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Trazodone Once a Day in Major Depression Disorder

Primary Purpose

Major Depressive Disorder

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Trazodone
Venlafaxine
Sponsored by
Aziende Chimiche Riunite Angelini Francesco S.p.A
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Major Depressive Disorder focused on measuring Trazodone, Venlafaxine, Major depressive disorder

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • men and women 18-75 years of age (limits included) with no limitation of race;
  • outpatients;
  • major depressive disorder according to DSM-IV criteria as assessed using the MINI International Neuropsychiatric Interview;
  • 17-item HAMD score > 18 at both screening and baseline visits with a decrease not exceeding 20% between screening and baseline;
  • symptoms of depression for at least one month before study entry (screening visit);
  • legally capable to give their consent to participate the study, and available to sign and date the written informed consent prior to the inclusion in the study;
  • women of childbearing potential must agree not to start a pregnancy from the signature of the informed consent up to 30 days after the last administration of the investigational product.

Exclusion Criteria:

  • participation in another trial involving any investigational drug during the past 60 days;
  • known hypersensitivity to venlafaxine or trazodone or their excipients;
  • use of venlafaxine or trazodone within the previous six months;
  • acute, or chronic, or recurrent medical conditions that might affect/jeopardize the study results;
  • significant liver disease, defined as active hepatitis or elevated liver enzymes > 3 times the upper boundary of the normal range;
  • significant renal disease, defined as urea and/or creatinine > 3 times the upper boundary of the normal range
  • myocardial infarction within 6 months prior to start of the double blind treatment;
  • positive present history of glaucoma;
  • history of risk factors for Torsade de Pointes, such as heart failure, cardiac arrhythmias, bradycardia, cardiac conduction abnormalities, family history of long QT syndrome, cardiac hypertrophy, cardiomyopathy, chronic cardiac insufficiency;
  • values of electrolytes (sodium, potassium, calcium, magnesium, chloride) outside the normal laboratory range and judged clinically relevant by the Investigator;
  • concomitant treatment with drugs known for QT prolongation, or with drugs producing hypokalemia, or diuretics;
  • QTcF values higher than 450 msec in the ECG performed at the screening;
  • history of major depression resistant to medical treatments (previous failure to respond to two consecutive antidepressants of different classes used for a sufficient length of time at appropriate doses);
  • history of seizure events other than a single childhood febrile seizure;
  • history of alcohol or psychoactive substance abuse or addiction (except caffeine or nicotine) during the last year as defined by DSM-IV criteria;
  • positive urine drug screen for CNS-active drugs (cocaine, opioids, amphetamines and cannabinoids) at Visit 1 (screening);
  • acute risk of suicide (HAMD, criterion 3 with a value > 3);
  • presence of any primary psychiatric disorder other than major depression;
  • history or presence of bipolar disorder, any psychotic disorder, mental disorder due to general medical conditions;
  • pregnancy, lactation, or female with a positive urine pregnancy test result at Visit 1 (Screening);
  • electroconvulsive therapy (ECT) within 30 days prior to the screening visit;
  • use of antipsychotic drugs within two months prior to the baseline visit (Visit 2);
  • use of any anxiolytic or sedative hypnotic drug within seven days prior to the baseline (Visit 2) and during the study. Exception is stable low doses of benzodiazepines for insomnia (if taken by the patient more than two weeks before the Treatment Phase);
  • use of any psychotropic drug or substance with central nervous system effects within seven days prior to the baseline visit (Visit 2);
  • use of any non-psychotropic drug with psychotropic effects (e.g. alpha-adrenergic blockers) within seven days prior to the baseline visit (visit 2), unless a stable dose of the drug has been maintained for at least one month (three months for thyroid or hormonal medications) before the baseline visit (visit 2);
  • concomitant treatment with CYP3A4 inhibitors (e.g. ketoconazole, ritonavir, indinavir);
  • hyperthyroidism, even if pharmacologically corrected;
  • start or discontinuation of psychotherapy within 6 weeks prior to screening;
  • clinically significant abnormalities on physical examination, vital signs, ECG, laboratory tests at the screening visit;
  • high blood pressure (supine systolic blood pressure > 160 mmHg or supine diastolic blood pressure > 90 mmHg) at screening or baseline, either untreated or under treatment with antihypertensives
  • inability to comply with the protocol requirements, instructions and study-related restrictions; e.g. uncooperative attitude, inability to return for study-visits, and improbability of completing the clinical study;
  • vulnerable subjects (e.g. persons kept in detention);
  • if subject is the Investigator or his/her deputies, first grade relative, research assistant, pharmacist, study coordinator, other staff of relative thereof directly involved in the conduct of the study.

Sites / Locations

  • Institute für Psychosomatik
  • AKH Wien
  • PRAGTIS, s.r.o.
  • Psychiatry Trial, s.r.o.
  • MEDICAL SERVICES PRAGUE, s.r.o.
  • Neuropsychiatrie s.r.o.
  • Saint Anne, s.r.o.
  • SUPERVIZE, s.r.o.
  • BIALBI s.r.o.
  • Fakultni Nemocnice Olomouc, Klinika Psychiatrie
  • MUDr. Eva Soukupová-Psychiatrická praxe, s.r.o.
  • NZZ- MUDr. Jaroslav Hronek, psychiatrická ambulance
  • UOPI di Psichiatria Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele, Presidio "Gaspare Rodolico"
  • Clinica Psichiatrica Nuovo Ospedale S. Salvatore Università degli Studi del L'Aquila
  • Ospedale Santa Maria della Misericordia Unità di Degenza Psichiatrica-SPDC
  • Azienda Ospedaliera Sant'Andrea Università La Sapienza Unità Operativa Complessa di Psichiatria
  • AOUS-Azienda Ospedaliera Universitaria Senese Policlinico Santa Maria alle Scotte Clinica Psichiatrica Universitaria
  • Department of Neurosciences University of Turin
  • Quantum Medical Center Srl
  • Spitalul clinic de psihiatrie "Prof. Dr. Al. Obregia"/Sectia 13
  • Spitalul Clinic de Psihiatrie "Prof. Dr. Al. Obregia"/Sectia 1
  • Spitalul Clinc de Urgenta Militar "Dr. Stefan Odobleja", Craiova
  • Spital Clinic de Psihiatrie SOCOLA / Iasi
  • Spitalul de Psihiatrie "Dr. Gh.Preda" Sibiu
  • Spitalul Clinc Judetean Mures, Centrul de Sanatate Mintala
  • Psychiatricka ambulancia
  • MENTUM, s.r.o.
  • EPAMED, s.r.o.
  • Psychiatricka nemocnica
  • Psycholine, s.r.o.
  • Psychiatricke oddelenie, NsP sv Barbory Roznava
  • Instituto de Investigacion y Asistencia Psiquiatrica - IIAP

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Trazodone

Venlafaxine XR

Arm Description

300 mg/day for 8 weeks (including 1 week 150 mg/day of dose-titration). After 3 and 5 weeks of treatment, non responders will have dose increases (in increments of 75 mg/day) till to reach the maximum of 450 mg/day. Dosage form: capsule.

75 mg/die for 8 weeks. After 3 and 5 weeks of treatment, non responders will have dose increases (in increments of 75 mg/day) till to reach the maximum of 225 mg/day. Dosage form: capsule.

Outcomes

Primary Outcome Measures

Hamilton Depression Rating Scale (HAMD) score
Mean change from baseline (Day 0) in HAMD score at Day 56.

Secondary Outcome Measures

Montgomery-Asberg Depression Rating Scale (MADRS) score
Mean change from baseline (Day 0) in MADRS score at Day 56.
Clinical Global Impression (CGI) Severity of Illness score
CGI-Severity of Illness improvement at Day 56.
Clinical Global Impression (CGI) Global improvement score
CGI-Global improvement at Day 56.
Percentage of responders
Rate of patients with a 50% decrease with respect to baseline on the HAMD score at Day 56.
Percentage of patients with remission
Rate of patients with a HAMD score <or= at Day 56.
Safety profile of trazodone OAD compared to venlafaxine XR
Safety and tolerability will be assessed through adverse events monitoring, physical examinations and monitoring of vital signs, body weight, clinical laboratory tests, ECG.

Full Information

First Posted
March 12, 2014
Last Updated
December 29, 2015
Sponsor
Aziende Chimiche Riunite Angelini Francesco S.p.A
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1. Study Identification

Unique Protocol Identification Number
NCT02086929
Brief Title
Trazodone Once a Day in Major Depression Disorder
Official Title
A Randomized, Double-blind Study Comparing the Efficacy and Safety of Trazodone OAD and Venlafaxine XR in the Treatment of Patients With Major Depressive Disorder.
Study Type
Interventional

2. Study Status

Record Verification Date
December 2015
Overall Recruitment Status
Completed
Study Start Date
December 2012 (undefined)
Primary Completion Date
April 2014 (Actual)
Study Completion Date
April 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Aziende Chimiche Riunite Angelini Francesco S.p.A

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The study objective is to evaluate the efficacy and safety of trazodone OAD vs venlafaxine extended release (venlafaxine XR) after an 8-week treatment period in patients with major depressive disorder.
Detailed Description
This randomized, venlafaxine-controlled, double-blind, parallel design study consists of a Pre-Treatment Phase (screening, wash-out) and a double-blind Treatment Phase (randomization to trazodone OAD or to venlafaxine XR, treatment for 8 weeks and tapering for 1 to 3 weeks). During the Pre-Treatment Phase, patients who sign an informed consent form will undergo initial screening. Potential candidates will be instructed to discontinue antidepressants or prohibited medications (wash-out) for a period specific to taper schedule (based on 5 elimination half-lives of the used medication). On the last day of the Pre-Treatment Phase, patients will be evaluated for the final eligibility, and those qualified will be randomly allocated in a 1:1 proportion to trazodone OAD 300 mg/day (1 week of tapering with trazodone OAD 150 mg/day) or to venlafaxine XR 75 mg/day once daily. After 3 and 5 weeks of treatment, subjects will be evaluated for the response. For non responding patients dose increases (in increments of 75 mg/day) will be done till to reach the maximum of 225 mg/day for venlafaxine XR and 450 mg/day for trazodone OAD. Patients non responding to treatment at the final visit will have their study medication tapered from 1 to 3 weeks, according to the maximum dose reached during the study. In order to prevent relapse of depression symptoms, responders at the final visit may continue the treatment. In this case, an unblinded third party Dispenser will open the treatment code and will prescribe the same medication taken by the patients during the trial, according to the formulation available on the market.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Major Depressive Disorder
Keywords
Trazodone, Venlafaxine, Major depressive disorder

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Trazodone
Arm Type
Experimental
Arm Description
300 mg/day for 8 weeks (including 1 week 150 mg/day of dose-titration). After 3 and 5 weeks of treatment, non responders will have dose increases (in increments of 75 mg/day) till to reach the maximum of 450 mg/day. Dosage form: capsule.
Arm Title
Venlafaxine XR
Arm Type
Active Comparator
Arm Description
75 mg/die for 8 weeks. After 3 and 5 weeks of treatment, non responders will have dose increases (in increments of 75 mg/day) till to reach the maximum of 225 mg/day. Dosage form: capsule.
Intervention Type
Drug
Intervention Name(s)
Trazodone
Intervention Type
Drug
Intervention Name(s)
Venlafaxine
Primary Outcome Measure Information:
Title
Hamilton Depression Rating Scale (HAMD) score
Description
Mean change from baseline (Day 0) in HAMD score at Day 56.
Time Frame
Day 56
Secondary Outcome Measure Information:
Title
Montgomery-Asberg Depression Rating Scale (MADRS) score
Description
Mean change from baseline (Day 0) in MADRS score at Day 56.
Time Frame
Day 56
Title
Clinical Global Impression (CGI) Severity of Illness score
Description
CGI-Severity of Illness improvement at Day 56.
Time Frame
Day 56
Title
Clinical Global Impression (CGI) Global improvement score
Description
CGI-Global improvement at Day 56.
Time Frame
Day 56
Title
Percentage of responders
Description
Rate of patients with a 50% decrease with respect to baseline on the HAMD score at Day 56.
Time Frame
Day 56
Title
Percentage of patients with remission
Description
Rate of patients with a HAMD score <or= at Day 56.
Time Frame
Day 56
Title
Safety profile of trazodone OAD compared to venlafaxine XR
Description
Safety and tolerability will be assessed through adverse events monitoring, physical examinations and monitoring of vital signs, body weight, clinical laboratory tests, ECG.
Time Frame
11 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: men and women 18-75 years of age (limits included) with no limitation of race; outpatients; major depressive disorder according to DSM-IV criteria as assessed using the MINI International Neuropsychiatric Interview; 17-item HAMD score > 18 at both screening and baseline visits with a decrease not exceeding 20% between screening and baseline; symptoms of depression for at least one month before study entry (screening visit); legally capable to give their consent to participate the study, and available to sign and date the written informed consent prior to the inclusion in the study; women of childbearing potential must agree not to start a pregnancy from the signature of the informed consent up to 30 days after the last administration of the investigational product. Exclusion Criteria: participation in another trial involving any investigational drug during the past 60 days; known hypersensitivity to venlafaxine or trazodone or their excipients; use of venlafaxine or trazodone within the previous six months; acute, or chronic, or recurrent medical conditions that might affect/jeopardize the study results; significant liver disease, defined as active hepatitis or elevated liver enzymes > 3 times the upper boundary of the normal range; significant renal disease, defined as urea and/or creatinine > 3 times the upper boundary of the normal range myocardial infarction within 6 months prior to start of the double blind treatment; positive present history of glaucoma; history of risk factors for Torsade de Pointes, such as heart failure, cardiac arrhythmias, bradycardia, cardiac conduction abnormalities, family history of long QT syndrome, cardiac hypertrophy, cardiomyopathy, chronic cardiac insufficiency; values of electrolytes (sodium, potassium, calcium, magnesium, chloride) outside the normal laboratory range and judged clinically relevant by the Investigator; concomitant treatment with drugs known for QT prolongation, or with drugs producing hypokalemia, or diuretics; QTcF values higher than 450 msec in the ECG performed at the screening; history of major depression resistant to medical treatments (previous failure to respond to two consecutive antidepressants of different classes used for a sufficient length of time at appropriate doses); history of seizure events other than a single childhood febrile seizure; history of alcohol or psychoactive substance abuse or addiction (except caffeine or nicotine) during the last year as defined by DSM-IV criteria; positive urine drug screen for CNS-active drugs (cocaine, opioids, amphetamines and cannabinoids) at Visit 1 (screening); acute risk of suicide (HAMD, criterion 3 with a value > 3); presence of any primary psychiatric disorder other than major depression; history or presence of bipolar disorder, any psychotic disorder, mental disorder due to general medical conditions; pregnancy, lactation, or female with a positive urine pregnancy test result at Visit 1 (Screening); electroconvulsive therapy (ECT) within 30 days prior to the screening visit; use of antipsychotic drugs within two months prior to the baseline visit (Visit 2); use of any anxiolytic or sedative hypnotic drug within seven days prior to the baseline (Visit 2) and during the study. Exception is stable low doses of benzodiazepines for insomnia (if taken by the patient more than two weeks before the Treatment Phase); use of any psychotropic drug or substance with central nervous system effects within seven days prior to the baseline visit (Visit 2); use of any non-psychotropic drug with psychotropic effects (e.g. alpha-adrenergic blockers) within seven days prior to the baseline visit (visit 2), unless a stable dose of the drug has been maintained for at least one month (three months for thyroid or hormonal medications) before the baseline visit (visit 2); concomitant treatment with CYP3A4 inhibitors (e.g. ketoconazole, ritonavir, indinavir); hyperthyroidism, even if pharmacologically corrected; start or discontinuation of psychotherapy within 6 weeks prior to screening; clinically significant abnormalities on physical examination, vital signs, ECG, laboratory tests at the screening visit; high blood pressure (supine systolic blood pressure > 160 mmHg or supine diastolic blood pressure > 90 mmHg) at screening or baseline, either untreated or under treatment with antihypertensives inability to comply with the protocol requirements, instructions and study-related restrictions; e.g. uncooperative attitude, inability to return for study-visits, and improbability of completing the clinical study; vulnerable subjects (e.g. persons kept in detention); if subject is the Investigator or his/her deputies, first grade relative, research assistant, pharmacist, study coordinator, other staff of relative thereof directly involved in the conduct of the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Filippo Bogetto, MD
Organizational Affiliation
Department of Neuroscience University of Turin - Italy
Official's Role
Principal Investigator
Facility Information:
Facility Name
Institute für Psychosomatik
City
Vienna
ZIP/Postal Code
1010
Country
Austria
Facility Name
AKH Wien
City
Vienna
ZIP/Postal Code
1090
Country
Austria
Facility Name
PRAGTIS, s.r.o.
City
Praha 2
State/Province
Praha
ZIP/Postal Code
12000
Country
Czech Republic
Facility Name
Psychiatry Trial, s.r.o.
City
Praha 5
State/Province
Praha
ZIP/Postal Code
15800
Country
Czech Republic
Facility Name
MEDICAL SERVICES PRAGUE, s.r.o.
City
Praha 6
State/Province
Praha
ZIP/Postal Code
160 00
Country
Czech Republic
Facility Name
Neuropsychiatrie s.r.o.
City
Praha 6
State/Province
Praha
ZIP/Postal Code
160 00
Country
Czech Republic
Facility Name
Saint Anne, s.r.o.
City
Brno-mesto
ZIP/Postal Code
60200
Country
Czech Republic
Facility Name
SUPERVIZE, s.r.o.
City
Kutna Hora
ZIP/Postal Code
284 01
Country
Czech Republic
Facility Name
BIALBI s.r.o.
City
Litomerice
ZIP/Postal Code
41201
Country
Czech Republic
Facility Name
Fakultni Nemocnice Olomouc, Klinika Psychiatrie
City
Olomouc
ZIP/Postal Code
77 900
Country
Czech Republic
Facility Name
MUDr. Eva Soukupová-Psychiatrická praxe, s.r.o.
City
Plzeň
ZIP/Postal Code
301 00
Country
Czech Republic
Facility Name
NZZ- MUDr. Jaroslav Hronek, psychiatrická ambulance
City
Plzeň
ZIP/Postal Code
301 00
Country
Czech Republic
Facility Name
UOPI di Psichiatria Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele, Presidio "Gaspare Rodolico"
City
Catania
ZIP/Postal Code
95100
Country
Italy
Facility Name
Clinica Psichiatrica Nuovo Ospedale S. Salvatore Università degli Studi del L'Aquila
City
L'Aquila
ZIP/Postal Code
67100
Country
Italy
Facility Name
Ospedale Santa Maria della Misericordia Unità di Degenza Psichiatrica-SPDC
City
Perugia
ZIP/Postal Code
06132
Country
Italy
Facility Name
Azienda Ospedaliera Sant'Andrea Università La Sapienza Unità Operativa Complessa di Psichiatria
City
Rome
ZIP/Postal Code
00189
Country
Italy
Facility Name
AOUS-Azienda Ospedaliera Universitaria Senese Policlinico Santa Maria alle Scotte Clinica Psichiatrica Universitaria
City
Siena
ZIP/Postal Code
53100
Country
Italy
Facility Name
Department of Neurosciences University of Turin
City
Turin
ZIP/Postal Code
10126
Country
Italy
Facility Name
Quantum Medical Center Srl
City
Bucharest
ZIP/Postal Code
RO-011426
Country
Romania
Facility Name
Spitalul clinic de psihiatrie "Prof. Dr. Al. Obregia"/Sectia 13
City
Bucharest
ZIP/Postal Code
RO-041914
Country
Romania
Facility Name
Spitalul Clinic de Psihiatrie "Prof. Dr. Al. Obregia"/Sectia 1
City
Bucharest
ZIP/Postal Code
RO-041914
Country
Romania
Facility Name
Spitalul Clinc de Urgenta Militar "Dr. Stefan Odobleja", Craiova
City
Craiova
ZIP/Postal Code
RO-200530
Country
Romania
Facility Name
Spital Clinic de Psihiatrie SOCOLA / Iasi
City
Iasi
ZIP/Postal Code
RO-700282
Country
Romania
Facility Name
Spitalul de Psihiatrie "Dr. Gh.Preda" Sibiu
City
Sibiu
ZIP/Postal Code
RO-550082
Country
Romania
Facility Name
Spitalul Clinc Judetean Mures, Centrul de Sanatate Mintala
City
Targu Mures
ZIP/Postal Code
RO-540096
Country
Romania
Facility Name
Psychiatricka ambulancia
City
Bratislava
ZIP/Postal Code
81107
Country
Slovakia
Facility Name
MENTUM, s.r.o.
City
Bratislava
ZIP/Postal Code
82007
Country
Slovakia
Facility Name
EPAMED, s.r.o.
City
Kosice
ZIP/Postal Code
4000
Country
Slovakia
Facility Name
Psychiatricka nemocnica
City
Michalovce
ZIP/Postal Code
7101
Country
Slovakia
Facility Name
Psycholine, s.r.o.
City
Rimavska Sobota
ZIP/Postal Code
97901
Country
Slovakia
Facility Name
Psychiatricke oddelenie, NsP sv Barbory Roznava
City
Roznava
ZIP/Postal Code
4801
Country
Slovakia
Facility Name
Instituto de Investigacion y Asistencia Psiquiatrica - IIAP
City
Madrid
ZIP/Postal Code
28002
Country
Spain

12. IPD Sharing Statement

Links:
URL
http://www.angelinipharma.com
Description
Sponsor's website

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Trazodone Once a Day in Major Depression Disorder

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