Neural, Genetic, and Peripheral Correlates of SSRI Pharmaco-Response

NCT ID: NCT01251471

Last Updated: 2016-10-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

26 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-08-31

Study Completion Date

2015-03-31

Brief Summary

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The aim of this pharmaco-MRI study is to investigate neural correlates of variable antidepressant treatment response driven by genetic variation in multiple genes involved in depression.

Thirty Major Depressive Disorder (MDD) patients with a concurrent major depressive episode will undergo three MRI scanning sessions after escitalopram treatment initiation. Furthermore, extensive behavioral assessments and measures of potential peripheral markers such lymphocyte mRNA or pharmacological parameters on platelets or lymphocytes will be performed.

Imaging measures have been suggested to be superior for drug response assessment as compared to psychometric scales, which hardly correlate with biological parameters. Since imaging techniques are too expensive and sophisticated for a broad clinical use, this study will provide pilot data on potential peripheral biomarkers of neural activation being related to drug response.

Detailed Description

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The aim of this pharmaco-MRI study is to investigate neural correlates of variable antidepressant treatment response driven by genetic variation in multiple genes involved in depression.

Thirty Major Depressive Disorder (MDD) patients with a concurrent major depressive episode will undergo three MRI scanning sessions at baseline, 4 hours and 8 weeks after escitalopram treatment initiation. During each MRI session, one structural and 3 fMRI scans each engaging different brain circuitries will be performed. All subjects will undergo extensive behavioral assessment and will be genotyped. Furthermore, potential peripheral markers such lymphocyte mRNA or pharmacological parameters on platelets or lymphocytes will be assessed.

The investigators expect that genetic variants which have been associated with variable response to SSRIs in previous Imaging Genetics studies are modulating neural targets of drug response. Moreover, peripheral markers are expected to correlate with these brain region measurements.

Imaging measures have been suggested to be superior for drug response assessment as compared to psychometric scales, which hardly correlate with biological parameters. Since imaging techniques are too expensive and sophisticated for a broad clinical use, this study will provide pilot data on peripheral biomarkers of neural activation being related to drug response. Furthermore, this study will demonstrate whether and how genotypes impact on the dynamics of neural drug response in vivo.

Conditions

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Depression

Keywords

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major depressive disorder MDD imaging genetics pharmacoMRI

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Escitalopram

Escitalopram, p.o., 10 mg/d; optional 20 mg/d after 2 weeks for 8 weeks

Group Type EXPERIMENTAL

Escitalopram

Intervention Type DRUG

10 mg/d; optional 20 mg/d after 2 weeks.

Interventions

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Escitalopram

10 mg/d; optional 20 mg/d after 2 weeks.

Intervention Type DRUG

Other Intervention Names

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Lexapro Cipralex Seroplex Lexamil

Eligibility Criteria

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Inclusion Criteria

* Male or female
* Age 18 -45 years
* Right-handedness
* DSM-IV diagnosis of a major depressive episode (SCID)
* a MADRS score ≥20 and ≤ 30
* ability to be managed as outpatients
* ability to fulfill the criteria to undergo an MRI scan
* Caucasian subjects of European ancestry

Exclusion Criteria

* previous or concurrent major medical or neurological illness
* clinically significant abnormal values in routine laboratory screening or general physical examination
* DSM-IV diagnosis of substance dependence within the past year, except for caffeine or nicotine or current substance abuse
* DSM-IV diagnosis of schizophrenia, schizoaffective disorder, bipolar disorder, or an anxiety disorder as a primary diagnosis
* the use of any psychotropic drug within the last two months unresponsiveness of a former major depressive episode to an adequate antidepressive drug dosing of at least 6 weeks duration or any kind of therapy resistance
* a history of severe drug allergy or hypersensitivity or known hypersensitivity to escitalopram
* being acutely suicidal either indicated by a score ≥ 5 on item 10 (suicidal thoughts) on the MADRS or a score ≥ 4 on the HAM-D 21 (suicidal thoughts) or according to the investigator´s opinion
* failures to comply with the study protocol or to follow the instructions of the investigating team
* current pregnancy or breast feeding
* metallic implants or other contraindications to MRI
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medical University of Vienna

OTHER

Sponsor Role lead

Responsible Party

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Lukas Pezawas

Lukas Pezawas, MD, Medical University of Vienna

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Lukas Pezawas, MD

Role: PRINCIPAL_INVESTIGATOR

Medical University of Vienna, Dept. of Psychiatry and Psychotherapy

Locations

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Medical University of Vienna, Dept. of Psychiatry and Psychotherapy

Vienna, Vienna, Austria

Site Status

Countries

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Austria

References

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Scharinger C, Rabl U, Sitte HH, Pezawas L. Imaging genetics of mood disorders. Neuroimage. 2010 Nov 15;53(3):810-21. doi: 10.1016/j.neuroimage.2010.02.019. Epub 2010 Feb 13.

Reference Type BACKGROUND
PMID: 20156570 (View on PubMed)

Pezawas L, Meyer-Lindenberg A. Imaging genetics: Progressing by leaps and bounds. Neuroimage. 2010 Nov 15;53(3):801-3. doi: 10.1016/j.neuroimage.2010.08.001. No abstract available.

Reference Type BACKGROUND
PMID: 20816317 (View on PubMed)

Rabl U, Scharinger C, Muller M, Pezawas L. Imaging genetics: implications for research on variable antidepressant drug response. Expert Rev Clin Pharmacol. 2010 Jul;3(4):471-89. doi: 10.1586/ecp.10.35.

Reference Type BACKGROUND
PMID: 22111678 (View on PubMed)

Related Links

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http://www.meduniwien.ac.at/psychiatrie/

Dep. Psychiatry and Psychotherapy

Other Identifiers

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OENB-13903

Identifier Type: -

Identifier Source: org_study_id