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Probiotics to Treat "Inflammatory Depression"

Primary Purpose

Depression

Status
Active
Phase
Not Applicable
Locations
Sweden
Study Type
Interventional
Intervention
Probiotics
Placebo
Sponsored by
Region Skane
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Depression focused on measuring Inflammation

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age, 18-85
  2. Depressive episode according to the DSM-V
  3. MADRS-M score >18
  4. All subjects will be stable on an antidepressant medication or in Cognitive Behavioural Therapy (CBT) for >4 weeks
  5. Subjects will be willing not to significantly alter their diet during the period of the study
  6. A hs-CRP value ≥1mg/L and BMI >25

Exclusion Criteria:

  1. Serious or unstable medical illness that in the investigator's opinion could compromise response to treatment or interpretation of study results.
  2. Known or suspected allergy to the study compounds.
  3. Ongoing infection.
  4. A diagnosis of psychotic disorder, bipolar disorder, personality disorder mental retardation, dementia, or individual whom, due to other causes, lack the ability to make an informed decision.
  5. Ongoing ECT.
  6. Patients who, in the investigator's judgment, pose a current, serious suicidal.
  7. A diagnosis for any Substance Use Disorder (except nicotine or caffeine) in the 3 months prior to the screening visit.
  8. Any medications (within 1 week of baseline or during the trial) that might confound the biomarker findings, including: Regular ingestion of NSAIDs or COX-2 inhibitors, or any use of oral steroids, immunosuppressants, interferon, chemotherapy (Patients will be instructed not to take an NSAID, COX-2 inhibitor or Aspirin in the 24 hours prior to a biomarker assessment visit).
  9. Antibiotic treatment/consumption within four (4) weeks before baseline visit.
  10. Patients who have taken foods or supplements with Probiotics later than two (2) weeks before baseline visit.
  11. Active participation in other clinical studies with ongoing study visits.
  12. Pregnancy.

Sites / Locations

  • Psychiatry Clinic, Lund, Region Skåne

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Probiotics

Placebo

Arm Description

Outcomes

Primary Outcome Measures

Montgomery-Åsberg Depression Rating Scale (interview version)
Decrease in depressive symtoms indicated by lower total score on mentioned scale, with 10 items, ranging from 0-60, a higher score indicating increased severity
"Inflammatory depressive symptoms"
Total composite score of the following items from the Patient Health Questionnaire (PHQ-9): item 3 (sleep problems), item 4 (lack of energy), and item 5 (appetite disturbance)

Secondary Outcome Measures

Gastrointestinal Symptom Rating Scale for Irritable Bowel Syndrome (GSRS-IBS)
Total Composite score indicate severity of gastrointestinal symtoms, ranging from 0-78
Dimensional Anhedonia Rating Scale (DARS)
Total Composite score of 17 items, measuring different hedonic domains.
WHO Disability Assessment Schedule (WHODAS)
Total Composite score of 36 items, measuring Health and disability within 6 different domains, ranging from 0-144.
Generalized Anxiety Disorder-7 (GAD-7)
Total Composite score of 7 items, measuring anxiety symtoms, ranging from 0-21.
Insomnia Severity Index (ISI)
Total Composite score of 7 items, ranging from 0-28
Fatigue Severity Scale (FSS)
Total Composite score of 9 items, measuring severity of fatigue, ranging from 1-63
Wechsler Adult Intelligence Scale (WAIS-IV)
Two Composite scores of two tests measuring cognitive functioning. Symbol search, ranging from 0-60 and Digit symbol coding test ranging from 0-135.

Full Information

First Posted
September 4, 2018
Last Updated
October 13, 2023
Sponsor
Region Skane
Collaborators
BioGaia AB
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1. Study Identification

Unique Protocol Identification Number
NCT03660280
Brief Title
Probiotics to Treat "Inflammatory Depression"
Official Title
Probiotics to Treat "Inflammatory Depression" - a Randomized Controlled Trial
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
November 6, 2018 (Actual)
Primary Completion Date
October 2023 (Anticipated)
Study Completion Date
December 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Region Skane
Collaborators
BioGaia AB

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The main aims of this project are to test if: i) Specific probiotic lactobacilli (added to stabilized ongoing treatment) are efficacious in treating depressive symptoms in individuals with low-grade inflammation, defined using high sensitivity C-reactive protein (hs-CRP) and BMI. ii) This effect is mediated through decrease of inflammation, estimated by treatment-associated changes in blood and faeces biomarkers. Secondary aims are to investigate the relationship between specific depressive symptoms and inflammation and if there is a correlation between certain pro-inflammatory or metabolic markers and depression.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Depression
Keywords
Inflammation

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Intervention will be add-on specific probiotic to ongoing treatment with antidepressant medication or Cognitive Behavioral Therapy (CBT). Subjects will be randomized to placebo or probiotic. To assure a balanced subject recruitment, block randomization within strata (ongoing treatment with CBT, antidepressant or both) will be performed. Blood sampling and symptom rating scales will be completed at baseline, at weeks 4 and 8 (end of study). Feces will be collected at baseline and end of study. Biomarkers (from baseline, week 4 and week 8) will be analyzed after the study. Subjects will be recruited from outpatient or inpatient settings, Psychiatry Skåne or primary care clinics in Skåne, Sweden. Subjects will be recruited via clinical referrals, but also via ads.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
75 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Probiotics
Arm Type
Experimental
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Dietary Supplement
Intervention Name(s)
Probiotics
Intervention Description
Specific probiotic lactobacilli (added to stabilized ongoing treatment)
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Placebo
Primary Outcome Measure Information:
Title
Montgomery-Åsberg Depression Rating Scale (interview version)
Description
Decrease in depressive symtoms indicated by lower total score on mentioned scale, with 10 items, ranging from 0-60, a higher score indicating increased severity
Time Frame
8 weeks
Title
"Inflammatory depressive symptoms"
Description
Total composite score of the following items from the Patient Health Questionnaire (PHQ-9): item 3 (sleep problems), item 4 (lack of energy), and item 5 (appetite disturbance)
Time Frame
8 weeks
Secondary Outcome Measure Information:
Title
Gastrointestinal Symptom Rating Scale for Irritable Bowel Syndrome (GSRS-IBS)
Description
Total Composite score indicate severity of gastrointestinal symtoms, ranging from 0-78
Time Frame
8 weeks
Title
Dimensional Anhedonia Rating Scale (DARS)
Description
Total Composite score of 17 items, measuring different hedonic domains.
Time Frame
8 weeks
Title
WHO Disability Assessment Schedule (WHODAS)
Description
Total Composite score of 36 items, measuring Health and disability within 6 different domains, ranging from 0-144.
Time Frame
8 weeks
Title
Generalized Anxiety Disorder-7 (GAD-7)
Description
Total Composite score of 7 items, measuring anxiety symtoms, ranging from 0-21.
Time Frame
8 weeks
Title
Insomnia Severity Index (ISI)
Description
Total Composite score of 7 items, ranging from 0-28
Time Frame
8 weeks
Title
Fatigue Severity Scale (FSS)
Description
Total Composite score of 9 items, measuring severity of fatigue, ranging from 1-63
Time Frame
8 weeks
Title
Wechsler Adult Intelligence Scale (WAIS-IV)
Description
Two Composite scores of two tests measuring cognitive functioning. Symbol search, ranging from 0-60 and Digit symbol coding test ranging from 0-135.
Time Frame
8 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age, 18-85 Depressive episode according to the DSM-V MADRS-M score >18 All subjects will be stable on an antidepressant medication or in Cognitive Behavioural Therapy (CBT) for >4 weeks Subjects will be willing not to significantly alter their diet during the period of the study A hs-CRP value ≥1mg/L and BMI >25 Exclusion Criteria: Serious or unstable medical illness that in the investigator's opinion could compromise response to treatment or interpretation of study results. Known or suspected allergy to the study compounds. Ongoing infection. A diagnosis of psychotic disorder, bipolar disorder, personality disorder mental retardation, dementia, or individual whom, due to other causes, lack the ability to make an informed decision. Ongoing ECT. Patients who, in the investigator's judgment, pose a current, serious suicidal. A diagnosis for any Substance Use Disorder (except nicotine or caffeine) in the 3 months prior to the screening visit. Any medications (within 1 week of baseline or during the trial) that might confound the biomarker findings, including: Regular ingestion of NSAIDs or COX-2 inhibitors, or any use of oral steroids, immunosuppressants, interferon, chemotherapy (Patients will be instructed not to take an NSAID, COX-2 inhibitor or Aspirin in the 24 hours prior to a biomarker assessment visit). Antibiotic treatment/consumption within four (4) weeks before baseline visit. Patients who have taken foods or supplements with Probiotics later than two (2) weeks before baseline visit. Active participation in other clinical studies with ongoing study visits. Pregnancy.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Daniel Lindqvist, PhD
Organizational Affiliation
Region Skane
Official's Role
Principal Investigator
Facility Information:
Facility Name
Psychiatry Clinic, Lund, Region Skåne
City
Lund
ZIP/Postal Code
22358
Country
Sweden

12. IPD Sharing Statement

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Probiotics to Treat "Inflammatory Depression"

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