Efficacy and Safety Study of Org 50081 (Esmirtazapine) in Elderly Participants (P05709)
Insomnia, Sleep Initiation and Maintenance Disorders, Mental Disorders
About this trial
This is an interventional treatment trial for Insomnia focused on measuring elderly, randomized, placebo controlled
Eligibility Criteria
Inclusion Criteria:
- are at least 65 years of age at screening;
- sign written informed consent after the scope and
nature of the investigation have been explained to
them, before screening evaluations;
- are able to speak, read and understand the language of
the investigator, study staff (including raters) and the
informed consent form, and possess the ability to
respond to questions, follow instructions and complete
questionnaires;
- have demonstrated capability to independently
complete the LogPad questionnaires and have
completed the questionnaires at least 6 out of 7 days of
the week preceding randomization;
- have a regular sleep pattern, meaning bedtime regularly
occurs between 2100 hours and 2400 hours, with no more variation
from these boundaries than 2 times/ week, with 5-8.5
hours in bed;
- have a documented diagnosis of chronic primary
insomnia, defined as fulfillment of the Diagnostic and Statistical Manual of Mental Disorders IV - Text Revision (DSM-IV-TR) criteria
for primary insomnia (DSM-IV-TR 307.42) with a duration
of >= 1 month; fulfill the following PSG criteria on the
two screening/baseline PSG nights:
- average Total Sleep Time (TST) < 6.5 h (and each night greater than or
equal to 3 h and < 7 h),
- average WASO greater than or equal to 45 minutes
(and each night greater than or equal to 30 min),
- average Latency to Persistent Sleep (LPS) 15 min (and each night greater than or
equal to 10 min).
Exclusion Criteria:
- have other sleep disorders (DSM-IV-TR), such as sleep
related breathing disorders Apnea-Hypopnea Index (AHI) greater than or equal
to 15), Periodic Leg Movements with Arousals Index (PLMAI)
greater than or equal to 10), restless leg syndrome,
narcolepsy, circadian sleep wake rhythm disorders,
Rapid Eye Movement (REM) behavioral disorder or any parasomnia;
- have any significant medical or DSM-IV-TR
psychiatric illness causing the sleep disturbances;
- currently meet diagnostic criteria for DSM-IV-TR
depression Major Depressive Disorder (MDD) or have been diagnosed and treated
for MDD within the last 2 years;
- have a history of bipolar disorder, a history of suicide attempt or a family history of suicide. A family history of suicide is defined as any history of suicide in the first and second degree family (parents, siblings, grandparents, or offspring), or a pattern of completed suicides (more than one) in the third degree family (aunts, uncles, nieces and nephews);
- have a history or signs of dementia or other serious
cognitive impairment, as defined by a score of less than
26 on the Mini-Mental State Examination;
- have a significant, unstable medical illness e.g. acute or
chronic pain, hepatic, renal, metabolic or cardiac
disease;
- had serious head injury or stroke within the past year,
or a history of (non-febrile) seizures;
- have clinically relevant electrocardiogram (ECG) abnormalities at
screening, as judged by the investigator;
- have clinically relevant abnormal hematology or
biochemistry values at screening, as judged by the
investigator;
- have DSM-IV-TR substance abuse or DSM-IV-TR
addiction within the last year;
- drink more than 2 alcoholic drinks in a day. One drink is approximately equal to: 12 oz or 360 ml of beer (regular or light), or 4 oz or 120 ml of red or white wine, or 2 oz or 60 ml of desert wine (e.g. port, sherry), or 12 oz or 360 ml of wine cooler (regular or light), or 1 oz or 30 ml or spirits (80 to 100 proof, e.g. whiskey, vodka);
- are routinely sleeping during daytime (napping) for more than 20 minutes per day, 3 days or more per week;
- are night workers or rotating shift workers currently, or in the past 6 months
- use of psychotropic drugs affecting sleep within two weeks prior to randomization (fluoxetine: five weeks);
- use of concomitant medication affecting sleep (e.g. anxiolytics, sedatives, antidepressants, antipsychotics, centrally active sedating antihistamines, central nervous system (CNS)
stimulants, alpha-2-antagonists, respiratory stimulants and decongestants);
- smoke > 15 cigarettes per day and/or can not abstain from smoking during the night;
- drink excessive amounts of caffeinated beverages/day (more than 500 mg caffeine per day);
- have a body mass index (BMI) >= 36;
- have a positive urine drug screen at screening or at baseline;
- have a known hypersensitivity to mirtazapine or to any of the excipients;
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Experimental
Experimental
Placebo Comparator
Esmirtazapine 0.5 mg
Esmirtazapine 1.5 mg
Esmirtazapine 3.0 mg
Placebo
one placebo tablet daily for 14 days, followed by one 0.5 mg tablet Esmirtazapine daily for 16 days, and then one placebo tablet daily for 7 days
one placebo tablet daily for 14 days, followed by one 1.5 mg tablet Esmirtazapine daily for 16 days, and then one placebo tablet daily for 7 days
one placebo tablet daily for 14 days, followed by one 3.0 mg tablet Esmirtazapine daily for 16 days, and then one placebo tablet daily for 7 days
one placebo tablet daily for 14 days, followed by one placebo tablet daily for 16 days, and then one placebo tablet daily for 7 days