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Efficacy and Safety Study of Org 50081 (Esmirtazapine) in Elderly Participants (P05709)

Primary Purpose

Insomnia, Sleep Initiation and Maintenance Disorders, Mental Disorders

Status
Completed
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Esmirtazapine
Placebo
Sponsored by
Merck Sharp & Dohme LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Insomnia focused on measuring elderly, randomized, placebo controlled

Eligibility Criteria

65 Years - undefined (Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • are at least 65 years of age at screening;
  • sign written informed consent after the scope and

nature of the investigation have been explained to

them, before screening evaluations;

  • are able to speak, read and understand the language of

the investigator, study staff (including raters) and the

informed consent form, and possess the ability to

respond to questions, follow instructions and complete

questionnaires;

  • have demonstrated capability to independently

complete the LogPad questionnaires and have

completed the questionnaires at least 6 out of 7 days of

the week preceding randomization;

  • have a regular sleep pattern, meaning bedtime regularly

occurs between 2100 hours and 2400 hours, with no more variation

from these boundaries than 2 times/ week, with 5-8.5

hours in bed;

  • have a documented diagnosis of chronic primary

insomnia, defined as fulfillment of the Diagnostic and Statistical Manual of Mental Disorders IV - Text Revision (DSM-IV-TR) criteria

for primary insomnia (DSM-IV-TR 307.42) with a duration

of >= 1 month; fulfill the following PSG criteria on the

two screening/baseline PSG nights:

  • average Total Sleep Time (TST) < 6.5 h (and each night greater than or

equal to 3 h and < 7 h),

  • average WASO greater than or equal to 45 minutes

(and each night greater than or equal to 30 min),

  • average Latency to Persistent Sleep (LPS) 15 min (and each night greater than or

equal to 10 min).

Exclusion Criteria:

  • have other sleep disorders (DSM-IV-TR), such as sleep

related breathing disorders Apnea-Hypopnea Index (AHI) greater than or equal

to 15), Periodic Leg Movements with Arousals Index (PLMAI)

greater than or equal to 10), restless leg syndrome,

narcolepsy, circadian sleep wake rhythm disorders,

Rapid Eye Movement (REM) behavioral disorder or any parasomnia;

  • have any significant medical or DSM-IV-TR

psychiatric illness causing the sleep disturbances;

  • currently meet diagnostic criteria for DSM-IV-TR

depression Major Depressive Disorder (MDD) or have been diagnosed and treated

for MDD within the last 2 years;

  • have a history of bipolar disorder, a history of suicide attempt or a family history of suicide. A family history of suicide is defined as any history of suicide in the first and second degree family (parents, siblings, grandparents, or offspring), or a pattern of completed suicides (more than one) in the third degree family (aunts, uncles, nieces and nephews);
  • have a history or signs of dementia or other serious

cognitive impairment, as defined by a score of less than

26 on the Mini-Mental State Examination;

  • have a significant, unstable medical illness e.g. acute or

chronic pain, hepatic, renal, metabolic or cardiac

disease;

  • had serious head injury or stroke within the past year,

or a history of (non-febrile) seizures;

  • have clinically relevant electrocardiogram (ECG) abnormalities at

screening, as judged by the investigator;

  • have clinically relevant abnormal hematology or

biochemistry values at screening, as judged by the

investigator;

  • have DSM-IV-TR substance abuse or DSM-IV-TR

addiction within the last year;

  • drink more than 2 alcoholic drinks in a day. One drink is approximately equal to: 12 oz or 360 ml of beer (regular or light), or 4 oz or 120 ml of red or white wine, or 2 oz or 60 ml of desert wine (e.g. port, sherry), or 12 oz or 360 ml of wine cooler (regular or light), or 1 oz or 30 ml or spirits (80 to 100 proof, e.g. whiskey, vodka);
  • are routinely sleeping during daytime (napping) for more than 20 minutes per day, 3 days or more per week;
  • are night workers or rotating shift workers currently, or in the past 6 months
  • use of psychotropic drugs affecting sleep within two weeks prior to randomization (fluoxetine: five weeks);
  • use of concomitant medication affecting sleep (e.g. anxiolytics, sedatives, antidepressants, antipsychotics, centrally active sedating antihistamines, central nervous system (CNS)

stimulants, alpha-2-antagonists, respiratory stimulants and decongestants);

  • smoke > 15 cigarettes per day and/or can not abstain from smoking during the night;
  • drink excessive amounts of caffeinated beverages/day (more than 500 mg caffeine per day);
  • have a body mass index (BMI) >= 36;
  • have a positive urine drug screen at screening or at baseline;
  • have a known hypersensitivity to mirtazapine or to any of the excipients;

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm Type

    Experimental

    Experimental

    Experimental

    Placebo Comparator

    Arm Label

    Esmirtazapine 0.5 mg

    Esmirtazapine 1.5 mg

    Esmirtazapine 3.0 mg

    Placebo

    Arm Description

    one placebo tablet daily for 14 days, followed by one 0.5 mg tablet Esmirtazapine daily for 16 days, and then one placebo tablet daily for 7 days

    one placebo tablet daily for 14 days, followed by one 1.5 mg tablet Esmirtazapine daily for 16 days, and then one placebo tablet daily for 7 days

    one placebo tablet daily for 14 days, followed by one 3.0 mg tablet Esmirtazapine daily for 16 days, and then one placebo tablet daily for 7 days

    one placebo tablet daily for 14 days, followed by one placebo tablet daily for 16 days, and then one placebo tablet daily for 7 days

    Outcomes

    Primary Outcome Measures

    Average Wake Time After Sleep Onset Measured by Polysomnography
    Wake time after sleep onset (WASO) is the total time awake between sleep onset and "lights on"; i.e. from the onset of persistent sleep until the end of the 8-hour polysomnography (PSG) recording. PSG assesses the quality of sleep by monitoring brain waves, breathing, heart function, muscle activity and eye movement. PSG measurements of WASO (observed data only) taken during the 16-day double-blind treatment period, over days 1 and 2 and days 15 and 16, were averaged.

    Secondary Outcome Measures

    Average Latency to Persistent Sleep Measured by Polysomnography
    Latency to Persistent Sleep (LPS) is the time from lights out to the first 20 consecutive epochs scored as sleep by PSG. PSG assesses the quality of sleep by monitoring brain waves, breathing, heart function, muscle activity and eye movement. PSG measurements of LPS (observed data only) taken during the 16-day double-blind treatment period, over days 1 and 2 and days 15 and 16, were averaged.
    Average Total Sleep Time Measured by Polysomnography
    Total sleep time (TST) is the sleep time recorded by PSG. PSG assesses the quality of sleep by monitoring brain waves, breathing, heart function, muscle activity and eye movement. PSG measurements of TST (observed data only) taken during the 16-day double-blind treatment period, over days 1 and 2 and days 15 and 16, were averaged.
    Average Number of Awakenings Measured by Polysomnography
    Number of awakenings (NAW) was measured by PSG. PSG assesses the quality of sleep by monitoring brain waves, breathing, heart function, muscle activity and eye movement. PSG measurements of NAW (observed data only) taken during the 16-day double-blind treatment period, over days 1 and 2 and days 15 and 16, were averaged.
    Average Wake Time After Sleep Onset in the First Quarter of the Night Measured by Polysomnography
    Wake time after sleep onset (WASO) is the total time awake between sleep onset and "lights on"; i.e. from the onset of persistent sleep until the end of the 8-hour PSG recording. WASO was recorded in the first quarter of the night, for at most 2 hours, by PSG. PSG assesses the quality of sleep by monitoring brain waves, breathing, heart function, muscle activity and eye movement. PSG measurements of WASO (observed data only) taken during the 16-day double-blind treatment period, over days 1 and 2 and days 15 and 16, were averaged.
    Average Wake Time After Sleep Onset in the Second Quarter of the Night Measured by Polysomnography
    Wake time after sleep onset (WASO) is the total time awake between sleep onset and "lights on"; i.e. from the onset of persistent sleep until the end of the 8-hour PSG recording. WASO was recorded in the second quarter of the night, for at most 2 hours, by PSG. PSG assesses the quality of sleep by monitoring brain waves, breathing, heart function, muscle activity and eye movement. PSG measurements of WASO (observed data only) taken during the 16-day double-blind treatment period, over days 1 and 2 and days 15 and 16, were averaged.
    Average Wake Time After Sleep Onset in the Third Quarter of the Night Measured by Polysomnography
    Wake time after sleep onset (WASO) is the total time awake between sleep onset and "lights on"; i.e. from the onset of persistent sleep until the end of the 8-hour PSG recording. WASO was recorded in the third quarter of the night, for at most 2 hours, by PSG. PSG assesses the quality of sleep by monitoring brain waves, breathing, heart function, muscle activity and eye movement. PSG measurements of WASO (observed data only) taken during the 16-day double-blind treatment period, over days 1 and 2 and days 15 and 16, were averaged.
    Average Wake Time After Sleep Onset in the Fourth Quarter of the Night Measured by Polysomnography
    Wake time after sleep onset (WASO) is the total time awake between sleep onset and "lights on"; i.e. from the onset of persistent sleep until the end of the 8-hour PSG recording. WASO was recorded in the fourth quarter of the night, for at most 2 hours, by PSG. PSG assesses the quality of sleep by monitoring brain waves, breathing, heart function, muscle activity and eye movement. PSG measurements of WASO (observed data only) taken during the 16-day double-blind treatment period, over days 1 and 2 and days 15 and 16, were averaged.
    Average Number of Stage Shifts to Stage 1 or Wake Measured by Polysomnography
    Number of stage shifts to stage 1 of sleep or to awaken was measured by PSG. A stage shift is the transition measured by PSG between various sleep stages. PSG assesses the quality of sleep by monitoring brain waves, breathing, heart function, muscle activity and eye movement. PSG measurements of the number of stage shifts (observed data only) taken during the 16-day double-blind treatment period, over days 1 and 2 and days 15 and 16, were averaged.
    Average Subjective Total Sleep Time Based on Sleep Diary
    Total Sleep Time (TST) is a subjective time (observed data only) recorded daily by the participant in an electronic diary, that was averaged over the entire 16-day, double-blind treatment period.
    Average Subjective Sleep Latency Based on Sleep Diary
    Sleep latency (SL) is the time taken to fall asleep (observed data only) recorded daily by the participant in an electronic diary, that was averaged over the entire 16-day, double-blind treatment period.
    Average Subjective Number of Awakenings Based on Sleep Diary
    Number of awakenings between sleep onset and final awakening (NAW) is a subjective number (observed data only) recorded daily by the participant in an electronic diary, that was averaged over the entire 16-day, double-blind treatment period.
    Average Subjective Wake Time After Sleep Onset Based on Sleep Diary
    Wake Time after Sleep Onset (WASO) is after falling asleep initially, the subjective time that the participant was awake during the night. Daily recordings by the participant in an electronic diary (observed data only), were averaged over the entire 16-day, double-blind treatment period.
    Average Subjective Quality of Sleep Based on Sleep Diary
    Quality of Sleep (QS) is a subjective number on a Visual Analog Scale ranging from 0 to 100, where very poor is rated at 0, up to excellent, rated at 100. Daily recordings by the participant in an electronic diary (observed data only) were averaged over the entire 16-day, double-blind treatment period.
    Average Subjective Satisfaction of Sleep Duration Based on Sleep Diary
    Satisfaction of Sleep Duration (SSD) is a subjective number on a Visual Analog Scale ranging from 0 to 100, where very unsatisfied is rated at 0, up to fully satisfied, rated at 100. Daily recordings by the participant in an electronic diary (observed data only) were averaged over the entire 16-day, double-blind treatment period.
    Number of Participants With an Adverse Event During the 16 Day, Double-blind Treatment Period
    An Adverse Event (AE) is any untoward occurrence in a participant who is administered any pharmaceutical product, and which does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding) symptom, or disease temporarily associated with the use of an investigational medicinal product (IMP), whether or not it is related to the IMP.
    Number of Participants Who Discontinued Treatment Due to an Adverse Event During the 16 Day, Double-blind Treatment Period
    An AE is any untoward occurrence in a participant who is administered any pharmaceutical product, and which does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding) symptom, or disease temporarily associated with the use of an IMP, whether or not it is related to the IMP.

    Full Information

    First Posted
    November 19, 2007
    Last Updated
    September 4, 2018
    Sponsor
    Merck Sharp & Dohme LLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00561821
    Brief Title
    Efficacy and Safety Study of Org 50081 (Esmirtazapine) in Elderly Participants (P05709)
    Official Title
    A Double-Blind, Randomized, Parallel Group, Placebo- Controlled Sleep Laboratory Efficacy and Safety Study With Org 50081 in Elderly Subjects With Chronic Primary Insomnia
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2018
    Overall Recruitment Status
    Completed
    Study Start Date
    November 20, 2007 (Actual)
    Primary Completion Date
    December 21, 2009 (Actual)
    Study Completion Date
    December 21, 2009 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Merck Sharp & Dohme LLC

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    This study was conducted to investigate the efficacy of treatment with Org 50081 (Esmirtazapine) compared to placebo in elderly participants with chronic primary insomnia. Primary efficacy variable is Wake time After Sleep Onset (WASO), averaged over all in-treatment time points and measured by polysomnography (PSG).
    Detailed Description
    Insomnia is a common complaint or disorder throughout the world. About one third of the population in the industrial countries reports difficulty initiating or maintaining sleep, resulting in a non-refreshing or non-restorative sleep. The majority of the insomniacs suffer chronically from their complaints. The maleic acid salt of Org 4420, code name Org 50081, known as Esmirtazapine, was selected for development in the treatment of insomnia. The first clinical trial with Esmirtazapine was a proof-of-concept trial with a four-way cross-over design. All 3 Esmirtazapine dose groups showed a statistically significant positive effect on TST (objective and subjective) and WASO, as compared to placebo. The current study is designed to assess the efficacy and safety of Esmirtazapine in a double-blind, placebo-controlled, parallel, randomized trial in elderly participants suffering from chronic primary insomnia.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Insomnia, Sleep Initiation and Maintenance Disorders, Mental Disorders, Dyssomnias, Sleep Disorders
    Keywords
    elderly, randomized, placebo controlled

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    538 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Esmirtazapine 0.5 mg
    Arm Type
    Experimental
    Arm Description
    one placebo tablet daily for 14 days, followed by one 0.5 mg tablet Esmirtazapine daily for 16 days, and then one placebo tablet daily for 7 days
    Arm Title
    Esmirtazapine 1.5 mg
    Arm Type
    Experimental
    Arm Description
    one placebo tablet daily for 14 days, followed by one 1.5 mg tablet Esmirtazapine daily for 16 days, and then one placebo tablet daily for 7 days
    Arm Title
    Esmirtazapine 3.0 mg
    Arm Type
    Experimental
    Arm Description
    one placebo tablet daily for 14 days, followed by one 3.0 mg tablet Esmirtazapine daily for 16 days, and then one placebo tablet daily for 7 days
    Arm Title
    Placebo
    Arm Type
    Placebo Comparator
    Arm Description
    one placebo tablet daily for 14 days, followed by one placebo tablet daily for 16 days, and then one placebo tablet daily for 7 days
    Intervention Type
    Drug
    Intervention Name(s)
    Esmirtazapine
    Intervention Description
    one tablet daily
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo
    Intervention Description
    one tablet daily
    Primary Outcome Measure Information:
    Title
    Average Wake Time After Sleep Onset Measured by Polysomnography
    Description
    Wake time after sleep onset (WASO) is the total time awake between sleep onset and "lights on"; i.e. from the onset of persistent sleep until the end of the 8-hour polysomnography (PSG) recording. PSG assesses the quality of sleep by monitoring brain waves, breathing, heart function, muscle activity and eye movement. PSG measurements of WASO (observed data only) taken during the 16-day double-blind treatment period, over days 1 and 2 and days 15 and 16, were averaged.
    Time Frame
    Up to Day 16
    Secondary Outcome Measure Information:
    Title
    Average Latency to Persistent Sleep Measured by Polysomnography
    Description
    Latency to Persistent Sleep (LPS) is the time from lights out to the first 20 consecutive epochs scored as sleep by PSG. PSG assesses the quality of sleep by monitoring brain waves, breathing, heart function, muscle activity and eye movement. PSG measurements of LPS (observed data only) taken during the 16-day double-blind treatment period, over days 1 and 2 and days 15 and 16, were averaged.
    Time Frame
    Up to Day 16
    Title
    Average Total Sleep Time Measured by Polysomnography
    Description
    Total sleep time (TST) is the sleep time recorded by PSG. PSG assesses the quality of sleep by monitoring brain waves, breathing, heart function, muscle activity and eye movement. PSG measurements of TST (observed data only) taken during the 16-day double-blind treatment period, over days 1 and 2 and days 15 and 16, were averaged.
    Time Frame
    Up to Day 16
    Title
    Average Number of Awakenings Measured by Polysomnography
    Description
    Number of awakenings (NAW) was measured by PSG. PSG assesses the quality of sleep by monitoring brain waves, breathing, heart function, muscle activity and eye movement. PSG measurements of NAW (observed data only) taken during the 16-day double-blind treatment period, over days 1 and 2 and days 15 and 16, were averaged.
    Time Frame
    Up to Day 16
    Title
    Average Wake Time After Sleep Onset in the First Quarter of the Night Measured by Polysomnography
    Description
    Wake time after sleep onset (WASO) is the total time awake between sleep onset and "lights on"; i.e. from the onset of persistent sleep until the end of the 8-hour PSG recording. WASO was recorded in the first quarter of the night, for at most 2 hours, by PSG. PSG assesses the quality of sleep by monitoring brain waves, breathing, heart function, muscle activity and eye movement. PSG measurements of WASO (observed data only) taken during the 16-day double-blind treatment period, over days 1 and 2 and days 15 and 16, were averaged.
    Time Frame
    Up to Day 16
    Title
    Average Wake Time After Sleep Onset in the Second Quarter of the Night Measured by Polysomnography
    Description
    Wake time after sleep onset (WASO) is the total time awake between sleep onset and "lights on"; i.e. from the onset of persistent sleep until the end of the 8-hour PSG recording. WASO was recorded in the second quarter of the night, for at most 2 hours, by PSG. PSG assesses the quality of sleep by monitoring brain waves, breathing, heart function, muscle activity and eye movement. PSG measurements of WASO (observed data only) taken during the 16-day double-blind treatment period, over days 1 and 2 and days 15 and 16, were averaged.
    Time Frame
    Up to Day 16
    Title
    Average Wake Time After Sleep Onset in the Third Quarter of the Night Measured by Polysomnography
    Description
    Wake time after sleep onset (WASO) is the total time awake between sleep onset and "lights on"; i.e. from the onset of persistent sleep until the end of the 8-hour PSG recording. WASO was recorded in the third quarter of the night, for at most 2 hours, by PSG. PSG assesses the quality of sleep by monitoring brain waves, breathing, heart function, muscle activity and eye movement. PSG measurements of WASO (observed data only) taken during the 16-day double-blind treatment period, over days 1 and 2 and days 15 and 16, were averaged.
    Time Frame
    Up to Day 16
    Title
    Average Wake Time After Sleep Onset in the Fourth Quarter of the Night Measured by Polysomnography
    Description
    Wake time after sleep onset (WASO) is the total time awake between sleep onset and "lights on"; i.e. from the onset of persistent sleep until the end of the 8-hour PSG recording. WASO was recorded in the fourth quarter of the night, for at most 2 hours, by PSG. PSG assesses the quality of sleep by monitoring brain waves, breathing, heart function, muscle activity and eye movement. PSG measurements of WASO (observed data only) taken during the 16-day double-blind treatment period, over days 1 and 2 and days 15 and 16, were averaged.
    Time Frame
    Up to Day 16
    Title
    Average Number of Stage Shifts to Stage 1 or Wake Measured by Polysomnography
    Description
    Number of stage shifts to stage 1 of sleep or to awaken was measured by PSG. A stage shift is the transition measured by PSG between various sleep stages. PSG assesses the quality of sleep by monitoring brain waves, breathing, heart function, muscle activity and eye movement. PSG measurements of the number of stage shifts (observed data only) taken during the 16-day double-blind treatment period, over days 1 and 2 and days 15 and 16, were averaged.
    Time Frame
    Up to Day 16
    Title
    Average Subjective Total Sleep Time Based on Sleep Diary
    Description
    Total Sleep Time (TST) is a subjective time (observed data only) recorded daily by the participant in an electronic diary, that was averaged over the entire 16-day, double-blind treatment period.
    Time Frame
    Up to Day 16
    Title
    Average Subjective Sleep Latency Based on Sleep Diary
    Description
    Sleep latency (SL) is the time taken to fall asleep (observed data only) recorded daily by the participant in an electronic diary, that was averaged over the entire 16-day, double-blind treatment period.
    Time Frame
    Up to Day 16
    Title
    Average Subjective Number of Awakenings Based on Sleep Diary
    Description
    Number of awakenings between sleep onset and final awakening (NAW) is a subjective number (observed data only) recorded daily by the participant in an electronic diary, that was averaged over the entire 16-day, double-blind treatment period.
    Time Frame
    Up to Day 16
    Title
    Average Subjective Wake Time After Sleep Onset Based on Sleep Diary
    Description
    Wake Time after Sleep Onset (WASO) is after falling asleep initially, the subjective time that the participant was awake during the night. Daily recordings by the participant in an electronic diary (observed data only), were averaged over the entire 16-day, double-blind treatment period.
    Time Frame
    Up to Day 16
    Title
    Average Subjective Quality of Sleep Based on Sleep Diary
    Description
    Quality of Sleep (QS) is a subjective number on a Visual Analog Scale ranging from 0 to 100, where very poor is rated at 0, up to excellent, rated at 100. Daily recordings by the participant in an electronic diary (observed data only) were averaged over the entire 16-day, double-blind treatment period.
    Time Frame
    Up to Day 16
    Title
    Average Subjective Satisfaction of Sleep Duration Based on Sleep Diary
    Description
    Satisfaction of Sleep Duration (SSD) is a subjective number on a Visual Analog Scale ranging from 0 to 100, where very unsatisfied is rated at 0, up to fully satisfied, rated at 100. Daily recordings by the participant in an electronic diary (observed data only) were averaged over the entire 16-day, double-blind treatment period.
    Time Frame
    Up to Day 16
    Title
    Number of Participants With an Adverse Event During the 16 Day, Double-blind Treatment Period
    Description
    An Adverse Event (AE) is any untoward occurrence in a participant who is administered any pharmaceutical product, and which does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding) symptom, or disease temporarily associated with the use of an investigational medicinal product (IMP), whether or not it is related to the IMP.
    Time Frame
    Up to Day 16
    Title
    Number of Participants Who Discontinued Treatment Due to an Adverse Event During the 16 Day, Double-blind Treatment Period
    Description
    An AE is any untoward occurrence in a participant who is administered any pharmaceutical product, and which does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding) symptom, or disease temporarily associated with the use of an IMP, whether or not it is related to the IMP.
    Time Frame
    Up to Day 16

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    65 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: are at least 65 years of age at screening; sign written informed consent after the scope and nature of the investigation have been explained to them, before screening evaluations; are able to speak, read and understand the language of the investigator, study staff (including raters) and the informed consent form, and possess the ability to respond to questions, follow instructions and complete questionnaires; have demonstrated capability to independently complete the LogPad questionnaires and have completed the questionnaires at least 6 out of 7 days of the week preceding randomization; have a regular sleep pattern, meaning bedtime regularly occurs between 2100 hours and 2400 hours, with no more variation from these boundaries than 2 times/ week, with 5-8.5 hours in bed; have a documented diagnosis of chronic primary insomnia, defined as fulfillment of the Diagnostic and Statistical Manual of Mental Disorders IV - Text Revision (DSM-IV-TR) criteria for primary insomnia (DSM-IV-TR 307.42) with a duration of >= 1 month; fulfill the following PSG criteria on the two screening/baseline PSG nights: average Total Sleep Time (TST) < 6.5 h (and each night greater than or equal to 3 h and < 7 h), average WASO greater than or equal to 45 minutes (and each night greater than or equal to 30 min), average Latency to Persistent Sleep (LPS) 15 min (and each night greater than or equal to 10 min). Exclusion Criteria: have other sleep disorders (DSM-IV-TR), such as sleep related breathing disorders Apnea-Hypopnea Index (AHI) greater than or equal to 15), Periodic Leg Movements with Arousals Index (PLMAI) greater than or equal to 10), restless leg syndrome, narcolepsy, circadian sleep wake rhythm disorders, Rapid Eye Movement (REM) behavioral disorder or any parasomnia; have any significant medical or DSM-IV-TR psychiatric illness causing the sleep disturbances; currently meet diagnostic criteria for DSM-IV-TR depression Major Depressive Disorder (MDD) or have been diagnosed and treated for MDD within the last 2 years; have a history of bipolar disorder, a history of suicide attempt or a family history of suicide. A family history of suicide is defined as any history of suicide in the first and second degree family (parents, siblings, grandparents, or offspring), or a pattern of completed suicides (more than one) in the third degree family (aunts, uncles, nieces and nephews); have a history or signs of dementia or other serious cognitive impairment, as defined by a score of less than 26 on the Mini-Mental State Examination; have a significant, unstable medical illness e.g. acute or chronic pain, hepatic, renal, metabolic or cardiac disease; had serious head injury or stroke within the past year, or a history of (non-febrile) seizures; have clinically relevant electrocardiogram (ECG) abnormalities at screening, as judged by the investigator; have clinically relevant abnormal hematology or biochemistry values at screening, as judged by the investigator; have DSM-IV-TR substance abuse or DSM-IV-TR addiction within the last year; drink more than 2 alcoholic drinks in a day. One drink is approximately equal to: 12 oz or 360 ml of beer (regular or light), or 4 oz or 120 ml of red or white wine, or 2 oz or 60 ml of desert wine (e.g. port, sherry), or 12 oz or 360 ml of wine cooler (regular or light), or 1 oz or 30 ml or spirits (80 to 100 proof, e.g. whiskey, vodka); are routinely sleeping during daytime (napping) for more than 20 minutes per day, 3 days or more per week; are night workers or rotating shift workers currently, or in the past 6 months use of psychotropic drugs affecting sleep within two weeks prior to randomization (fluoxetine: five weeks); use of concomitant medication affecting sleep (e.g. anxiolytics, sedatives, antidepressants, antipsychotics, centrally active sedating antihistamines, central nervous system (CNS) stimulants, alpha-2-antagonists, respiratory stimulants and decongestants); smoke > 15 cigarettes per day and/or can not abstain from smoking during the night; drink excessive amounts of caffeinated beverages/day (more than 500 mg caffeine per day); have a body mass index (BMI) >= 36; have a positive urine drug screen at screening or at baseline; have a known hypersensitivity to mirtazapine or to any of the excipients;
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Medical Director
    Organizational Affiliation
    Merck Sharp & Dohme LLC
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    https://www.merck.com/clinical-trials/pdf/ProcedureAccessClinicalTrialData.pdf
    IPD Sharing URL
    http://engagezone.msd.com/ds_documentation.php

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    Efficacy and Safety Study of Org 50081 (Esmirtazapine) in Elderly Participants (P05709)

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