A Randomized, Double-Blind, Placebo-Controlled, Sequential Parallel Study of CERC-301 in the Adjunctive Treatment of Subjects With Severe Depression and Recent Active Suicidal Ideation Despite Antidepressant Treatment
Major Depressive Disorder
About this trial
This is an interventional treatment trial for Major Depressive Disorder
Eligibility Criteria
Inclusion Criteria:
- Male or female 18 to 70 years of age inclusive.
Females must be either:
- Post-menopausal (amenorrhea for at least 12 consecutive months), surgically sterile -or-
- Women of childbearing potential (WOCBP) meeting the criteria below:
i. Uses an acceptable double-barrier method of contraception as determined by the Investigator -and- ii. Is not lactating, has a negative serum beta human chorionic gonadotropin pregnancy test at screening and a negative urine pregnancy test prior to randomization on Day 0.
- Male subjects must agree to use a condom if partner is of childbearing potential.
- Diagnosis of MDD recurrent without psychotic features according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria with diagnosis confirmed using the Structured Clinical Interview for DSM-IV Axis I Disorders Clinical Trials Version (SCID-CT).
- Currently adhering to antidepressant drug regimen that consists of stable SSRI or SNRI therapy
- Inadequate antidepressant response to current antidepressant therapy despite adequate dose and duration
- HDRS-17 score ≥ 21 on the HDRS-17 performed by the site at screening
- Recent active suicidal ideation defined as a score of 2 on the intensity of ideation section on the Columbia-Suicide Severity Rating Scale (C-SSRS) during the four weeks prior to screening using the "Baseline/Screening" version of the C-SSRS.
- In otherwise good general health without any unstable medical conditions (as determined by medical history, physical examination, 12-lead ECG, clinical laboratory testing, etc.).
Exclusion Criteria:
- History of substance abuse or dependence within the 3 months prior to screening.
- Positive urine drug test at screening and prior to randomization on Day 0 unless due to a permitted medication that is documented in the subject's medication history.
- Positive ethanol breath test at screening and/or prior to randomization on Day 0.
- Elevated semi-recumbent blood pressure at screening and prior to randomization on Day 0, defined as systolic blood pressure > 140 mm Hg and diastolic blood pressure
- Active, comorbid disease that might limit the ability of the subject to participate in the study as determined by the Investigator (i.e. poorly controlled diabetes mellitus, unstable angina, coronary artery disease, congestive heart failure, etc.).
- Subjects with clinical laboratory test abnormality deemed clinically significant by the Investigator at screening.
- Axis I diagnosis of obsessive compulsive disorder, posttraumatic stress disorder, bipolar I or II mood disorders, eating disorders (e.g., anorexia nervosa, bulimia nervosa), psychotic disorders (e.g., schizoaffective disorder, schizophrenia), significant cognitive disorders (e.g., delirium, dementia, amnesia), or dissociative disorders.
- Subjects with Axis II diagnosis of borderline, antisocial, paranoid, schizoid, schizotypal, or histrionic personality disorder.
- Subjects with a neurologic disorder that could cause or contribute to depression (e.g., Alzheimer's disease, Parkinson's disease).
- Female subjects currently experiencing postpartum depression.
- Subjects who, in the opinion of the Investigator, are not appropriate for a 35-day placebo-controlled study due to risk of significant threat to self or others during screening or study conduct.
- Use of other NMDA-receptor modulators (e.g., dextromethorphan, ketamine, amantadine, memantine) within 30 days of screening and throughout the study.
The following concomitant medication use is excluded within six weeks prior to screening:
- Bupropion or tricyclic antidepressants
- Intermittent, symptomatic use of benzodiazepines (e.g. symptomatic treatment of anxiety or panic attacks)
- Antipsychotics
- Lithium
- Any medications known to directly interact with central or peripheral serotonergic receptors, other than the permitted antidepressants.
- Any medications known to directly interact with central noradrenergic receptors, other than the permitted antidepressants.
- Electroconvulsive therapy, transcranial magnetic stimulation, or vagal nerve stimulation during the current depressive episode.
- Participation in an investigational drug or device study within the 6 months prior to screening.
- Subjects with suicidal behavior within 6 months prior to screening as measured by the C-SSRS "Baseline/Screening" version.
- Subjects with a C-SSRS score > 2 on the intensity of ideation section at randomization (Visit 2a), using the "Since Last Visit" version of the C-SSRS.
Sites / Locations
- University of Alabama at Birmingham
- Arizona TMS Therapy Center
- ProScience Research Group
- Collaborative NeuroScience Network, Inc.
- Behavioral Research Specialists
- Synergy Clinical Research Center
- Pacific Clinical Trials, LLC
- Southern CA Psychiatrists
- Artemis Institute for Clinical Research
- Clinical Neuroscience Solutions
- Scientific Clinical Research, Inc.
- Clinical Neuroscience Solutions
- Atlanta Center for Medical Research
- Northwest Behavioral Research Center
- Chicago Psychiatry Associates
- Sheppard Pratt Health System
- PCRC
- Bioscience Research
- The Medical Research Network
- Finger Lakes Clinical Research
- Neuro-Behavioral Clinical Research, Inc.
- Suburban Research Associates
- FutureSearch Trials of Dallas
- Northwest Clinical Research Center
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Placebo Comparator
CERC-301, Treatment Sequence 1
CERC-301, Treatment Sequence 2
Placebo, Treatment Sequence 3
Treatment Sequence 1 - 7 days on placebo and 28 days on study drug (either 12mg or 8mg)
Treatment Sequence 2 - Placebo for 7 days and study drug for 28 days (8 mgs)
Treatment Sequence 3 - Placebo for 35 Day treatment period