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Pivotal Trial (D02) of Vagus Nerve Stimulation (VNS) for Treatment-Resistant Depression (TRD)

Primary Purpose

Major Depressive Disorder

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
vagus nerve stimulation (VNS)
Sponsored by
Cyberonics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Major Depressive Disorder focused on measuring depression, vagus nerve stimulation

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. diagnosed with major depressive episode (MDE)
  2. chronic (>=2 years)or recurrent (>-=4) lifetime MDEs
  3. resistant to >=2 treatments from different categories
  4. completed >=6 weeks of psychotherapy
  5. score >=20 on 24-item Hamilton Rating Scale of Depression
  6. IQ >=70
  7. stable on current antidepressant medication (no more than 5 antidepressant meds) or taking no antidepressant meds for >=4 weeks before Visit B1
  8. stable on atypical antipsychotic and anticonvulsant medications as for item #7
  9. age >=18 amd <=80 years
  10. male or nonpregnant female adequately protected from conception.
  11. able to comply with testing and follow-up visits
  12. voluntarily signed informed consent
  13. patients with bipolar disorder demonstrated a resistance to lithium treatment or has a medical contraindication to treatment with lithium or is known to be intolerant to lithium (not applicable to patients with MDD)

Exclusion Criteria:

  1. atypical depression at study entry or psychotic symptoms in any MDE
  2. history of schizophrenia, schizoaffective disorder, or delusional disorders
  3. rapid cycling bopolar disorder
  4. secondary diagnosis of, or signs of, delirium, dementia, amnestic, or other cognitive disorders
  5. failed 7 or more antidepressant treatments
  6. a. suicide attempt requiring medical attention within previous 12 months b. >=2 suicide attempts in the past 12 months c. cannot guarantee that will not implement suicide d. likely to attempt suicide within next 6 mon in investigator's opinion
  7. alcohol or substance dependence within previous 12 months or abuse within previous 6 mon other than nicotine dependence or abuse
  8. history of myocardial infarction or cardiac arrest
  9. other progressive neurological disease, significant central nervous system disease or injury, or cervical fracture that makes implantation difficult
  10. received general anesthesia with 390 days before enrollment.
  11. taken an investigational drug within a clearance duration of 5 x the half-life of the investigational drug or within <=4weeks before Visit B1, whichever time is greater
  12. enrolled in another investigational study
  13. using another investigational device
  14. significant cardiac or pulmonary condition currently under treatment resulting in an ASA score >=III
  15. history of, or evidence of, significant brain malformation or significant head injury or clinically apparent cerebral vascular events, or prior brain surgery such as cingulatomy
  16. unilateral or bilateral cervical vagotomy
  17. demand cardiac pacemaker, implantable defibrillator, or other implantable stimulator
  18. likely to require a whole body MRI after NCP implantation
  19. currently receiving or likely to receive short-wave diathermy, microwave diathermy, or therapeutic ultrasound diathermy after implantation
  20. plans to relocate or move to a location distant from the study site within one year of enrollment
  21. previously enrolled in this or any other NCP System study -

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

1

2

Arm Description

Patients implanted with the vagus nerve stimulation (VNS) device and receiving VNS Intervention: vagus nerve stimulation (VNS)

Implanted with vagus nerve stimulation (VNS) device, but not receiving VNS

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
September 20, 2007
Last Updated
September 21, 2007
Sponsor
Cyberonics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00533832
Brief Title
Pivotal Trial (D02) of Vagus Nerve Stimulation (VNS) for Treatment-Resistant Depression (TRD)
Official Title
A Multicernter, Pivotal, Safety and Efficacy Study of the NeuroCtybernetic Prosthesis (NCP(R)) System in Patients With Depression
Study Type
Interventional

2. Study Status

Record Verification Date
September 2007
Overall Recruitment Status
Completed
Study Start Date
July 2000 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
July 2005 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Cyberonics, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To confirm the safety and efficacy of the NCP System in treating patients in a nmajor depressive episode.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Major Depressive Disorder
Keywords
depression, vagus nerve stimulation

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
266 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Active Comparator
Arm Description
Patients implanted with the vagus nerve stimulation (VNS) device and receiving VNS Intervention: vagus nerve stimulation (VNS)
Arm Title
2
Arm Type
Placebo Comparator
Arm Description
Implanted with vagus nerve stimulation (VNS) device, but not receiving VNS
Intervention Type
Device
Intervention Name(s)
vagus nerve stimulation (VNS)
Intervention Description
intermittent vagus nerve stimulation Placebo group were implanted, but did not receive vagus nerve stimulation during the acute phase.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: diagnosed with major depressive episode (MDE) chronic (>=2 years)or recurrent (>-=4) lifetime MDEs resistant to >=2 treatments from different categories completed >=6 weeks of psychotherapy score >=20 on 24-item Hamilton Rating Scale of Depression IQ >=70 stable on current antidepressant medication (no more than 5 antidepressant meds) or taking no antidepressant meds for >=4 weeks before Visit B1 stable on atypical antipsychotic and anticonvulsant medications as for item #7 age >=18 amd <=80 years male or nonpregnant female adequately protected from conception. able to comply with testing and follow-up visits voluntarily signed informed consent patients with bipolar disorder demonstrated a resistance to lithium treatment or has a medical contraindication to treatment with lithium or is known to be intolerant to lithium (not applicable to patients with MDD) Exclusion Criteria: atypical depression at study entry or psychotic symptoms in any MDE history of schizophrenia, schizoaffective disorder, or delusional disorders rapid cycling bopolar disorder secondary diagnosis of, or signs of, delirium, dementia, amnestic, or other cognitive disorders failed 7 or more antidepressant treatments a. suicide attempt requiring medical attention within previous 12 months b. >=2 suicide attempts in the past 12 months c. cannot guarantee that will not implement suicide d. likely to attempt suicide within next 6 mon in investigator's opinion alcohol or substance dependence within previous 12 months or abuse within previous 6 mon other than nicotine dependence or abuse history of myocardial infarction or cardiac arrest other progressive neurological disease, significant central nervous system disease or injury, or cervical fracture that makes implantation difficult received general anesthesia with 390 days before enrollment. taken an investigational drug within a clearance duration of 5 x the half-life of the investigational drug or within <=4weeks before Visit B1, whichever time is greater enrolled in another investigational study using another investigational device significant cardiac or pulmonary condition currently under treatment resulting in an ASA score >=III history of, or evidence of, significant brain malformation or significant head injury or clinically apparent cerebral vascular events, or prior brain surgery such as cingulatomy unilateral or bilateral cervical vagotomy demand cardiac pacemaker, implantable defibrillator, or other implantable stimulator likely to require a whole body MRI after NCP implantation currently receiving or likely to receive short-wave diathermy, microwave diathermy, or therapeutic ultrasound diathermy after implantation plans to relocate or move to a location distant from the study site within one year of enrollment previously enrolled in this or any other NCP System study -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Investigator
Organizational Affiliation
Cyberonics, Inc.
Official's Role
Study Director
Facility Information:
City
Houston
State/Province
Texas
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
16139582
Citation
George MS, Rush AJ, Marangell LB, Sackeim HA, Brannan SK, Davis SM, Howland R, Kling MA, Moreno F, Rittberg B, Dunner D, Schwartz T, Carpenter L, Burke M, Ninan P, Goodnick P. A one-year comparison of vagus nerve stimulation with treatment as usual for treatment-resistant depression. Biol Psychiatry. 2005 Sep 1;58(5):364-73. doi: 10.1016/j.biopsych.2005.07.028.
Results Reference
result
PubMed Identifier
16139581
Citation
Rush AJ, Sackeim HA, Marangell LB, George MS, Brannan SK, Davis SM, Lavori P, Howland R, Kling MA, Rittberg B, Carpenter L, Ninan P, Moreno F, Schwartz T, Conway C, Burke M, Barry JJ. Effects of 12 months of vagus nerve stimulation in treatment-resistant depression: a naturalistic study. Biol Psychiatry. 2005 Sep 1;58(5):355-63. doi: 10.1016/j.biopsych.2005.05.024.
Results Reference
result
PubMed Identifier
16139580
Citation
Rush AJ, Marangell LB, Sackeim HA, George MS, Brannan SK, Davis SM, Howland R, Kling MA, Rittberg BR, Burke WJ, Rapaport MH, Zajecka J, Nierenberg AA, Husain MM, Ginsberg D, Cooke RG. Vagus nerve stimulation for treatment-resistant depression: a randomized, controlled acute phase trial. Biol Psychiatry. 2005 Sep 1;58(5):347-54. doi: 10.1016/j.biopsych.2005.05.025.
Results Reference
result
PubMed Identifier
18786301
Citation
Cohen LJ, Allen JC Jr. Estimating the potential savings with vagus nerve stimulation for treatment-resistant depression: a payer perspective. Curr Med Res Opin. 2008 Aug;24(8):2203-17. doi: 10.1185/03007990802229050.
Results Reference
derived
PubMed Identifier
18571625
Citation
Nierenberg AA, Alpert JE, Gardner-Schuster EE, Seay S, Mischoulon D. Vagus nerve stimulation: 2-year outcomes for bipolar versus unipolar treatment-resistant depression. Biol Psychiatry. 2008 Sep 15;64(6):455-60. doi: 10.1016/j.biopsych.2008.04.036. Epub 2008 Jun 24.
Results Reference
derived

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Pivotal Trial (D02) of Vagus Nerve Stimulation (VNS) for Treatment-Resistant Depression (TRD)

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