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Functional Outcome in Postpartum Depression in Women Treated With Desvenlafaxine

Primary Purpose

Depression

Status
Completed
Phase
Phase 3
Locations
Canada
Study Type
Interventional
Intervention
Desvenlafaxine
Sponsored by
BC Women's Hospital & Health Centre
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Depression focused on measuring Major Depressive Disorder, Postpartum Onset

Eligibility Criteria

19 Years - 45 Years (Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. To be able to read and write English.
  2. Written informed consent before initiation of any study related procedures.
  3. Diagnosis of Major Depressive Disorder (MDD) with onset of depressive symptoms within 12 months of delivery.
  4. Diagnosis of additional comorbid panic, generalized anxiety or obsessive compulsive disorder, if they occur in addition to MDD.
  5. Patients will be required to have a score of (greater than or equal than) 25 on the Montgomery-Asberg Depression Rating Scale (MADRS) at enrolment (moderate to severe depression).
  6. Patients need to be referred by their usual treating primary care physician.
  7. Those referrals must meet the clinic criteria for accepting referrals so that all potential participants are eligible to receive treatment in the clinic as per usual clinical practice.
  8. Patient does not wish to pursue CBT elsewhere.
  9. The patient is using an appropriate method of contraception, which may include abstinence, in order to avoid pregnancy during the study.
  10. The patient is not currently breastfeeding.

Exclusion Criteria:

  1. The patient is currently breastfeeding or pregnant.
  2. The patient has a significant risk of suicide according to investigator's opinion or presents a score ³5 on item 10 (suicidal thoughts) of the MADRS.
  3. The patient meets DSM-IV-TR criteria for:

    • current Post-traumatic Stress Disorder,
    • past or current manic or hypomanic episode,
    • past or current psychotic symptoms or disorder,
    • current drug or alcohol abuse or dependence,
    • current eating disorder (anorexia or bulimia).
  4. The patient uses the following disallowed recent or concomitant medication within the specified time periods:

    • any antidepressant or any drug used for augmentation of antidepressant action within the last 1 week and 3 weeks for fluoxetine (longer half life) prior to baseline. Subject's mood will be monitored.
    • any hypnotics within the last week prior to baseline
    • oral antipsychotics within 2 weeks or depot antipsychotics within 6 months prior to baseline.
    • serotonergic medicinal products (for example, triptans, tryptophan, tramadol) within the last week prior to baseline.
    • Psychoactive herbal remedies (for example, St. Johns Wort, kava kava, valerian, ginkgo biloba) within the last 2 weeks prior to baseline.
    • any other drug with potential psychotropic effects within the last 2 weeks prior to baseline.
    • any anticonvulsant drug within the last 2 weeks prior to baseline.
    • any investigational product within 3 months prior to baseline.
  5. The patient is currently receiving formal cognitive or behavioural therapy, systematic psychotherapy elsewhere, or plans to initiate such therapy during the study outside of the clinic.
  6. The current depressive symptoms of the patient are considered by the investigator to have been resistant to two well-conducted antidepressant treatments of at least 6 weeks duration.
  7. The patient has a serious illness or serious sequelae thereof, including liver or renal insufficiency, or a cardiovascular, pulmonary, gastrointestinal, endocrine, neurological (including epilepsy), infectious, neoplastic, or metabolic disturbance. (If there is a history of such disease but the condition has been stable for at least one year and is judged by the investigator not to render inclusion unsafe and not to interfere with the patient's participation in the study, the patient may be included).

Sites / Locations

  • BC Women's Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

SNRI treatment

Arm Description

Participants are undergoing pharmacotherapy treatment with Desvenlafaxine (SNRI).

Outcomes

Primary Outcome Measures

Sheehan Disability Scale (SDS)
The Sheehan Disability Scale (SDS), which measures global functional impairment, as well as the individual score on each subscale (work/school; social life; family life/home responsibilities). To provide estimates for further studies, the mean change in score will be estimated with 95% confidence limits as a measure of variability. In addition, the proportion of subjects showing a change of more than clinically important change of more than 5 points will be estimated.
Sheehan Disability Scale (SDS)
The Sheehan Disability Scale (SDS), which measures global functional impairment, as well as the individual score on each subscale (work/school; social life; family life/home responsibilities). To provide estimates for further studies, the mean change in score will be estimated with 95% confidence limits as a measure of variability. In addition, the proportion of subjects showing a change of more than clinically important change of more than 5 points will be estimated.

Secondary Outcome Measures

Montgomery-Asberg Depression Rating Scale (MADRS), the Hamilton Rating Scale- Anxiety (HAM-A), the Yale-Brown Obsessive Compulsive Scale (YBOCS), the Panic Disorder Severity Scale (PDSS), and the Penn Sate Worry Questionnaire (PSWQ).
Secondary efficacy assessment will be comprised of several measures. The secondary endpoint will be change from baseline on the total scores of these measures after 6 and 12-weeks of treatment. Resulting scores from these scales will be used to provide estimates and will be tabulated.
Montgomery-Asberg Depression Rating Scale (MADRS), the Hamilton Rating Scale- Anxiety (HAM-A), the Yale-Brown Obsessive Compulsive Scale (YBOCS), the Panic Disorder Severity Scale (PDSS), and the Penn Sate Worry Questionnaire (PSWQ).
Secondary efficacy assessment will be comprised of several measures. The secondary endpoint will be change from baseline on the total scores of these measures after 6 and 12-weeks of treatment. Resulting scores from these scales will be used to provide estimates and will be tabulated.
Montgomery-Asberg Depression Rating Scale (MADRS), the Hamilton Rating Scale- Anxiety (HAM-A), the Yale-Brown Obsessive Compulsive Scale (YBOCS), the Panic Disorder Severity Scale (PDSS), and the Penn Sate Worry Questionnaire (PSWQ).
Secondary efficacy assessment will be comprised of several measures. The secondary endpoint will be change from baseline on the total scores of these measures after 6 and 12-weeks of treatment. Resulting scores from these scales will be used to provide estimates and will be tabulated.

Full Information

First Posted
October 14, 2010
Last Updated
January 26, 2015
Sponsor
BC Women's Hospital & Health Centre
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1. Study Identification

Unique Protocol Identification Number
NCT01527786
Brief Title
Functional Outcome in Postpartum Depression in Women Treated With Desvenlafaxine
Official Title
A Pilot Study of Functional Outcome in Postpartum Depression in Women Treated With Desvenlafaxine
Study Type
Interventional

2. Study Status

Record Verification Date
January 2015
Overall Recruitment Status
Completed
Study Start Date
November 2010 (undefined)
Primary Completion Date
February 2014 (Actual)
Study Completion Date
February 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
BC Women's Hospital & Health Centre

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Postpartum depressed women suffer from functional impairment in their mood, thoughts, cognition and physical well being leading to poor motivation, bonding difficulties, decreased productivity, conflict and neglect. Moderate/ severe depression responds best to a combination of antidepressants and counseling. This study will estimate the proportion of women who return to functionality after treatment with Desvenlafaxine and examine the differential impact of change in depression and anxiety symptoms on functionality over twelve weeks. Depression and anxiety symptoms will be monitored through six mood questionnaires; functional recovery will be monitored through a simple self-report questionnaire at each visit.
Detailed Description
Women will be recruited through a tertiary level care program and advertisements in BC Children's & Women's Hospital as well as St.Paul's Hospital, Vancouver, B.C., Canada. If deemed eligible for the study (meeting a diagnosis of postpartum depression with or without comorbid anxiety disorder) and the potential participant agrees to participate, consent will be signed. The participant will return on a bi-weekly basis for study visits, where mood and anxiety will be monitored, in addition to blood pressure and weight. Starting dose of Desvenlafaxine is 50mg, and this can be titrated to 100mg/per day if needed. Questionnaires will assess depression symptoms, anxiety symptoms, quality of life, panic disorder, obsessive-compulsive disorder and generalized anxiety disorder.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Depression
Keywords
Major Depressive Disorder, Postpartum Onset

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
25 (Actual)

8. Arms, Groups, and Interventions

Arm Title
SNRI treatment
Arm Type
Experimental
Arm Description
Participants are undergoing pharmacotherapy treatment with Desvenlafaxine (SNRI).
Intervention Type
Drug
Intervention Name(s)
Desvenlafaxine
Intervention Description
50mg-100mg everyday for 12 weeks over 7 study visits
Primary Outcome Measure Information:
Title
Sheehan Disability Scale (SDS)
Description
The Sheehan Disability Scale (SDS), which measures global functional impairment, as well as the individual score on each subscale (work/school; social life; family life/home responsibilities). To provide estimates for further studies, the mean change in score will be estimated with 95% confidence limits as a measure of variability. In addition, the proportion of subjects showing a change of more than clinically important change of more than 5 points will be estimated.
Time Frame
Baseline
Title
Sheehan Disability Scale (SDS)
Description
The Sheehan Disability Scale (SDS), which measures global functional impairment, as well as the individual score on each subscale (work/school; social life; family life/home responsibilities). To provide estimates for further studies, the mean change in score will be estimated with 95% confidence limits as a measure of variability. In addition, the proportion of subjects showing a change of more than clinically important change of more than 5 points will be estimated.
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Montgomery-Asberg Depression Rating Scale (MADRS), the Hamilton Rating Scale- Anxiety (HAM-A), the Yale-Brown Obsessive Compulsive Scale (YBOCS), the Panic Disorder Severity Scale (PDSS), and the Penn Sate Worry Questionnaire (PSWQ).
Description
Secondary efficacy assessment will be comprised of several measures. The secondary endpoint will be change from baseline on the total scores of these measures after 6 and 12-weeks of treatment. Resulting scores from these scales will be used to provide estimates and will be tabulated.
Time Frame
Baseline
Title
Montgomery-Asberg Depression Rating Scale (MADRS), the Hamilton Rating Scale- Anxiety (HAM-A), the Yale-Brown Obsessive Compulsive Scale (YBOCS), the Panic Disorder Severity Scale (PDSS), and the Penn Sate Worry Questionnaire (PSWQ).
Description
Secondary efficacy assessment will be comprised of several measures. The secondary endpoint will be change from baseline on the total scores of these measures after 6 and 12-weeks of treatment. Resulting scores from these scales will be used to provide estimates and will be tabulated.
Time Frame
6 weeks
Title
Montgomery-Asberg Depression Rating Scale (MADRS), the Hamilton Rating Scale- Anxiety (HAM-A), the Yale-Brown Obsessive Compulsive Scale (YBOCS), the Panic Disorder Severity Scale (PDSS), and the Penn Sate Worry Questionnaire (PSWQ).
Description
Secondary efficacy assessment will be comprised of several measures. The secondary endpoint will be change from baseline on the total scores of these measures after 6 and 12-weeks of treatment. Resulting scores from these scales will be used to provide estimates and will be tabulated.
Time Frame
12 weeks

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
19 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: To be able to read and write English. Written informed consent before initiation of any study related procedures. Diagnosis of Major Depressive Disorder (MDD) with onset of depressive symptoms within 12 months of delivery. Diagnosis of additional comorbid panic, generalized anxiety or obsessive compulsive disorder, if they occur in addition to MDD. Patients will be required to have a score of (greater than or equal than) 25 on the Montgomery-Asberg Depression Rating Scale (MADRS) at enrolment (moderate to severe depression). Patients need to be referred by their usual treating primary care physician. Those referrals must meet the clinic criteria for accepting referrals so that all potential participants are eligible to receive treatment in the clinic as per usual clinical practice. Patient does not wish to pursue CBT elsewhere. The patient is using an appropriate method of contraception, which may include abstinence, in order to avoid pregnancy during the study. The patient is not currently breastfeeding. Exclusion Criteria: The patient is currently breastfeeding or pregnant. The patient has a significant risk of suicide according to investigator's opinion or presents a score ³5 on item 10 (suicidal thoughts) of the MADRS. The patient meets DSM-IV-TR criteria for: current Post-traumatic Stress Disorder, past or current manic or hypomanic episode, past or current psychotic symptoms or disorder, current drug or alcohol abuse or dependence, current eating disorder (anorexia or bulimia). The patient uses the following disallowed recent or concomitant medication within the specified time periods: any antidepressant or any drug used for augmentation of antidepressant action within the last 1 week and 3 weeks for fluoxetine (longer half life) prior to baseline. Subject's mood will be monitored. any hypnotics within the last week prior to baseline oral antipsychotics within 2 weeks or depot antipsychotics within 6 months prior to baseline. serotonergic medicinal products (for example, triptans, tryptophan, tramadol) within the last week prior to baseline. Psychoactive herbal remedies (for example, St. Johns Wort, kava kava, valerian, ginkgo biloba) within the last 2 weeks prior to baseline. any other drug with potential psychotropic effects within the last 2 weeks prior to baseline. any anticonvulsant drug within the last 2 weeks prior to baseline. any investigational product within 3 months prior to baseline. The patient is currently receiving formal cognitive or behavioural therapy, systematic psychotherapy elsewhere, or plans to initiate such therapy during the study outside of the clinic. The current depressive symptoms of the patient are considered by the investigator to have been resistant to two well-conducted antidepressant treatments of at least 6 weeks duration. The patient has a serious illness or serious sequelae thereof, including liver or renal insufficiency, or a cardiovascular, pulmonary, gastrointestinal, endocrine, neurological (including epilepsy), infectious, neoplastic, or metabolic disturbance. (If there is a history of such disease but the condition has been stable for at least one year and is judged by the investigator not to render inclusion unsafe and not to interfere with the patient's participation in the study, the patient may be included).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shaila Misri, MD
Organizational Affiliation
BC Women's Hospital/UBC
Official's Role
Principal Investigator
Facility Information:
Facility Name
BC Women's Hospital
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V6H 3N1
Country
Canada

12. IPD Sharing Statement

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Functional Outcome in Postpartum Depression in Women Treated With Desvenlafaxine

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