Neurobiology of Treatment Responses in MDD

Major Depressive Disorder Clinical Trial

Official title:

Neurobiology of Non-Specific and Specific Treatment Responses in Major Depression

Clinical Trial Details — Status: Withdrawn

Administrative data

• NCT number: NCT03068247
• Other study ID #: 00095062
• Status: Withdrawn
• Phase: Phase 3
• Start date: November 2021
• Est. completion date: May 2023

Study information

• Verified date: April 2021
• Source: University of Utah
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The primary study intent is to examine biological mechanisms associated with acute and chronic treatment responses in major depressive disorder (MDD). It is hypothesized that treatment responsiveness, representing endogenous opioid system function, will be associated with acute improvements in mood state over a 10-week treatment trial in MDD. Potential (bio) markers of treatment effects will be tested against psychophysical responses to placebo and active treatments.

Description:

Volunteers will be randomized to receive placebo pills or a commercially available SNRI for 10 weeks. Volunteers will undergo imaging with structural and functional MRI and PET with [11C]carfentanil to determine baseline μOR BPND and changes in BPND measures during acute i.v. medication administration at the time of scanning before and after the 10-week treatment period.

To elicit the activation of µ-opioid-mediated neurotransmission in the scanner, we utilize the introduction of medication (active or inactive) 1mL into an intravenous port every 4 minutes, 15 sec per infusion, starting 45 minutes after radiotracer administration, until scan completion. Participants are made aware that the study drug will be administered at the time a computer-generated human voice recording reads a second-by-second count of the infusion timing (15 sec).

Recruitment information / eligibility

• Status: Withdrawn
• Enrollment: 0
• Est. completion date: May 2023
• Est. primary completion date: May 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 55 Years

Eligibility

Inclusion Criteria:

• Meet DSM V criteria for Major Depressive Episode, single episode or recurrent, for at least a month;

• Unmedicated for at least 10 half-lives of the previous AD used;

• Willing to limit the introduction of any new treatments during the study;

• 18 - 55 years of age;

• Right handed;

• Capable of giving written informed consent;

• Hamilton Depression Rating Scale (17-item HDRS, not including atypical features) >15 at screening and randomization;

Exclusion Criteria:

• Major medical illness (e.g., cancer, HIV, Hepatitis C, etc.) or concurrent, untreated, or symptomatic medical illnesses, including acute or ongoing pain, autoimmune or inflammatory disease;

• Use of narcotic analgesics within the last 6 months or regular use of sleeping aids (including benzodiazepines and related compounds), more than twice a week;

• Recent history of substance abuse (within the last 6 months) or history of substance dependence (lifetime);

• Other comorbid psychiatric illnesses, such as Bipolar Disorder, Obsessive Compulsive Disorder, Panic Disorder, any psychosis, or Axis II diagnoses. Generalized Anxiety and Social Anxiety Disorders will NOT be considered exclusionary given their common association with MDD

• Concurrent participation in other therapeutic trials;

• Pregnancy/nursing;

• Ongoing treatment with medications with psychotropic properties;

• Contraindications to PET or MRI methods;

• Impairments, activities or situations that would prevent completion of the study protocol;

• Prior non-response to duloxetine;

• Active suicidal ideation.

• Urine screens positive for opioids or any substances of abuse.

• Allergy to fentanyl (because of structural similarity to the radiotracer [11C]carfentanil to be employed in the study).

Related Conditions & MeSH terms

• Depressive Disorder
• Depressive Disorder, Major
• Major Depressive Disorder

Intervention

Drug:
• Duloxetine
10 week treatment
• Placebo
10 week treatment

Locations

Country	Name	City	State
United States	University of Utah	Salt Lake City	Utah

Sponsors (1)

Lead Sponsor	Collaborator
University of Utah

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	mu-opioid receptor binding capacity	derived from PET scans	10 weeks
Primary	depression score	HRSD-17 score	10 weeks