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Maintenance NeuroStar Transcranial Magnetic Stimulation (TMS) in Patients With Major Depressive Disorder

Primary Purpose

Major Depressive Disorder

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
NeuroStar TMS
Sponsored by
Neuronetics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Major Depressive Disorder focused on measuring TMS, Major Depressive Disorder, NeuroStar TMS

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Primary diagnosis by DSM-IV criteria for Major Depressive Episode, single episode or recurrent course of illness, with the additional stipulation of a duration for this episode of ≥ 4 weeks and CGI-S ≥ 4.
  • Duration of current episode of depression ≤ 3 years (the definition of an episode is demarcated by a period of ≥ 2 months when the patient did not meet full criteria for the DSM-IV definition of Major Depressive Episode.
  • Capable and willing to provide informed consent.
  • Signed HIPAA authorization.
  • Able to adhere with the treatment schedule, and withdrawal of ongoing pharmacotherapy.
  • If currently taking antidepressant pharmacotherapy, must be clinically appropriate to discontinue treatment with those agents.

Exclusion Criteria:

  • Investigators, site personnel directly affiliated with this study, and their immediate families (immediate family is defined as a spouse, parent, child or sibling, whether by birth or legal adoption).
  • Individuals diagnosed by the Investigator with the following conditions (current unless otherwise stated):

    • Depression secondary to a general medical condition, or substance- induced;
    • Seasonal pattern of depression as defined by DSM-IV;
    • History of substance abuse or dependence within the past year except nicotine and caffeine);
    • Any psychotic disorder (lifetime), including schizoaffective disorder, or major depression with psychotic features in this or previous episodes;
    • Bipolar disorder;
    • Eating disorder (current or within the past year);
    • Obsessive compulsive disorder (lifetime); or
    • Post-traumatic stress disorder (current or within the past year).
  • An Axis II Personality Disorder, which in the judgment of the Investigator may hinder the patient in completing the procedures required by the study protocol.
  • Individuals with a clinically defined neurological disorder or insult including, but not limited to:

    • Any condition likely to be associated with increased intracranial pressure;
    • Space occupying brain lesion;
    • History of cerebrovascular accident;
    • Transient ischemic attack within two years;
    • Cerebral aneurysm;
    • Dementia;
    • Parkinson's disease;
    • Huntington's chorea;
    • Multiple sclerosis.
  • Increased risk of seizure for any reason, including but not limited to prior diagnosis of increased intracranial pressure (such as after large infarctions or trauma), or history of significant head trauma with loss of consciousness for ≥ 5 minutes.
  • History of treatment with Vagus Nerve Stimulation.
  • Cardiac pacemakers, implanted medication pumps, intracardiac lines, or acute, unstable cardiac disease.

Sites / Locations

  • Rush University Medical Center
  • Sheppard Pratt Health System
  • Premier Psychiatric Group, L.L.C.
  • Butler Hospital
  • Medical University of South Carolina
  • Center for Anxiety and Depression

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Scheduled Treatment Arm

Monthly Observational Follow up Arm

Arm Description

3 Week TMS taper, clinical assessments and one NeuroStar TMS session every 4th week of block and TMS reintroduction as needed for clinical deterioration.

3 Week TMS Taper, clinical assessments and office follow up every 4th week of block and NeuroStar TMS reintroduction as needed for clinical deterioration.

Outcomes

Primary Outcome Measures

Examining the proportion of patients maintaining a sustained response throughout a 12 month maintenance treatment phase.
Sustained response is defined as not requiring TMS reintroduction at every observation point during the maintenance phase.

Secondary Outcome Measures

Compare the average time to first reintroduction of TMS between the two maintenance treatment arms.
Change in depressive symptomatology will be assessed across the duration of maintenance treatment using observer and self-administered efficacy measures.

Full Information

First Posted
August 10, 2011
Last Updated
September 30, 2021
Sponsor
Neuronetics
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1. Study Identification

Unique Protocol Identification Number
NCT01415154
Brief Title
Maintenance NeuroStar Transcranial Magnetic Stimulation (TMS) in Patients With Major Depressive Disorder
Official Title
A 12-Month Prospective Randomized Dual-Arm Pilot Study of Maintenance NeuroStar Transcranial Magnetic Stimulation (TMS) in Patients With Major Depressive Disorder
Study Type
Interventional

2. Study Status

Record Verification Date
September 2021
Overall Recruitment Status
Completed
Study Start Date
August 2011 (undefined)
Primary Completion Date
September 2013 (Actual)
Study Completion Date
July 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Neuronetics

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to evaluate the efficacy of scheduled maintenance Transcranial Magnetic Stimulation (TMS) treatment compared to on-demand TMS treatment for symptomatic worsening in patients who have shown a clinical response to acute TMS treatment.
Detailed Description
This is a 12-month maintenance treatment study for patients who have responded to a 6 week course of acute TMS treatment for major depressive disorder (MDD). The study will seek to assess the change in depressive symptomatology across the duration of maintenance treatment using observer and self-administered efficacy measures. Describe the efficacy of TMS re-introduction in patients not receiving maintenance pharmacotherapy who show a recurrence of depressive symptoms. Assess the safety and durability of acute TMS therapy followed by maintenance TMS treatment for up to 12 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Major Depressive Disorder
Keywords
TMS, Major Depressive Disorder, NeuroStar TMS

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
67 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Scheduled Treatment Arm
Arm Type
Experimental
Arm Description
3 Week TMS taper, clinical assessments and one NeuroStar TMS session every 4th week of block and TMS reintroduction as needed for clinical deterioration.
Arm Title
Monthly Observational Follow up Arm
Arm Type
Experimental
Arm Description
3 Week TMS Taper, clinical assessments and office follow up every 4th week of block and NeuroStar TMS reintroduction as needed for clinical deterioration.
Intervention Type
Device
Intervention Name(s)
NeuroStar TMS
Intervention Description
NeuroStar TMS treatmant - 120% of Observed MT, 10 pulses per second, 4 second on-time, 26 second off-time, 75 trains, 3,000 total pulses/sessions for 6 days. 3 treatments in taper week 1, 2 treatments in taper week 2 and 1 treatment in taper week 3.
Primary Outcome Measure Information:
Title
Examining the proportion of patients maintaining a sustained response throughout a 12 month maintenance treatment phase.
Description
Sustained response is defined as not requiring TMS reintroduction at every observation point during the maintenance phase.
Time Frame
12 month evaluation
Secondary Outcome Measure Information:
Title
Compare the average time to first reintroduction of TMS between the two maintenance treatment arms.
Description
Change in depressive symptomatology will be assessed across the duration of maintenance treatment using observer and self-administered efficacy measures.
Time Frame
12 Month evaluation

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Primary diagnosis by DSM-IV criteria for Major Depressive Episode, single episode or recurrent course of illness, with the additional stipulation of a duration for this episode of ≥ 4 weeks and CGI-S ≥ 4. Duration of current episode of depression ≤ 3 years (the definition of an episode is demarcated by a period of ≥ 2 months when the patient did not meet full criteria for the DSM-IV definition of Major Depressive Episode. Capable and willing to provide informed consent. Signed HIPAA authorization. Able to adhere with the treatment schedule, and withdrawal of ongoing pharmacotherapy. If currently taking antidepressant pharmacotherapy, must be clinically appropriate to discontinue treatment with those agents. Exclusion Criteria: Investigators, site personnel directly affiliated with this study, and their immediate families (immediate family is defined as a spouse, parent, child or sibling, whether by birth or legal adoption). Individuals diagnosed by the Investigator with the following conditions (current unless otherwise stated): Depression secondary to a general medical condition, or substance- induced; Seasonal pattern of depression as defined by DSM-IV; History of substance abuse or dependence within the past year except nicotine and caffeine); Any psychotic disorder (lifetime), including schizoaffective disorder, or major depression with psychotic features in this or previous episodes; Bipolar disorder; Eating disorder (current or within the past year); Obsessive compulsive disorder (lifetime); or Post-traumatic stress disorder (current or within the past year). An Axis II Personality Disorder, which in the judgment of the Investigator may hinder the patient in completing the procedures required by the study protocol. Individuals with a clinically defined neurological disorder or insult including, but not limited to: Any condition likely to be associated with increased intracranial pressure; Space occupying brain lesion; History of cerebrovascular accident; Transient ischemic attack within two years; Cerebral aneurysm; Dementia; Parkinson's disease; Huntington's chorea; Multiple sclerosis. Increased risk of seizure for any reason, including but not limited to prior diagnosis of increased intracranial pressure (such as after large infarctions or trauma), or history of significant head trauma with loss of consciousness for ≥ 5 minutes. History of treatment with Vagus Nerve Stimulation. Cardiac pacemakers, implanted medication pumps, intracardiac lines, or acute, unstable cardiac disease.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David G. Brock, MD
Organizational Affiliation
Neuronetics
Official's Role
Study Director
Facility Information:
Facility Name
Rush University Medical Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
Sheppard Pratt Health System
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21285
Country
United States
Facility Name
Premier Psychiatric Group, L.L.C.
City
Lincoln
State/Province
Nebraska
ZIP/Postal Code
68526
Country
United States
Facility Name
Butler Hospital
City
Providence
State/Province
Rhode Island
ZIP/Postal Code
02906
Country
United States
Facility Name
Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Facility Name
Center for Anxiety and Depression
City
Mercer Island
State/Province
Washington
ZIP/Postal Code
98040
Country
United States

12. IPD Sharing Statement

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Maintenance NeuroStar Transcranial Magnetic Stimulation (TMS) in Patients With Major Depressive Disorder

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