Memantine Plus Es-citalopram in Elderly Depressed Patients With Cognitive Impairment
NCT ID: NCT01876823
Last Updated: 2014-10-24
Study Results
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View full resultsBasic Information
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COMPLETED
PHASE2/PHASE3
60 participants
INTERVENTIONAL
2006-04-30
2010-03-31
Brief Summary
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Over the last decade, it has been well documented that mild cognitive impairment (MCI) increases the risk of conversion to AD and that coincident depression and MCI (Dep-MCI) further increases the risk 2 to 3 fold. The primary focus of this line of investigation is to treat the very high risk to dement patient population with Dep-MCI, before they develop AD, in the hopes of delaying AD onset.
Memantine had not been studied in DEP-MCI patients. Since treatment of these patients with combined antidepressant and AChEIs has been associated with cognitive improvement in pilot studies, we explore whether treatment of DEP-MCI with memantine in addition to antidepressant treatment would benefit cognitive performance and lead to a low rate of conversion to dementia. We evaluate the cognitive and antidepressant benefit of combined open-label es-citalopram and memantine treatment over 48 weeks in a DEP-CI sample.
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Detailed Description
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This will tell us about the efficacy and tolerability of es-citalopram+memantine on both cognitive and depressive symptoms in Dep-MCI patients and will potentially have broader public health implications because Dep-MCI is a wide-spread clinical problem where management needs to be improved.
Conditions
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Study Design
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NA
SINGLE_GROUP
TREATMENT
NONE
Study Groups
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es-citalopram and Memantine Treatment
concurrent es-citalopram plus memantine were administered for 48 weeks.
es-citalopram
es-citalopram 10mg/day will be given for the first week, and 20mg/day starting at week 2.
Memantine
After two weeks on Lexapro, Memantine 5mg will be added. The dose will increase to 10mg for the second week and will be increased at a rate of 5mg per week. Memantine dosage will not exceed 20mg.
Interventions
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es-citalopram
es-citalopram 10mg/day will be given for the first week, and 20mg/day starting at week 2.
Memantine
After two weeks on Lexapro, Memantine 5mg will be added. The dose will increase to 10mg for the second week and will be increased at a rate of 5mg per week. Memantine dosage will not exceed 20mg.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
2. Meets criteria for both "depression" and "cognitive impairment".
3. Study Criteria for "depression":
i. Patients who meet DSM-IV criteria for Major Depression, Dysthymic Disorder, or Dysthymia symptoms criteria of minimum 6 month duration (not the 2 year DSM-IV criteria). ii. 24-item HAM-D greater than 13; and iii. Clinical Global Impression (CGI) for severity of Depression greater than 2 (absolute score at least mild to moderate depression on a 7-point scale)
4. Study Criteria for "cognitive deficit":
i. Subjective memory complaint ii.Mini Mental Status Exam (MMSE) greater than 24; and at least one of a, b, or c:
1. less than 3 on MMSE 5 min delay on recall
2. scores on 2 neuropsychological tests greater than 1 Standard Deviation (SD) below standardized norms, or
3. score on 1 neuropsychological tests greater than 2 SD below standardized norms.
Selective Reminding Test with delay Wechsler Memory Scale (WMS): Visual Reproduction - with delay, % savings from immed to delay Controlled Oral Word Association Test Trails B Digit symbol subtest of Wechsler Adult Intelligence Scale (WAIS)-III Continuous Performance Test iii. CGI for severity of Cognitive deficit greater than 2 (absolute score on a 7-point scale:1=no deficit to 7=severe deficit). iv. Clinical Dementia Rating (CDR) = 0 or 0.5
5. Willing and capable of giving informed consent
Exclusion Criteria
2. Meets criteria for:
1. schizophrenia
2. alcohol or substance dependence or abuse within the last 6 months.
3. Suicidal attempt in last 6 months or current suicidal intent.
4. Patients currently on an effective antidepressant medication
5. Use of cholinesterase inhibitors in the last year.
6. Neurological disease including stroke, epilepsy, or other neurodegenerative disorders.
7. An acute, severe or unstable medical condition such as metastatic or active cancer, hepatic disease, or primary renal disease requiring dialysis.
8. Patients who can not tolerate being tapered off antidepressant medication (i.e. greater than a 25% incr. in baseline HAM-D) or has a history indicating patient is unlikely to tolerate psychotropic washout.
9. Patient with a history of non-response to Citalopram or es-citalopram
50 Years
90 Years
ALL
No
Sponsors
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New York State Psychiatric Institute
OTHER
Responsible Party
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Principal Investigators
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Gregory Pelton, M.D.
Role: PRINCIPAL_INVESTIGATOR
New York State Psychiatric Institute
Davangere Devanand, M.D.
Role: STUDY_CHAIR
New York State Psychiatric Institute
Locations
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New York State Psychiatric Institute
New York, New York, United States
Countries
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References
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Other Identifiers
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6277R
Identifier Type: -
Identifier Source: org_study_id
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