A Study of Seltorexant Compared to Quetiapine XR as Adjunctive Therapy to Antidepressants in Adult and Elderly Participants With Major Depressive Disorder With Insomnia Symptoms Who Have Responded Inadequately to Antidepressant Therapy
Depressive Disorder, Major
About this trial
This is an interventional treatment trial for Depressive Disorder, Major
Eligibility Criteria
Inclusion Criteria:
- Meet diagnostic and statistical manual of mental disorders-5th edition (DSM-5) diagnostic criteria for major depressive disorder (MDD), without psychotic features, based upon clinical assessment and confirmed by the structured clinical interview for DSM-5 Axis I disorders-clinical trials version (SCID-CT) diagnosed with first depressive episode prior to age 60. The length of the current depressive episode must be less than or equal to (<=) 24 months
- Have had an inadequate response to at least 1 but no more than 2 antidepressants, administered at an adequate dose and duration in the current episode of depression. The current antidepressant cannot be the first antidepressant treatment for the first lifetime episode of depression. An inadequate response is defined as less than (<) 50 percent (%) reduction but with some improvement (that is, improvement greater than [>] 0%) in depressive symptom severity with residual symptoms present other than insomnia, and overall good tolerability, as assessed by the Massachusetts General Hospital-Antidepressant Treatment Response Questionnaire (MGH-ATRQ)
- Is receiving and tolerating well any one of the following selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI) for depressive symptoms at screening, in any formulation and available in the participating country: citalopram, duloxetine, escitalopram, fluvoxamine, fluoxetine, milnacipran, levomilnacipran, paroxetine, sertraline, venlafaxine, desvenlafaxine, vilazodone, or vortioxetine at a stable dose (at or above therapeutic dose level) for at least 6 weeks, and for no greater than 18 months in the current episode
- Have a hamilton depression rating scale (HDRS)-17 total score greater than or equal to (>=) 20 at the first screening interview, must not demonstrate a clinically significant improvement (that is, an improvement of > 20% on their HDRS-17 total score) from the first to the second independent HDRS-17 rating, and must have a HDRS-17 total score >18 at the second screening interview
- Have a patient version insomnia severity index (ISI) total score >= 15 as well as a clinician version of the ISI total score >= 15 at the second screening visit
- Body mass index (BMI) between 18 and 40 kilogram per meter square (kg/m^2), inclusive (BMI=weight/height^2)
- Participant must be medically stable on the basis of the following: physical examination, vital signs (including blood pressure), and 12-lead electrocardiogram (ECG) performed at screening and baseline
Exclusion Criteria:
- Has a recent (last 3 months) history of, or current signs and symptoms of, severe renal insufficiency (creatinine clearance [CrCl] less than [<] 30 milliliter per minute [mL/min]); clinically significant or unstable cardiovascular, respiratory, gastrointestinal, neurologic, hematologic, rheumatologic, immunologic or endocrine disorders. uncontrolled Type 1 or Type 2 diabetes mellitus
- Has a history of treatment-resistant MDD, defined as a lack of response to 2 or more adequate antidepressant treatments in the current episode, as indicated by no or minimal (<25% improvement in symptoms) when treated with an antidepressant of adequate dose (per MGH-ATRQ) and duration (at least 6 weeks)
- Has history or current diagnosis of a psychotic disorder, bipolar disorder, intellectual disability, autism spectrum disorder, borderline personality disorder, somatoform disorders
- Has a history of moderate to severe substance use disorder including alcohol use disorder according to DSM-5 criteria within 6 months before screening
- Has any significant primary sleep disorder, including but not limited to obstructive sleep apnea, restless leg syndrome, or parasomnias. Participants with insomnia disorder are allowed
Sites / Locations
- University of Alabama at BirminghamRecruiting
- SW Biomedical Research, LLCRecruiting
- Proscience Research GroupRecruiting
- Pharmacology Research Institute
- Collaborative NeuroScience Network
- Collaborative NeuroScience Network
- Pharmacology Research Institute
- CalNeuro Research
- Pharmacology Research Institute
- NRC Research InstituteRecruiting
- Pacific Neuropsychiatric SpecialistsRecruiting
- CNRI-Los Angeles, LLCRecruiting
- Prospective Research Innovations, Inc.Recruiting
- Anderson Clinical Research
- University of California at San DiegoRecruiting
- National Research InstituteRecruiting
- CI Trials
- CMB Clinical TrialsRecruiting
- Schuster Medical Research Institute
- Pacific Clinical Research Medical GroupRecruiting
- Hartford Hospital
- Moonshine Research Center, Inc
- Velocity Clinical Research, Hallandale BeachRecruiting
- Indago Research & Health Center IncRecruiting
- New Life Medical Research Center, Inc.Recruiting
- Amedica Research Institute, Inc.
- Meridien Research
- Premier Clinical ResearchRecruiting
- Global Medical InstitutesRecruiting
- Miami Jewish Health System
- Clinical Neuroscience SolutionsRecruiting
- Synexus Research Orlando
- University of South FloridaRecruiting
- Compass Research LLC-Bioclinica Research
- Synexus Clinical Research US, IncRecruiting
- Atlanta Center for Medical ResearchRecruiting
- iResearch Atlanta LLCRecruiting
- Psych Atlanta, P.C.
- Chicago Research Center
- Capstone Clinical Research
- Alexian Brothers Health SystemRecruiting
- Baber Research GroupRecruiting
- Lemah Creek Clinical ResearchRecruiting
- Ascension via Christi ResearchRecruiting
- Riverstar Research
- Pharmasite Research, Inc.Recruiting
- BTC of New BedfordRecruiting
- Boston Clinical Trials & Medical ResearchRecruiting
- Psychiatric Care and Research Center (PCRC)Recruiting
- Bio Behavioral HealthRecruiting
- SPRI Clinical Trials, LLCRecruiting
- Fieve Clinical Research, Inc.Recruiting
- The Medical Research Network, LLC
- Finger Lakes Clinical ResearchRecruiting
- Richmond Behavioral AssociatesRecruiting
- Velocity Clinical Research, Inc.
- University of Cincinnati, Dept of Psychiatry & Behavioral NeuroscienceRecruiting
- Midwest Clinical Research Center
- Neuro-Behavioral Clinical ResearchRecruiting
- Sooner Clinical ResearchRecruiting
- Paradigm Research Professionals, LLC
- Suburban Research AssociatesRecruiting
- Global Medical Institutes
- Coastal Carolina Research Center
- West Houston Clinical Research ServiceRecruiting
- North Texas Clinical TrialsRecruiting
- Hawkins Psychiatry, PCRecruiting
- Family Psychiatry of The WoodlandsRecruiting
- Grayline Research CenterRecruiting
- Alpine Research OrganizationRecruiting
- Cedar Clinical ResearchRecruiting
- University of VirginiaRecruiting
- Northwest Clinical Research CenterRecruiting
- Core Clinical ResearchRecruiting
- Cary J. Kohlenberg, MD, SC, dba, IPC Research.
- CENydET - Centro Neurobiologico y de Stress Traumatico
- Hospital FleniRecruiting
- Hospital ItalianoRecruiting
- FunDaMosRecruiting
- Fundacion LennoxRecruiting
- Instituto Privado Kremer
- Centro Medico LuquezRecruiting
- CENPIARecruiting
- Clinica Privada de Salud Mental Santa Teresa de ÁvilaRecruiting
- CENAINRecruiting
- Clinica Mayo de UMCBRecruiting
- AZ Sint-LucasRecruiting
- AZ NikolaasRecruiting
- Medical Center Medconsult-PlevenRecruiting
- MC 'Hipokrat - N', EOODRecruiting
- Mental Health Center - RousseRecruiting
- Medical Center St. NaumRecruiting
- Medical Center Intermedica, OODRecruiting
- MC 'Synexus Sofia' EOOD
- MC 'Synexus Sofia' EOOD
- UMHAT Prof. Dr. St. Kirkovich ADRecruiting
- State Psychiatric Hospital - Tzarev Brod
- Diagnostic Consulting Center Mladost - M VarnaRecruiting
- Mental Health Center - Veliko Tarnovo EOODRecruiting
- A.K. Munshi Medical Inc.
- Canadian Phase Onward
- Clinique Force Medic (GCP Trials)
- Psychiatricka ambulance Saint Anne s.r.o.Recruiting
- NeuropsychiatrieHK, s.r.o.
- A-Shine s.r.o.
- Clintrial s.r.o.
- AD71 s.r.o.Recruiting
- NeuropsychiatrieHK, s.r.o.Recruiting
- Institut Neuropsychiatricke peceRecruiting
- The Mental Hospital of Jelgava Ģintermuiža - PsychiatryRecruiting
- L. Keruze Practice in PsychiatryRecruiting
- Hospital of RezekneRecruiting
- Riga Centre of Psychiatry and NarcologyRecruiting
- Kaunas Silainiu Outpatient Clinic, Public Institution
- Republic Kaunas HospitalRecruiting
- Romuvos Klinika, JSCRecruiting
- Hospital of Lithuanian University of Health Sciences Kaunas ClinicsRecruiting
- Medical Center Puriena JSC
- Zirmunai Mental Health Center, Public Institution
- Antakalnis Psychiatric Consultation Centre, Public Institution
- Vilnius Mental Health CenterRecruiting
- Hospital Raja Permaisuri BainunRecruiting
- Hospital PermaiRecruiting
- Hospital Pulau PinangRecruiting
- Hospital Tuanku JaafarRecruiting
- Gabinet Lekarski Psychiatryczny Ireneusz KaczorowskiRecruiting
- Wlokiennicza MED Specjalistyczna Praktyka Lekarska dr n.med. Tomasz MarkowskiRecruiting
- Przychodnia Srodmiescie SP. z o.o.Recruiting
- Centrum Badań Klinicznych PI-House sp. z o.o.Recruiting
- Specjalistyczna Indywidualna Praktyka LekarskaRecruiting
- CCBR - Lodz - PL
- Specjalistyczna Praktyka Lekarska Marek DomanskiRecruiting
- Synexus Polska Sp. z.o.o. Oddzial w PoznaniuRecruiting
- Instytut Psychiatrii I NeurologiiRecruiting
- Specjalistyczny Osrodek Medycyny Wieku Dojrzalego Sp z o.o.
- Sverdlov Regional Psychiatric Clinical Hospital
- Engels psychiatric hospital
- Kemerovo Regional Clinical Psychiatric Hospital
- GUZ Lipetsk Regional psychoneurological Hospital #1
- JSC Scientific Centre of Personalized Medicine
- FSI Moscow SRI of Psychiatry of Minzdravsocrazvitia
- Moscow Scientific Research Institute of Psychiatry
- Clinical Psychiatry Hospital n.a. N.N. Solodovnikov
- St-Petersburg Bekhterev Psychoneurological Research Institute
- Klinika StoLet Ltd
- General Hospital Acibadem Bel MedicRecruiting
- General Hospital EuromedikRecruiting
- Institute of Mental Health SerbiaRecruiting
- University Clinical Center of SerbiaRecruiting
- University Clinical Hospital Center Dr Dragisa Misovic- DediRecruiting
- Special Neuropsychiatric Hospital KovinRecruiting
- University Clinical Center KragujevacRecruiting
- Clinical Center NisRecruiting
- Specialized Hospital for Neuropsychiatric Diseases Sveti VraceviRecruiting
- Psychomed-Svatosavsky, s.r.o.Recruiting
- Nemocnica s poliklinikou Prievidza so sidlom v BojniciachRecruiting
- Epamed sroRecruiting
- Liptovska Nemocnica S Poliklinikou Mudr. Ivana StodoluRecruiting
- Psychiatricka Ambulancia Psycholine S.R.O.Recruiting
- FN TrencinRecruiting
- Pro mente sana s.r.o.
- Fakultna nemocnica s poliklinikou v Ziline
- MNCE of Kyiv RC Regional Psychiatric and Narcological Medical Association
- Mnpe of Kharkiv Regional Council 'Regional Clinical Psychiatric Hospital #3'
- Kyiv Territorial Medical Incorporation 'Psychiatry'
- Railway Clinical Hospital #1 of Kiev Railway station of DTGO 'South-Western Railway'
- Medical Center Health and Happy
- Mnpe 'Regional Clinical Psychiatric Hospital of Kirovohrad Regional Council'
- Ternopil RCCPH Depts of Psychiatry #2 (m) & Psychiatry #4 (f) Ternopil I.Ya. Gorbachevskyi SMU
- Zaporizhzhia Regional Clinical Hospital
- Kingsway HospitalRecruiting
- Synexus
- Garden Valleys Resource CentreRecruiting
- Kings College Hospital NHS TrustRecruiting
- Cornwall Partnership Foundation TrustRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Seltorexant
Quetiapine Extended-Release (XR)
Adult participants will receive seltorexant once daily from Day 1-7 and together with matching placebo from Day 8 till Day 182. Elderly participants will receive seltorexant once daily from Day 1-3 and together with matching placebo from Day 4 till Day 182.
Adult participants will receive quetiapine XR once daily from Day 1-2, followed by an increase in dose from Day 3-7, and from Day 8-14 together with matching placebo. After Day 14, quetiapine XR twice daily from Day 14 till Day 182. Elderly participants will receive quetiapine XR once daily from Day 1-3 and twice from Day 4-7, followed by an increase in dose once daily from Day 8-14 together with matching placebo. After Day 14 till Day 182, quetiapine XR will be adjusted by investigator based on the participant's clinical response and tolerability.