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Mirtazapine for Sleep Disorders in Alzheimer's Disease

Primary Purpose

Alzheimer's Disease, Sleep Disorders

Status
Unknown status
Phase
Phase 3
Locations
Brazil
Study Type
Interventional
Intervention
Mirtazapine
Sponsored by
Brasilia University Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alzheimer's Disease focused on measuring Alzheimer's disease, Sleep disorders, Mirtazapine, Treatment, Intervention, insomnia

Eligibility Criteria

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

Inclusion Criteria:

Fifty-five years of age or older; Diagnosis of probable Alzheimer's disease by National Institute of Neurological and Communicative Disorders and Stroke/the Alzheimer's Disease and Related Disorders Association criteria; Hachinski Ischemia Scale score less than 5 Mini-Mental State Examination score of O to 26 Actigraph evidence of a mean time immobile of less than 7 hours per night based on at least 7 nights of complete actigraph data collected over a single week; For-week history of sleep disorder behaviors, occurring at least once weekly, as reported by the caregiver using the Neuropsychiatric Inventory (NPI) Nighttime Behavior scale; Sleep disturbance observed was not present before the diagnosis of AD; Other co-morbidities, especially delirium, depression, chronic pain and medication use may be present, but do not cooperate in the primary symptoms; Computed tomography or magnetic resonance imaging since the onset of memory problems showing no more than 1 lacunar infarct in a nonstrategic area and no clinical events suggestive of stroke or other intracranial disease or normal; Stable medications for 4 weeks prior to the screening visit; Having a mobile upper extremity to which to attach an actigraph; Residing with a responsible spouse, family member, or professional caregiver who is present during the night and would agree to assume the role of the principal caregiver for the 3-week protocol; Ability to ingest oral medication and participate in all scheduled evaluations

Exclusion Criteria:

Sleep disturbance associated with an acute illness, delirium or psychiatric disease; Clinically significant movement disorder, such as akinesia, that would affect actigraphic differentiation of sleep and wakefulness Severe agitation; Unstable medical condition; Discontinuation of psychotropic or sleep medications within 2 weeks of the screening visit; Patient unwilling to maintain caffeine abstinence after 2:00 PM for the duration of the protocol; Patient unwilling to comply with the maximum limit of 2 alcoholic drinks per day, and only 1 alcoholic drink after 6:00 PM for the duration of the protocol; Prior use of mirtazapine for the treatment of sleep disturbances; Caregiver deemed too unreliable to supervise the wearing of the actigraph, to administer trazodone the proper time, to maintain tbe sleep diary, or to bring the patient to the scheduled visits;

Sites / Locations

  • Brasilia UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Mirtazapine

Placebo

Arm Description

Mirtazapine, 15 mg once a day, at night for 14 days

Placebo 15 mg, once a day at night for 14 days

Outcomes

Primary Outcome Measures

Change From Baseline in Nighttime Total Sleep Time
Mean of Nighttime Total Sleep Time (in minutes) during the 12-h nocturnal epoch 8:00 PM - 08:00 AM after 2 weeks under treatment

Secondary Outcome Measures

Change From Baseline in Nighttime Number Of Awakenings
Change in scores from baseline to intervention week was analyzed using an analysis of covariance (ANCOVA) with the change score as the dependent variable and the treatment condition and baseline score as independent variables.
Change From Baseline in Nighttime Wake After Sleep Onset
Nighttime Wake After Sleep Onset (in minutes) after sleep onset until the final awakening during the 12-h nocturnal epoch 8:00 PM - 08:00 AM. After 2 weeks under treatment.
Change From Baseline in in Daytime Total Sleep Time
Change From Baseline in Number of Daytime Naps
Change in Cognitive Function (as Measured by the Mini-Mental State Examination)
Change in Activities of Daily Living (The Index of ADL - Katz)
Change of Baseline in Behavioral Variables (BAHAVE-AD Scale)
Change From Baseline in Cognitive Function (Digit Symbol Substitution Test)

Full Information

First Posted
May 30, 2013
Last Updated
June 3, 2013
Sponsor
Brasilia University Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT01867775
Brief Title
Mirtazapine for Sleep Disorders in Alzheimer's Disease
Official Title
Mirtazapine for the Treatment of Sleep Disorders in Alzheimer's Disease: a Randomized, Double-blind, Placebo-controlled Study
Study Type
Interventional

2. Study Status

Record Verification Date
May 2013
Overall Recruitment Status
Unknown status
Study Start Date
May 2012 (undefined)
Primary Completion Date
December 2013 (Anticipated)
Study Completion Date
May 2014 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Brasilia University Hospital

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine whether mirtazapine is effective in the treatment of sleep disorders in Alzheimers disease.
Detailed Description
Mirtazapine has been used for depressed elderly with sleep disorders with good tolerability and efficacy. The study hypothesis is that mirtazapine could also be used in demented with sleep disorders. Sleep disorders (SD) affects 35 to 50 percent of patients with Alzheimer Disease (AD). These disorders often make caring for patients at home very difficult and It's also associated with higher risk of institutionalization and increases health care costs. Treatment of SD in people with dementia may benefit both patients and their caregivers. However, little is known about the efficacy of pharmacological treatments for treating sleep disturbances in AD.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer's Disease, Sleep Disorders
Keywords
Alzheimer's disease, Sleep disorders, Mirtazapine, Treatment, Intervention, insomnia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Mirtazapine
Arm Type
Active Comparator
Arm Description
Mirtazapine, 15 mg once a day, at night for 14 days
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo 15 mg, once a day at night for 14 days
Intervention Type
Drug
Intervention Name(s)
Mirtazapine
Other Intervention Name(s)
Remeron
Intervention Description
Mirtazapine 15 mg, at night, once a day for 14 days
Primary Outcome Measure Information:
Title
Change From Baseline in Nighttime Total Sleep Time
Description
Mean of Nighttime Total Sleep Time (in minutes) during the 12-h nocturnal epoch 8:00 PM - 08:00 AM after 2 weeks under treatment
Time Frame
Baseline, 14 days follow-up
Secondary Outcome Measure Information:
Title
Change From Baseline in Nighttime Number Of Awakenings
Description
Change in scores from baseline to intervention week was analyzed using an analysis of covariance (ANCOVA) with the change score as the dependent variable and the treatment condition and baseline score as independent variables.
Time Frame
Baseline, 14 days follow-up
Title
Change From Baseline in Nighttime Wake After Sleep Onset
Description
Nighttime Wake After Sleep Onset (in minutes) after sleep onset until the final awakening during the 12-h nocturnal epoch 8:00 PM - 08:00 AM. After 2 weeks under treatment.
Time Frame
Baseline, 14 days follow-up
Title
Change From Baseline in in Daytime Total Sleep Time
Time Frame
Baseline, 14 days follow-up
Title
Change From Baseline in Number of Daytime Naps
Time Frame
Baseline, 14 days follow-up]
Title
Change in Cognitive Function (as Measured by the Mini-Mental State Examination)
Time Frame
Baseline, 14 days follow-up]
Title
Change in Activities of Daily Living (The Index of ADL - Katz)
Time Frame
Baseline, 14 days follow-up]
Title
Change of Baseline in Behavioral Variables (BAHAVE-AD Scale)
Time Frame
Baseline, 14 days follow-up]
Title
Change From Baseline in Cognitive Function (Digit Symbol Substitution Test)
Time Frame
Baseline, 14 days follow-up]

10. Eligibility

Sex
All
Minimum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Fifty-five years of age or older; Diagnosis of probable Alzheimer's disease by National Institute of Neurological and Communicative Disorders and Stroke/the Alzheimer's Disease and Related Disorders Association criteria; Hachinski Ischemia Scale score less than 5 Mini-Mental State Examination score of O to 26 Actigraph evidence of a mean time immobile of less than 7 hours per night based on at least 7 nights of complete actigraph data collected over a single week; For-week history of sleep disorder behaviors, occurring at least once weekly, as reported by the caregiver using the Neuropsychiatric Inventory (NPI) Nighttime Behavior scale; Sleep disturbance observed was not present before the diagnosis of AD; Other co-morbidities, especially delirium, depression, chronic pain and medication use may be present, but do not cooperate in the primary symptoms; Computed tomography or magnetic resonance imaging since the onset of memory problems showing no more than 1 lacunar infarct in a nonstrategic area and no clinical events suggestive of stroke or other intracranial disease or normal; Stable medications for 4 weeks prior to the screening visit; Having a mobile upper extremity to which to attach an actigraph; Residing with a responsible spouse, family member, or professional caregiver who is present during the night and would agree to assume the role of the principal caregiver for the 3-week protocol; Ability to ingest oral medication and participate in all scheduled evaluations Exclusion Criteria: Sleep disturbance associated with an acute illness, delirium or psychiatric disease; Clinically significant movement disorder, such as akinesia, that would affect actigraphic differentiation of sleep and wakefulness Severe agitation; Unstable medical condition; Discontinuation of psychotropic or sleep medications within 2 weeks of the screening visit; Patient unwilling to maintain caffeine abstinence after 2:00 PM for the duration of the protocol; Patient unwilling to comply with the maximum limit of 2 alcoholic drinks per day, and only 1 alcoholic drink after 6:00 PM for the duration of the protocol; Prior use of mirtazapine for the treatment of sleep disturbances; Caregiver deemed too unreliable to supervise the wearing of the actigraph, to administer trazodone the proper time, to maintain tbe sleep diary, or to bring the patient to the scheduled visits;
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Francisca M Scoralick, MD
Organizational Affiliation
University of Brasilia
Official's Role
Principal Investigator
Facility Information:
Facility Name
Brasilia University
City
Brasilia
State/Province
Distrito Federal
ZIP/Postal Code
70840
Country
Brazil
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Francisca M Scoralick
Email
franciscascoralick@gmail.com
First Name & Middle Initial & Last Name & Degree
Francisca M Scoralick

12. IPD Sharing Statement

Citations:
PubMed Identifier
33189083
Citation
McCleery J, Sharpley AL. Pharmacotherapies for sleep disturbances in dementia. Cochrane Database Syst Rev. 2020 Nov 15;11(11):CD009178. doi: 10.1002/14651858.CD009178.pub4.
Results Reference
derived

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Mirtazapine for Sleep Disorders in Alzheimer's Disease

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