A New Treatment Approach for Major Depressive Disorder Based Upon Targeting Monoamine Oxidase A (MAO-A)
Primary Purpose
Major Depressive Disorder
Status
Completed
Phase
Early Phase 1
Locations
Canada
Study Type
Interventional
Intervention
Sertraline
Citalopram
N-acetylcysteine (NAC)
Existing depression medication treatment
Sponsored by
About this trial
This is an interventional treatment trial for Major Depressive Disorder
Eligibility Criteria
Inclusion Criteria:
- DSM-IV diagnosis of current major depressive episode and major depressive disorder
- Hamilton Depression Rating Scale score of at least 20
Exclusion Criteria:
- Comorbid axis I or II disorders
- Antidepressant use in past 6 months
- Current use of herbal remedies
- Cigarette smoking
- Drug or medication use within past 8 weeks
- History of substance abuse/neurotoxin use
- History of psychotic symptoms
- History of CNS medical illness
- Current substance use
- Test positive on pregnancy test (women)
Sites / Locations
- Research Imaging Centre, Centre for Addiction and Mental Health
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Experimental
Experimental
Arm Label
Sertraline and n-acetylcysteine
Citalopram and n-acetylcysteine
Existing medication treatment & NAC
Arm Description
Sertraline and n-acetylcysteine for seven weeks of treatment
Citalopram and n-acetylcysteine for seven weeks of treatment
Existing depression medication treatment and n-acetylcysteine for seven weeks of treatment
Outcomes
Primary Outcome Measures
MAO-A distribution volume with positron emission tomography
Treatment take 1 week for titration and 6 weeks at full dose=7weeks average
Secondary Outcome Measures
Hamilton Depression Rating Scale Score
Treatment takes 1 week for titration and 6 weeks at full dose=7 weeks average
Magnetic Resonance Spectroscopy (n-acetylaspartate and glutathione levels)
Treatment takes 1 week for titration and 6 weeks at full dose=7 weeks average
Blood markers of monoamine oxidase-A fragment level and glutathione level
Treatment takes 1 week for titration and 6 weeks at full dose=7 weeks average
Full Information
NCT ID
NCT02269540
First Posted
August 11, 2014
Last Updated
May 22, 2019
Sponsor
Centre for Addiction and Mental Health
1. Study Identification
Unique Protocol Identification Number
NCT02269540
Brief Title
A New Treatment Approach for Major Depressive Disorder Based Upon Targeting Monoamine Oxidase A (MAO-A)
Official Title
A New Biomarker-Based Approach Towards Developing Improved Treatment for Major Depressive Disorder (MDD) Based Upon Targeting Monoamine Oxidase A (MAO-A)
Study Type
Interventional
2. Study Status
Record Verification Date
May 2019
Overall Recruitment Status
Completed
Study Start Date
October 2014 (undefined)
Primary Completion Date
June 2018 (Actual)
Study Completion Date
July 2018 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Centre for Addiction and Mental Health
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The investigators will be looking at MAO-A density before and after seven weeks of treatment with an antidepressant and dietary supplement. MAO-A is an enzyme that breaks down brain chemicals that regulate mood. MAO-A density is elevated in patients with major depressive episodes (MDE) secondary to major depressive disorder (MDD). Many remain treatment resistant with common antidepressant treatments and we think it may be due to poor targeting of brain pathologies. We want to test if adding a dietary supplement may normalize MAO-A.
Detailed Description
All subjects are getting the combined treatment of a selective serotonin reuptake inhibitor and the dietary supplement. There are two possible selective serotonin reuptake inhibitor treatments but the dietary supplement remains the same. No subjects are receiving the selective serotonin reuptake inhibitor alone and no subjects are receiving the dietary supplement alone. The dietary supplement is called n-acetylcysteine.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Major Depressive Disorder
7. Study Design
Primary Purpose
Treatment
Study Phase
Early Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
10 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Sertraline and n-acetylcysteine
Arm Type
Experimental
Arm Description
Sertraline and n-acetylcysteine for seven weeks of treatment
Arm Title
Citalopram and n-acetylcysteine
Arm Type
Experimental
Arm Description
Citalopram and n-acetylcysteine for seven weeks of treatment
Arm Title
Existing medication treatment & NAC
Arm Type
Experimental
Arm Description
Existing depression medication treatment and n-acetylcysteine for seven weeks of treatment
Intervention Type
Drug
Intervention Name(s)
Sertraline
Other Intervention Name(s)
Zoloft
Intervention Description
selective serotonin reuptake inhibitor
Intervention Type
Drug
Intervention Name(s)
Citalopram
Other Intervention Name(s)
Celexa
Intervention Description
selective serotonin reuptake inhibitor
Intervention Type
Drug
Intervention Name(s)
N-acetylcysteine (NAC)
Intervention Description
natural health product
Intervention Type
Drug
Intervention Name(s)
Existing depression medication treatment
Intervention Description
Continuation of depression medication treatment already taken prior to study enrollment except for drugs with affinity for MAO-A or potentially influencing MAO-A levels, including phenelzine, tranylcypromine, moclobemide, cytomel and lithium
Primary Outcome Measure Information:
Title
MAO-A distribution volume with positron emission tomography
Description
Treatment take 1 week for titration and 6 weeks at full dose=7weeks average
Time Frame
before and after treatment, 7 weeks on average between measures
Secondary Outcome Measure Information:
Title
Hamilton Depression Rating Scale Score
Description
Treatment takes 1 week for titration and 6 weeks at full dose=7 weeks average
Time Frame
before and after treatment, 7 weeks on average between measures
Title
Magnetic Resonance Spectroscopy (n-acetylaspartate and glutathione levels)
Description
Treatment takes 1 week for titration and 6 weeks at full dose=7 weeks average
Time Frame
before and after treatment, 7 weeks on average between measures
Title
Blood markers of monoamine oxidase-A fragment level and glutathione level
Description
Treatment takes 1 week for titration and 6 weeks at full dose=7 weeks average
Time Frame
before and after treatment, 7 weeks on average between measures
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
49 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
DSM-IV diagnosis of current major depressive episode and major depressive disorder
Hamilton Depression Rating Scale score of at least 20
Exclusion Criteria:
Comorbid axis I or II disorders
Antidepressant use in past 6 months
Current use of herbal remedies
Cigarette smoking
Drug or medication use within past 8 weeks
History of substance abuse/neurotoxin use
History of psychotic symptoms
History of CNS medical illness
Current substance use
Test positive on pregnancy test (women)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jeffrey H Meyer, MD, PhD
Organizational Affiliation
Centre for Addiction and Mental Health; University of Toronto
Official's Role
Principal Investigator
Facility Information:
Facility Name
Research Imaging Centre, Centre for Addiction and Mental Health
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5T 1R8
Country
Canada
12. IPD Sharing Statement
Links:
URL
http://www.camh.ca/en/research
Description
The Centre for Addiction and Mental Health (CAMH) is the leading mental health and addictions research facility in Canada, and one of the largest in the world.
Learn more about this trial
A New Treatment Approach for Major Depressive Disorder Based Upon Targeting Monoamine Oxidase A (MAO-A)
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