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Treatment Resistant Depression clinical trials

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NCT ID: NCT03742557 Recruiting - Clinical trials for Treatment Resistant Depression

Evaluation of Schemes of Administration of Intravenous Ketamine in Depression

Start date: October 1, 2018
Phase: Phase 3
Study type: Interventional

Mexico, prevalence reported for major depressive disorder (MDD) is of 7.2%. It is currently in the top 5 causes of disability worldwide. One third of patients will not achieve remission after two treatments, being classified as treatment-resistant. In a neurochemical level, evidence shows dysregulation of the excitatory neurotransmitter Glutamate in patients with MDD. Chronic stress has been related to this dysregulation. Ketamine, has shown to regulate glutamatergic neurotransmission, and specially promote the release and production of neurotrophic factors key in the causes of MDD inhibited by glutamate dysregulation), and allow restoration of areas affected. Clinical studies of ketamine in MDD have shown robust, durable , and rapid effects (during the first 4-24 hours), allowing a great opportunity for patients who do not achieve benefits from antidepressants or patients with suicidal ideation . These results have been reported in metaanalysis. To our knowledge, there are no studies using Magnetic Resonance Spectroscopy, in areas related to MDD, after a series of ketamine administrations, which we think may show changes after this chronic administration and explain its antidepressant properties. Goals: Provide clinical evidence of responseas well as a neurological basis or biomarker of response to a series of ketamine infusions.

NCT ID: NCT03711019 Not yet recruiting - Depression Clinical Trials

Efficacy of Convulsive Therapies During Continuation

Start date: October 2018
Phase: N/A
Study type: Interventional

This trial aims to assess the efficacy and tolerability of Magnetic Seizure Therapy (MST) and two different forms of electroconvulsive therapy (ECT) in sustaining response during and after a course of continuation treatment.

NCT ID: NCT03701724 Recruiting - Clinical trials for Treatment-resistant Depression

Cost-utility Analysis of Maintenance rTMS for Treatment-resistant Depression

Start date: November 5, 2018
Phase: N/A
Study type: Interventional

Treatment resistant depression (TRD) is a frequent, debilitating condition mostly treated by antidepressants. Repeated magnetic transcranial stimulation (rTMS) has proven adjuvant efficacy in TRD in the acute phase of treatment with a very good tolerance and acceptability. Maintenance rTMS (mTMS) is a strategy consisting in adding regular single TMS sessions after response to an acute course in order to keep the benefit of initial treatment over several month or years. Demonstrating that rTMS is efficient to improve long-term prognosis and decrease economic burden would have a tremendous impact in clinical practice in psychiatry. Thus the investigator's aim is to analyze the long term impact of mTMS treatment on costs, but also quality of life and clinical issues.

NCT ID: NCT03684447 Not yet recruiting - Clinical trials for Treatment Resistant Depression

Neural and Antidepressant Effects of Propofol

Start date: January 2019
Phase: Phase 2/Phase 3
Study type: Interventional

This study will compare the antidepressant effects of propofol versus a placebo intervention while measuring potential treatment-related biomarkers.

NCT ID: NCT03680781 Recruiting - Clinical trials for Treatment Resistant Depression

Accelerated Theta Burst in Treatment-Resistant Depression: A Dose Finding and Biomarker Study

Start date: April 13, 2018
Phase: N/A
Study type: Interventional

This study evaluates the effectiveness of re-treatment using accelerated schedule of intermittent theta-burst stimulation for treatment-resistant depression. This is an open label study.

NCT ID: NCT03653858 Recruiting - Clinical trials for Treatment-resistant Depression

Efficacy Study of Deep Brain Stimulation in Patients With Treatment Resistant Major Depression

Start date: September 3, 2018
Phase: N/A
Study type: Interventional

The primary objective of this multicenter, randomized, sham-controlled, double blind (patient and observer blinded) clinical trial is to assess the antidepressant effect of Deep Brain Stimulation (DBS) in patients with treatment resistant major depression using the Boston Scientific implantable Vercise™ GEVIA™ DBS system compared to sham.

NCT ID: NCT03606395 Recruiting - Clinical trials for Treatment Resistant Depression

Safety, Tolerability, PK and Efficacy of Single Doses of NV-5138 in Healthy Volunteers and Subjects With Treatment-Resistant Depression

Start date: June 6, 2018
Phase: Phase 1
Study type: Interventional

Randomized, two-part, placebo-controlled study of single ascending doses of NV-5138 in healthy volunteers, and a single dose of NV-5138 in subjects with Treatment-Resistant Depression (TRD)

NCT ID: NCT03573349 Not yet recruiting - Clinical trials for Major Depressive Disorder

Glutamate MRS During Ketamine Infusion

Start date: November 2018
Phase: Early Phase 1
Study type: Interventional

This is a feasibility study and the goal of this project is to evaluate whether ACC glutamine, quantified as a CSF-corrected absolute concentration percent change from baseline, is associated with clinical remission, Montgomery Asberg Depression Rating Scale (MADRS) total score of =9, to the anti-glutamatergic antidepressant ketamine. As MRS is expensive, we also aim to study a correlation between peripheral glutamate and central glutamate level.

NCT ID: NCT03564041 Recruiting - Clinical trials for Treatment-resistant Depression

SSM vs HEP in Late-Life Depression

Start date: August 20, 2018
Phase: N/A
Study type: Interventional

The investigators will conduct a randomized controlled trial (RCT), comparing SSM (n=96) versus HEP (n=96) in 192 LLD participants stratified by site and presence of treatment resistant late life depression (TR-LLD). Participants will be blinded to the treatment hypothesis while investigators, raters and treating clinicians will be additionally blinded to the intervention. Both SSM and HEP will be taught over 4 consecutive days in similar sized groups (4-10 participants) followed by weekly reinforcement sessions for subsequent 11 weeks. Trained raters will collect data on depression symptoms (HAM-D 17 scale) and cognition at baseline, 12-week and 26-week follow-up as the primary and secondary outcome measures respectively.

NCT ID: NCT03537794 Not yet recruiting - Clinical trials for Treatment Resistant Depression

Characterizing Dopamine Receptor Binding in Treatment Resistant Depression

Start date: June 2018
Study type: Observational

It is estimated that 30% of individuals with Major Depressive Disorder (MDD) fail to respond to conventional antidepressant medication which accounts for over 1 million Canadians in their lifetime. Treatment resistant depression (TRD) patients also have greater psychiatric and medical comorbidity, poorer quality of life and increased suicidal ideation. Yet, there are few treatment strategies available to target TRD and there is a significant lack of evidence about how TRD differs from treatment-responsive depression. This proposal represents the first study to elucidate the neurobiology of TRD with a focus on dopamine receptor function throughout the brain, in order to inform treatment development and clinical characterization of TRD.The ultimate goal of this unique study is to characterize striatal and extrastriatal dopamine D2 and D3 receptor binding potential in patients with TRD, non-resistant MDD and healthy controls. The primary hypothesis is that TRD patients will exhibit greater D2/D3 receptor binding potential compared to non-TRD patients in the following regions of interest: dorsolateral prefrontal cortex, orbitofrontal cortex, and ventral striatum. Secondarily, non-TRD patients will also demonstrate increased binding potential compared to healthy controls in the same brain regions. Whole brain analyses will allow us to take an exploratory approach to other brain regions that may differentiate TRD from non-TRD patients. Participants will be assessed at St. Michael's Hospital (SMH) and the Centre for Addiction and Mental Health (CAMH), which are within a 10 minute driving distance of each other. There will be 3 study visits following written informed consent. Eligibility will be confirmed at a screening visit at SMH where demographic information, including age, sex, education, and medication history will be obtained, as well as the administration of a structured Mini-International Neuropsychiatric Interview (MINI) for Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Axis I diagnoses (Sheehan et al, 2015), and an HRSD-17. Within two weeks of the screening visit, participants will undergo a structural magnetic resonance imaging (MRI) scan at SMH prior to the positron-emission tomography (PET) scan at CAMH. The order of the PHNO scans will be counterbalanced.