Predictors of the Outcome of Late Life Depression

NCT ID: NCT02441387

Last Updated: 2018-05-24

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

Total Enrollment

120 participants

Study Classification

OBSERVATIONAL

Study Start Date

2015-04-30

Study Completion Date

2019-07-31

Brief Summary

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Predictors of response to pharmacological treatment of major depressive disorder will be investigated. One hundred and twenty patients will be included in a naturalistic clinical trial. Psychopathology, personality traits, cognitive performance, brain structural changes and genetic polymorphisms will be evaluated. Patients will be followed for 18 months with a pharmacological treatment algorithm and will be evaluated monthly until 6th month and every 3 months, up to 18 months. Psychoeducation will be offered to patients who did not remit until 3 months of pharmacological tretment.

Detailed Description

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The relevance of depression prevention and treatment in older people tend to raise in future years, considering the rapid increase of the elderly population in Brazil and the growing impact of depression (the third cause of global burden of diseases in the world according to the World Health Association 2004 report). The association between structural brain changes and treatment response in patients with late-life depression (LLD) remains an intriguing area of research. Predictors of response to pharmacological treatment of major depressive disorder will be investigated in 120 elderly patients, who will be included in a naturalistic clinical trial, that will evaluate psychopathology, personality traits, cognitive performance, brain structural changes and genetic polymorphisms. Patients will be followed for 18 months with a treatment algorithm for depression and will be evaluated monthly until 6th month and every 3 months, up to 18 months, to assess factors associated to response to treatment.

Patients who are in the antidepressant treatment group and does not reach remission (MADRS score \<or =8) until 3 months of pharmacological treatment will be invited to be part of a psychoeducation program. If the patient accepts the psychoeducation intervention, he will be randomized to psychoeducation (pharmacological treatment plus psychoeducation) or treatment as usual (only pharmacological treatment). The psychoeducation program consists of 10 individual weekly sessions, conducted by a trained psychologist who will explain the main concepts of depression and its symptoms, the importance of adhering to treatment, the main side effects of pharmacological treatment, and how to cope with daily difficulties.

Conditions

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Major Depression

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Study Groups

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Antidepressant treatment

According to their previous treatment history and clinical presentation, patients may take:

Sertraline 50-250mg/day for 1 year or Escitalopram 10-20mg/day for 1 year or Mirtazapine 15-45mg/day for 1 year or Venlafaxine 37,5-300mg/day for 1 year or Lithium 300-900mg/day for 1 year.

Antidepressant

Intervention Type DRUG

Sertraline 50-250mg/day for 1 year or Escitalopram 10-20mg/day for 1 year or Mirtazapine 15-45mg/day for 1 year or Venlafaxine 37,5-300mg/day for 1 year or Lithium 300-900mg/day for 1 year.

Treatment as usual (only pharmacological treatment).

Intervention Type OTHER

Patients who are in the antidepressant treatment group and does not reach remission (MADRS score \<or =8) until visit 4 will be invited to be part of a psychoeducation program. If the patient accepts the psychoeducation intervention, he will be randomized to psychoeducation (pharmacological treatment plus psychoeducation) or treatment as usual (only pharmacological treatment).

Antidepressant treatment & Psychoeducation intervention

Antidepressant treatment and psych education program (10 weekly sessions).

Antidepressant

Intervention Type DRUG

Sertraline 50-250mg/day for 1 year or Escitalopram 10-20mg/day for 1 year or Mirtazapine 15-45mg/day for 1 year or Venlafaxine 37,5-300mg/day for 1 year or Lithium 300-900mg/day for 1 year.

Psychoeducation

Intervention Type OTHER

Patients who are in the antidepressant treatment group and does not reach remission (MADRS score \<or =8) until visit 4 will be invited to be part of a psychoeducation program. If the patient accepts the psychoeducation intervention, he will be randomized to psychoeducation (pharmacological treatment plus psychoeducation) or treatment as usual (only pharmacological treatment). The psychoeducation program consists of 10 individual sessions, conducted by a trained psychologist who will explain the main concepts of depression and its symptoms, the importance of adhering to treatment, the main side effects of pharmacological treatment, and how to cope with daily difficulties.

Interventions

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Antidepressant

Sertraline 50-250mg/day for 1 year or Escitalopram 10-20mg/day for 1 year or Mirtazapine 15-45mg/day for 1 year or Venlafaxine 37,5-300mg/day for 1 year or Lithium 300-900mg/day for 1 year.

Intervention Type DRUG

Psychoeducation

Patients who are in the antidepressant treatment group and does not reach remission (MADRS score \<or =8) until visit 4 will be invited to be part of a psychoeducation program. If the patient accepts the psychoeducation intervention, he will be randomized to psychoeducation (pharmacological treatment plus psychoeducation) or treatment as usual (only pharmacological treatment). The psychoeducation program consists of 10 individual sessions, conducted by a trained psychologist who will explain the main concepts of depression and its symptoms, the importance of adhering to treatment, the main side effects of pharmacological treatment, and how to cope with daily difficulties.

Intervention Type OTHER

Treatment as usual (only pharmacological treatment).

Patients who are in the antidepressant treatment group and does not reach remission (MADRS score \<or =8) until visit 4 will be invited to be part of a psychoeducation program. If the patient accepts the psychoeducation intervention, he will be randomized to psychoeducation (pharmacological treatment plus psychoeducation) or treatment as usual (only pharmacological treatment).

Intervention Type OTHER

Other Intervention Names

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zoloft, lexapro, efexor, remeron, carbolithium

Eligibility Criteria

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Inclusion Criteria

* 60 years old
* Major depression (DSMIV-TR)
* Evaluated with MINI
* Willing to participate.

Exclusion Criteria

* Less than 60 years old
* Dementia syndrome
* Delirium or other organic mental disorders
* Alcohol/drug dependence
* Anxiety disorders, or other psychiatric disorders, and not willing (or not able) to participate
Minimum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fundação de Amparo à Pesquisa do Estado de São Paulo

OTHER_GOV

Sponsor Role collaborator

University of Sao Paulo General Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Cassio MC Bottino, phD

Role: STUDY_DIRECTOR

Old Age Research Group (PROTER), Institute and Department of Psychiatry, Faculty of Medicine

Salma Rose Imanari Ribeiz, phD

Role: PRINCIPAL_INVESTIGATOR

Old Age Research Group (PROTER), Institute and Department of Psychiatry, Faculty of Medicine

Locations

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University of São Paulo, Faculty of Medicine, Institute and Department of Psychiatry

São Paulo, , Brazil

Site Status

Countries

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Brazil

Other Identifiers

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PREDLLD10446

Identifier Type: -

Identifier Source: org_study_id

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