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PF-04995274 and Emotional Processing in Treatment Resistant Depression (RESTART)

Primary Purpose

Depression, Unipolar, Treatment Resistant Depression

Status
Completed
Phase
Phase 1
Locations
United Kingdom
Study Type
Interventional
Intervention
PF-04995274
Placebo Oral Tablet
Sponsored by
University of Oxford
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Depression, Unipolar

Eligibility Criteria

16 Years - 65 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Male or female;
  • Aged 18-65 years;
  • Willing and able to give informed consent for participation in the study;
  • Sufficiently fluent English to understand and complete the tasks;
  • Registered with a GP and consents to GP being informed of participation in study;
  • Participants need to meet a number of concurrent clinical criteria:
  • Current criteria for Major Depressive Disorder [as determined by the Structured Clinical interview for DSM-V (SCID)];
  • Failure within the current depressive episode to respond clinically to at least one course of antidepressant therapy, each given at a therapeutic dose for at least four weeks [as determined by use of the MGH Antidepressant Treatment Response Questionnaire (ATRQ)];
  • Currently taking an antidepressant, which must be either a Selective Serotonin Reuptake Inhibitor (SSRI) - with the exception of fluoxetine, paroxetine or fluvoxamine - or a Serotonin-norepinephrine reuptake inhibitor (SNRI) ; Participants currently taking excluded medications can be switched to sertraline or citalopram;
  • Participants engaging in sex with a risk of pregnancy must agree to use a highly effective method of contraception from Screening Visit until 30 days after receiving study medication treatment, and male participants must not donate sperm.

Exclusion Criteria:

  • History of or current DSM-V bipolar disorder, schizophrenia or eating disorders. Participants who fulfil current criteria for other comorbid disorders may still be entered into the study, if, in the opinion of the Investigator, the psychiatric diagnosis will not compromise safety or affect data quality;
  • First-degree relative with a diagnosis of Bipolar Disorder type 1;
  • Participants currently taking strong cytochrome P450 (CYPs) enzymes inhibitors, such as fluoxetine, paroxetine or fluvoxamine (in order to avoid drug-drug interactions);
  • Participants currently taking psychotropic medications which in the opinion of the investigator may interfere with the safety of the participant or the scientific integrity of the study;
  • Participants who have previously failed a combination/augmentation therapy (i.e., therapy with the combination of two or more pharmacological agents) for the treatment of depression, which in the opinion of the Investigator may reduce the likelihood of responding;
  • Electroconvulsive therapy for the treatment of the current episode of depression;
  • Participants undergoing any form of face-to-face structured psychological treatment during the study;
  • Clinically significant abnormal values for liver function tests, clinical chemistry, urine drug screen, blood pressure measurement and ECG. A participant with a clinical abnormality or parameters outside the reference range for the population being studied may be included only if the Investigator considers that the finding is unlikely to introduce additional risk factors and will not interfere with the study procedures;
  • History of stimulant abuse (lifetime; e.g. amphetamine, cocaine), or of alcohol abuse within one year or of alcohol dependence within the lifetime;
  • History of, or current medical conditions which in the opinion of the investigator may interfere with the safety of the participant or the scientific integrity of the study, including epilepsy/seizures, brain injury, severe hepatic or renal disease, severe gastro-intestinal problems, Central Nervous System (CNS) tumors, severe neurological problems (like Parkinson's Disease; blackouts requiring hospitalisation);
  • Clinically significant risk of suicide;
  • Current pregnancy (as determined by urine pregnancy test taken during Screening and First Dose Visits), breastfeeding or planning a pregnancy during the course of the study;
  • Participant not willing to use a suitable method of contraception for 30 days after receiving study medication treatment;
  • Participants with Body Mass Index (BMI - kg/m2) outside the 18 - 36 range at the Screening Visit;
  • Night-shift working or recent travel involving significant change of timezones;
  • Excessive caffeine consumption, i.e., consumption higher than 8 cups of standard caffeinated drinks (tea, instant coffee) or higher than 6 cups of stronger coffee or other drinks containing methylxanthines such as coca cola or Red Bull per day;
  • Participation in a psychological or medical study involving the use of medication within the last 3 months;
  • Previous participation in a study using the same, or similar, emotional processing tasks;
  • Smoker > 10 cigarettes per day or similar levels of tobacco consumption in other forms.
  • Participant received prescribed medication within 28 days prior to First Dose Visit (apart from their prescribed antidepressant and the contraceptive pill). Participants who have taken prescription medication may still be entered into the study, if, in the opinion of the Investigator, the medication received will not interfere with the study procedures or compromise safety;
  • Participant received non-prescription medication, including supplements such as vitamins and herbal supplements within 48 hours prior to First Dose Visit (apart from paracetamol). Participants who have taken non-prescription medication may still be entered into the study, if, in the opinion of the Investigator, the medication received will not interfere with the study procedures or compromise safety;
  • Participant with a known hypersensitivity to PF-04995274 or any other serotonergic agents;
  • Participant with planned medical treatment within the study period that might interfere with the study procedures;
  • Participant who is unlikely to comply with the clinical study protocol or is unsuitable for any other reason, in the opinion of the Investigator.

Sites / Locations

  • University of Oxford

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

PF-04995274

Placebo

Arm Description

PF-04995274, three x 5mg tablet (15mg total), once daily for 7-9 days

3 placebo tablets, once daily for 7-9 days

Outcomes

Primary Outcome Measures

Facial Expression Recognition Task (FERT)
Facial expressions of basic emotions (happiness, fear, anger, disgust, sadness, surprise) are displayed on the screen and participants are asked to correctly classify them. Each emotion is presented at different intensity levels. Responses are made via a button-press and accuracy and reaction time are recorded.
Auditory Verbal Learning Task (AVLT)
Accuracy of recall on the auditory verbal learning task

Secondary Outcome Measures

Emotional Memory Task
Recall and recognition of affective words displayed earlier in the testing session is tested
Probabilistic Instrumental Learning Task (PILT)
Participants have to learn which shapes are associated with wins and losses and sensitivity to reward is assessed.

Full Information

First Posted
April 23, 2018
Last Updated
November 1, 2022
Sponsor
University of Oxford
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1. Study Identification

Unique Protocol Identification Number
NCT03515733
Brief Title
PF-04995274 and Emotional Processing in Treatment Resistant Depression
Acronym
RESTART
Official Title
The Effects of PF-04995274 on Emotional Processing in Treatment-resistant, Medicated, Depressed Patients
Study Type
Interventional

2. Study Status

Record Verification Date
July 2022
Overall Recruitment Status
Completed
Study Start Date
May 31, 2018 (Actual)
Primary Completion Date
July 26, 2022 (Actual)
Study Completion Date
July 26, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Oxford

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This study will test whether seven days adjunctive administration of a serotonin receptor subtype 4 (5HT4) agonist called PF-04995274 has positive effects on emotional processing and non-emotional cognition in medicated, treatment-resistant depressed patients compared to placebo.
Detailed Description
This study uses a double-blind, placebo-controlled, randomised between-groups design to test if adjunctive administration of a serotonin receptor subtype 4 (5HT4) agonist called PF-04995274 has positive effects on emotional processing and neural activity in medicated treatment-resistant depressed patients. Participants are patients who fulfill criteria for current episode of Major Depressive Disorder (MDD) and have shown lack of response to antidepressant treatment, and they will be randomised to receive 7 days treatment with either PF-04995274 (15 mg daily) or a matched placebo. Participants will come for a Screening Visit, a First Dose Visit, and a Research Visit (including measures of emotional processing and non-emotion cognition).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Depression, Unipolar, Treatment Resistant Depression

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Model Description
Participants will be randomly allocated to one of two groups (PF-04995264 or placebo) and receive their allocated study medication for 7 days.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
54 (Actual)

8. Arms, Groups, and Interventions

Arm Title
PF-04995274
Arm Type
Experimental
Arm Description
PF-04995274, three x 5mg tablet (15mg total), once daily for 7-9 days
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
3 placebo tablets, once daily for 7-9 days
Intervention Type
Drug
Intervention Name(s)
PF-04995274
Intervention Description
PF-04995274 tablets
Intervention Type
Drug
Intervention Name(s)
Placebo Oral Tablet
Intervention Description
Placebo tablet, identical appearance to experimental tablet
Primary Outcome Measure Information:
Title
Facial Expression Recognition Task (FERT)
Description
Facial expressions of basic emotions (happiness, fear, anger, disgust, sadness, surprise) are displayed on the screen and participants are asked to correctly classify them. Each emotion is presented at different intensity levels. Responses are made via a button-press and accuracy and reaction time are recorded.
Time Frame
Completed on Day 7
Title
Auditory Verbal Learning Task (AVLT)
Description
Accuracy of recall on the auditory verbal learning task
Time Frame
Completed on Day 7
Secondary Outcome Measure Information:
Title
Emotional Memory Task
Description
Recall and recognition of affective words displayed earlier in the testing session is tested
Time Frame
Completed on Day 7
Title
Probabilistic Instrumental Learning Task (PILT)
Description
Participants have to learn which shapes are associated with wins and losses and sensitivity to reward is assessed.
Time Frame
Completed on Day 7

10. Eligibility

Sex
All
Minimum Age & Unit of Time
16 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female; Aged 18-65 years; Willing and able to give informed consent for participation in the study; Sufficiently fluent English to understand and complete the tasks; Registered with a GP and consents to GP being informed of participation in study; Participants need to meet a number of concurrent clinical criteria: Current criteria for Major Depressive Disorder [as determined by the Structured Clinical interview for DSM-V (SCID)]; Failure within the current depressive episode to respond clinically to at least one course of antidepressant therapy, each given at a therapeutic dose for at least four weeks [as determined by use of the MGH Antidepressant Treatment Response Questionnaire (ATRQ)]; Currently taking an antidepressant, which must be either a Selective Serotonin Reuptake Inhibitor (SSRI) - with the exception of fluoxetine, paroxetine or fluvoxamine - or a Serotonin-norepinephrine reuptake inhibitor (SNRI) ; Participants currently taking excluded medications can be switched to sertraline or citalopram; Participants engaging in sex with a risk of pregnancy must agree to use a highly effective method of contraception from Screening Visit until 30 days after receiving study medication treatment, and male participants must not donate sperm. Exclusion Criteria: History of or current DSM-V bipolar disorder, schizophrenia or eating disorders. Participants who fulfil current criteria for other comorbid disorders may still be entered into the study, if, in the opinion of the Investigator, the psychiatric diagnosis will not compromise safety or affect data quality; First-degree relative with a diagnosis of Bipolar Disorder type 1; Participants currently taking strong cytochrome P450 (CYPs) enzymes inhibitors, such as fluoxetine, paroxetine or fluvoxamine (in order to avoid drug-drug interactions); Participants currently taking psychotropic medications which in the opinion of the investigator may interfere with the safety of the participant or the scientific integrity of the study; Participants who have previously failed a combination/augmentation therapy (i.e., therapy with the combination of two or more pharmacological agents) for the treatment of depression, which in the opinion of the Investigator may reduce the likelihood of responding; Electroconvulsive therapy for the treatment of the current episode of depression; Participants undergoing any form of face-to-face structured psychological treatment during the study; Clinically significant abnormal values for liver function tests, clinical chemistry, urine drug screen, blood pressure measurement and ECG. A participant with a clinical abnormality or parameters outside the reference range for the population being studied may be included only if the Investigator considers that the finding is unlikely to introduce additional risk factors and will not interfere with the study procedures; History of stimulant abuse (lifetime; e.g. amphetamine, cocaine), or of alcohol abuse within one year or of alcohol dependence within the lifetime; History of, or current medical conditions which in the opinion of the investigator may interfere with the safety of the participant or the scientific integrity of the study, including epilepsy/seizures, brain injury, severe hepatic or renal disease, severe gastro-intestinal problems, Central Nervous System (CNS) tumors, severe neurological problems (like Parkinson's Disease; blackouts requiring hospitalisation); Clinically significant risk of suicide; Current pregnancy (as determined by urine pregnancy test taken during Screening and First Dose Visits), breastfeeding or planning a pregnancy during the course of the study; Participant not willing to use a suitable method of contraception for 30 days after receiving study medication treatment; Participants with Body Mass Index (BMI - kg/m2) outside the 18 - 36 range at the Screening Visit; Night-shift working or recent travel involving significant change of timezones; Excessive caffeine consumption, i.e., consumption higher than 8 cups of standard caffeinated drinks (tea, instant coffee) or higher than 6 cups of stronger coffee or other drinks containing methylxanthines such as coca cola or Red Bull per day; Participation in a psychological or medical study involving the use of medication within the last 3 months; Previous participation in a study using the same, or similar, emotional processing tasks; Smoker > 10 cigarettes per day or similar levels of tobacco consumption in other forms. Participant received prescribed medication within 28 days prior to First Dose Visit (apart from their prescribed antidepressant and the contraceptive pill). Participants who have taken prescription medication may still be entered into the study, if, in the opinion of the Investigator, the medication received will not interfere with the study procedures or compromise safety; Participant received non-prescription medication, including supplements such as vitamins and herbal supplements within 48 hours prior to First Dose Visit (apart from paracetamol). Participants who have taken non-prescription medication may still be entered into the study, if, in the opinion of the Investigator, the medication received will not interfere with the study procedures or compromise safety; Participant with a known hypersensitivity to PF-04995274 or any other serotonergic agents; Participant with planned medical treatment within the study period that might interfere with the study procedures; Participant who is unlikely to comply with the clinical study protocol or is unsuitable for any other reason, in the opinion of the Investigator.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Catherine Harmer
Organizational Affiliation
University of Oxford
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Oxford
City
Oxford
State/Province
Oxfordshire
ZIP/Postal Code
OX3 7JX
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
32241310
Citation
Murphy SE, de Cates AN, Gillespie AL, Godlewska BR, Scaife JC, Wright LC, Cowen PJ, Harmer CJ. Translating the promise of 5HT4 receptor agonists for the treatment of depression. Psychol Med. 2021 May;51(7):1111-1120. doi: 10.1017/S0033291720000604. Epub 2020 Apr 3.
Results Reference
derived

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PF-04995274 and Emotional Processing in Treatment Resistant Depression

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