Examination of a Soy-Based Supplement for Major Depression

INCLUSION CRITERIA: Subjects may be included in the study only if they meet all of the following criteria: Male or female subjects, 18 or older. Female subjects of childbearing potential must be using a medically accepted means of contraception as defined by one of the following: a) A barrier method of contraception. A barrier method of contraception is a physical barrier designed to prevent pregnancy, i.e., contraceptive foam or suppositories, spermicides, condoms, or diaphragm. b)Oral contraceptives, estrogen/progesterone-based or progesterone based. Women of childbearing potential also must have a negative serum beta-HCG at prestudy. Each subject must have a level of understanding sufficient to agree to all tests and examinations required by the protocol. Each subject must understand the nature of the study and must sign an informed consent document. Subjects must fulfill the criteria for major depression without psychotic features as defined in DSM-IV based on clinical assessment and confirmed by structured diagnostic interview SCID-P. Subjects must have a score at Visit 1 and Visit 2 of at least 20 on the MADRS (within 20%) and CGI-S greater than or equal to 3. EXCLUSION CRITERIA: Participation in a clinical trial of another investigational drug within 1 month (30 days) prior to study entry (Visit 1). Female subjects who are either pregnant or nursing. Patients initiating hormonal treatment (e.g., estrogen) in the last 3 months for mood, perimenopausal, or menstrual symptoms (OCP for birth control are acceptable but should not have been started in the last 2 month). Women ages 40-55 with irregular periods, or last menstrual period within the last 12 months, AND laboratory evidence confirming possible perimenopause, FSH greater than 14 IU/L. Serious, unstable illnesses including hepatic, renal, gastroenterologic, respiratory, cardiovascular (including ischemic heart disease), endocrinologic, neurologic, immunologic, or hematologic disease. History of malignancies or neoplastic disorders. Any present or past history of breast carcinoma, or any woman with a family history of the following: premenopausal breast cancer or bilateral breast cancer in a first-degree relative; multiple family members (greater than 3 relatives) with postmenopausal breast cancer. History of porphyria. History of pulmonary embolus or thrombophlebitis. Women with a history of endometriosis, pelvic lesions, ovarian enlargement, or abnormal vaginal bleeding. Subjects with uncorrected hypothyroidism or hyperthyroidism. Subjects with one or more seizures without a clear and resolved etiology. Documented history of hypersensitivity to soy products. DSM-IV substance abuse (except nicotine and caffeine) within the past 90 days and substance dependence within the past 12 months. Treatment with a reversible monoamine oxidase inhibitor, guanethidine, or guanadrel within 2 week prior to Visit 2. Treatment with fluoxetine within 2 weeks prior to Visit 2. Treatment with any other concomitant medication with primarily CNS activity, other than specified in the Appendix. Current diagnosis of schizophrenia or other psychotic disorder as defined in the DSM-IV. Known allergy to soy or soy constituents. Judged suicidal risk based on use of the HAM-D suicide item greater than or equal to 3. Patients will not be allowed to receive a new course of structured psychotherapy during the trial. Patients will be excluded who have previously failed greater than 3 antidepressant trials by ATHF criteria. Patients will be excluded who have had ECT in the past 12 weeks.