Optimizing Antidepressant Treatment by Genotype-dependent Adjustment of Medication According to the ABCB1 Gene

NCT ID: NCT02237937

Last Updated: 2014-09-12

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-09-30

Study Completion Date

2014-12-31

Brief Summary

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The study evaluates the ABCB1-genotype dependent efficacy of a quick dose-escalation strategy within 28 days of treatment with approved antidepressants that are known substrates of the P-glycoprotein, an efflux pump of the blood-brain barrier expressed by the ABCB1 gene.

Moreover, the study evaluates ABCB1-genotype dependent side-effects of approved antidepressants that are known substrates of the P-glycoprotein, an efflux pump of the blood-brain barrier expressed by the ABCB1 gene.

Detailed Description

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Conditions

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Major Depression

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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Normal dosage

Selected antidepressants that are substrates of the P-glycoprotein:

Dosage:

* paroxetine \< 40 mg/d
* sertraline \< 100 mg/d
* citalopram \< 40 mg/d
* escitalopram \< 20 mg/d
* venlafaxine \< 225 mg/d
* amitriptyline \< 150 mg/d
* amitriptylinoxide \< 150 mg/d
* nortriptyline \< 150 mg/d
* trimipramine \< 150 mg/d

Group Type EXPERIMENTAL

Paroxetine

Intervention Type DRUG

Sertraline

Intervention Type DRUG

Citalopram

Intervention Type DRUG

Venlafaxine

Intervention Type DRUG

Amitriptyline

Intervention Type DRUG

Escitalopram

Intervention Type DRUG

Amitriptylinoxide

Intervention Type DRUG

Nortriptyline

Intervention Type DRUG

Trimipramine

Intervention Type DRUG

High dosage

Selected antidepressants that are substrates of the P-glycoprotein:

Dosage:

* paroxetine \< 80 mg/d
* sertraline \< 200 mg/d
* citalopram \< 80 mg/d
* escitalopram \< 40 mg/d
* venlafaxine \< 450 mg/d
* amitriptyline \< 300 mg/d
* amitriptylinoxide \< 300 mg/d
* nortriptyline \< 300 mg/d
* trimipramine \< 300 mg/d

Group Type EXPERIMENTAL

Paroxetine

Intervention Type DRUG

Sertraline

Intervention Type DRUG

Citalopram

Intervention Type DRUG

Venlafaxine

Intervention Type DRUG

Amitriptyline

Intervention Type DRUG

Escitalopram

Intervention Type DRUG

Amitriptylinoxide

Intervention Type DRUG

Nortriptyline

Intervention Type DRUG

Trimipramine

Intervention Type DRUG

Interventions

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Paroxetine

Intervention Type DRUG

Sertraline

Intervention Type DRUG

Citalopram

Intervention Type DRUG

Venlafaxine

Intervention Type DRUG

Amitriptyline

Intervention Type DRUG

Escitalopram

Intervention Type DRUG

Amitriptylinoxide

Intervention Type DRUG

Nortriptyline

Intervention Type DRUG

Trimipramine

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Male and female patients
* Age between 18 and 80 years
* Inpatients with a DSM-IV diagnosis of Major Depression
* single episode or recurrent
* moderate to severe intensity
* without psychotic features
* Inpatients with a DSM-IV diagnosis of bipolar disorder I or II
* current episode with depressive symptoms
* moderate to severe intensity
* without psychotic features
* HAM-D score at the time of inclusion in the study ≥ 14
* Patient has already been adjusted to one of the following antidepressants in a dose which is still under the defined normal-dose:
* paroxetine \< 40 mg/d
* sertraline \< 100 mg/d
* citalopram \< 40 mg/d
* escitalopram \< 20 mg/d
* venlafaxine \< 225 mg/d
* amitriptyline \< 150 mg/d
* amitriptylinoxide \< 150 mg/d
* nortriptyline \< 150 mg/d
* trimipramine \< 150 mg/d

Exclusion Criteria

* Acute suicidality (HAM-D Item 3 score \> 2)
* Acute alcohol-, hypnotics-, analgesics- or psychopharmacological intoxication or delirium
* Current alcohol dependence, or dependencies from other psychotropic substances
* Severe medical or neurological diseases: patients with severe hepatic (severe impairment of liver function, cirrhosis of the liver), renal (kidney malfunctions), cardiovascular (recent myocardial infarction, instable heart disease), neurological diseases (e.g. multiple sclerosis, Parkinson, dementia)
* Patients incapable of giving informed consent
* Pregnant or breast-feeding women
* Women of reproductive age without effective contraception
* Simultaneous participation in other clinical trials or participation in an other clinical trial within 6 weeks before the start of the study
* Hypersensitivity to the study medication or to one of the ingredients of the medication
* Simultaneous treatment with another antidepressant besides study medication (exception: trazodone up to 75 mg/d, mirtazapine up to 15 mg/d, trimipramine up to 50 mg/d)
* Simultaneous treatment with mood stabilizers or neuroleptic drugs (exception: quetiapine up to 50 mg/d, olanzapine up to 5 mg/d)
Minimum Eligible Age

18 Years

Maximum Eligible Age

79 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Max-Planck-Institute of Psychiatry

OTHER

Sponsor Role collaborator

HolsboerMaschmeyer NeuroChemie GmbH

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Florian Holsboer, MD, PHD

Role: PRINCIPAL_INVESTIGATOR

Max-Planck-Institute of Psychiatry

Locations

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Max Planck Institute of Psychiatry

Munich, Bavaria, Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Barbara Breitenstein, MSc

Role: CONTACT

0049 89 30622 ext. 244

Other Identifiers

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2011-003190-29

Identifier Type: -

Identifier Source: org_study_id

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