or mood incongruent psychotic features, substance dependence disorders (including alcohol)
  • History of or current diagnosis of dementia, or a score of less than 26 on the Mini Mental Status Examination at screening
  • History of multiple adverse drug reactions or allergic reaction to the study drugs
  • Currently taking psychotropic drugs or antidepressant medications
  • Clinical or laboratory evidence of hypothyroidism
  • Failure to respond during current major depressive episode to at least one adequate antidepressant trial, defined as 6 weeks or more of treatment with 40 mg of citalopram per day (or its antidepressant equivalent)
  • History of electroconvulsive therapy (ECT) within the 6 months prior to study entry
  • Pregnant
  • Subjects with a CGI score a 6 ("severely depressed") or 7 ("among the most extremely depressed patients")
  • A BMI of 39 or greater, for comfort in scanner
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years to 65 Years   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE Yes
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT00183677
Other Study ID Numbers  ICMJE K23MH067111( U.S. NIH Grant/Contract )
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product Not Provided
IPD Sharing Statement  ICMJE Not Provided
Responsible Party David Mischoulon, MD, Massachusetts General Hospital
Study Sponsor  ICMJE Massachusetts General Hospital
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Principal Investigator: Dan V. Iosifescu, MD Massachusetts General Hospital
PRS Account Massachusetts General Hospital
Verification Date November 2016

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP