Depression Clinical Trial
Official title:
Mecamylamine for the Treatment of Patients With Depression and Alcohol Dependence
The objective of this study is to evaluate the efficacy of mecamylamine (MEC, 10 mg/day) versus placebo in reducing depressive and alcohol symptoms in patients with depression and co-morbid alcohol dependence. The researchers hypothesize that MEC will significantly reduce depressive symptoms and decrease alcohol consumption compared to placebo in patients with depression and alcohol dependence who are on a stable dose of a selective serotonin reuptake inhibitor (SSRI).
Depression with co-morbid alcohol dependence is very prevalent and it is very costly to
treat. The co occurrence of the two disorders leads to greater severity and worse long-term
outcome, including suicide. Although a number of treatment strategies have been implemented
for depressed patients with alcohol dependence the controversy concerning best treatment
options for those patients persists.
The clinical relationship between depression and alcohol dependence suggests some common
mechanism underlying both disorders. It has been hypothesized that medications that block
presynaptic nAChR may be effective in the treatment of alcoholism and depression.
Mecamylamine (Inversine ®) is a noncompetitive, high affinity nAChR antagonist with low
selectivity for the alpha-7 receptor. Mecamylamine has never been investigated as an
effective adjunct treatment for dually diagnosed patients with depression and alcohol
dependence. Methods: Thirty participants with a current diagnosis of depression and alcohol
dependence will be recruited for this 12-week treatment study. Fifteen participants will be
randomized to mecamylamine and fifteen to placebo. Participants will be included in the
study if: they meet current DSM-IV criteria for Major Depression and Alcohol Dependence and
have been on a stable SSRI dose for 2 weeks. All participants will come weekly to take their
medications and complete weekly assessments. Weekly assessments will consist of questioners
that will assess depressive symptoms and alcohol consumption over the entire treatment
period. Significance: This study is the first to evaluate the efficacy of mecamylamine as an
augmenting agent for treatment of depression and alcohol dependence.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Factorial Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
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