Trial Outcomes & Findings for Depressed Mood Improvement Through Nicotine Dosing (Depressed MIND Study) (NCT NCT02816138)

NCT ID: NCT02816138

Last Updated: 2018-09-27

Results Overview

Primary mood outcome measured by the total score of the clinician-rated MADRS. MADRS was measured every 3 weeks (baseline, week 3, week 6, week 9, and week 12). MADRS total score range is 0-60, where higher scores indicate greater depression severity.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

15 participants

Primary outcome timeframe

Baseline to week 12

Results posted on

2018-09-27

Participant Flow

Participant milestones

Participant milestones
Measure
Transdermal Nicotine Patch
Transdermal nicotine patch, administered on awakening and removed at bedtime (16h/d). Dosing began at 3.5mg patch/daily, titrated over study to maximum dose of 21mg patch/daily. Dose could be reduced to the prior level or an intermediate level for tolerability. Titration schedule: 3.5mg patch x 1 week, 7mg patch x 2 weeks, 14mg patch x 3 weeks, 21mg patch x 6 weeks. Nicotine: Open-label transdermal nicotine patch
Overall Study
STARTED
15
Overall Study
COMPLETED
14
Overall Study
NOT COMPLETED
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Transdermal Nicotine Patch
Transdermal nicotine patch, administered on awakening and removed at bedtime (16h/d). Dosing began at 3.5mg patch/daily, titrated over study to maximum dose of 21mg patch/daily. Dose could be reduced to the prior level or an intermediate level for tolerability. Titration schedule: 3.5mg patch x 1 week, 7mg patch x 2 weeks, 14mg patch x 3 weeks, 21mg patch x 6 weeks. Nicotine: Open-label transdermal nicotine patch
Overall Study
Adverse Event
1

Baseline Characteristics

Depressed Mood Improvement Through Nicotine Dosing (Depressed MIND Study)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Transdermal Nicotine Patch
n=15 Participants
Transdermal nicotine patch, administered on awakening and removed at bedtime (16h/d). Dosing began at 3.5mg patch/daily, titrated over study to maximum dose of 21mg patch/daily. Dose could be reduced to the prior level or an intermediate level for tolerability. Titration schedule: 3.5mg patch x 1 week, 7mg patch x 2 weeks, 14mg patch x 3 weeks, 21mg patch x 6 weeks. Nicotine: Open-label transdermal nicotine patch
Age, Categorical
<=18 years
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
8 Participants
n=5 Participants
Age, Categorical
>=65 years
7 Participants
n=5 Participants
Age, Continuous
64.9 years
STANDARD_DEVIATION 4.6 • n=5 Participants
Sex: Female, Male
Female
10 Participants
n=5 Participants
Sex: Female, Male
Male
5 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
15 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=5 Participants
Race (NIH/OMB)
White
13 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Region of Enrollment
United States
15 participants
n=5 Participants
Past smoker (defined as smoking at least 1 cigarette daily for at least 6 months over the lifetime)
5 Participants
n=5 Participants
Depression severity (measured by Montgomery Asberg Depression Rating Scale total score)
27.7 units on a scale
STANDARD_DEVIATION 4.0 • n=5 Participants

PRIMARY outcome

Timeframe: Baseline to week 12

Population: Analyses included all participants, including the one subject who withdrew early. Missing values were imputed using the mean value of the sample at that time point.

Primary mood outcome measured by the total score of the clinician-rated MADRS. MADRS was measured every 3 weeks (baseline, week 3, week 6, week 9, and week 12). MADRS total score range is 0-60, where higher scores indicate greater depression severity.

Outcome measures

Outcome measures
Measure
Transdermal Nicotine Patch
n=15 Participants
Transdermal nicotine patch, administered on awakening and removed at bedtime (16h/d). Dosing began at 3.5mg patch/daily, titrated over study to maximum dose of 21mg patch/daily. Dose could be reduced to the prior level or an intermediate level for tolerability. Titration schedule: 3.5mg patch x 1 week, 7mg patch x 2 weeks, 14mg patch x 3 weeks, 21mg patch x 6 weeks. Nicotine: Open-label transdermal nicotine patch
Change in Total MADRS (Montgomery Asberg Depression Rating Scale) Score
-18.45 units on a scale
Standard Deviation 7.98

PRIMARY outcome

Timeframe: Baseline to week 12

Population: Subject who withdrew early not included due to no 12-week data.

Primary cognitive outcome, the CPT is a neuropsychological test that measures attention. In this 14-minute test, participants are asked to respond when any letter appears, except the non-target letter "X". This test is conducted at baseline and at week 12. The specific primary outcome metric is standard error of change in the inter-stimulus hit reaction time, or variability between different trials. There is no absolute range, but lower scores indicate decreased variability across trials and overall better performance.

Outcome measures

Outcome measures
Measure
Transdermal Nicotine Patch
n=14 Participants
Transdermal nicotine patch, administered on awakening and removed at bedtime (16h/d). Dosing began at 3.5mg patch/daily, titrated over study to maximum dose of 21mg patch/daily. Dose could be reduced to the prior level or an intermediate level for tolerability. Titration schedule: 3.5mg patch x 1 week, 7mg patch x 2 weeks, 14mg patch x 3 weeks, 21mg patch x 6 weeks. Nicotine: Open-label transdermal nicotine patch
Change in Continuous Performance Task (CPT) Performance
-0.003 milliseconds
Standard Deviation 0.135

SECONDARY outcome

Timeframe: Baseline to week 12

Population: One subject not included due to early withdrawal

Secondary mood outcome: Change in anhedonia measured by SHAPS, a self-report questionnaire that ranges from 0-42, where higher scores indicate greater anhedonia.

Outcome measures

Outcome measures
Measure
Transdermal Nicotine Patch
n=14 Participants
Transdermal nicotine patch, administered on awakening and removed at bedtime (16h/d). Dosing began at 3.5mg patch/daily, titrated over study to maximum dose of 21mg patch/daily. Dose could be reduced to the prior level or an intermediate level for tolerability. Titration schedule: 3.5mg patch x 1 week, 7mg patch x 2 weeks, 14mg patch x 3 weeks, 21mg patch x 6 weeks. Nicotine: Open-label transdermal nicotine patch
Change in Snaith-Hamilton Pleasure Scale (SHAPS) Score
-3.4 units on a scale
Standard Deviation 6.6

SECONDARY outcome

Timeframe: Baseline to week 12

Population: One participant not included due to early withdrawal.

Secondary mood outcome: Change in anxiety and worry measured by PSWQ, a self-report questionnaire with a range of 16-80, where higher scores indicate greater anxiety and worry.

Outcome measures

Outcome measures
Measure
Transdermal Nicotine Patch
n=14 Participants
Transdermal nicotine patch, administered on awakening and removed at bedtime (16h/d). Dosing began at 3.5mg patch/daily, titrated over study to maximum dose of 21mg patch/daily. Dose could be reduced to the prior level or an intermediate level for tolerability. Titration schedule: 3.5mg patch x 1 week, 7mg patch x 2 weeks, 14mg patch x 3 weeks, 21mg patch x 6 weeks. Nicotine: Open-label transdermal nicotine patch
Change in Penn State Worry Questionnaire (PSWQ)
-5.1 units on a scale
Standard Deviation 13.4

SECONDARY outcome

Timeframe: Baseline to week 12

Population: Subject who withdrew early not included due to no 12-week data.

Secondary mood outcome: Change in rumination measured by the Ruminative Response Scale total score measured at baseline and week 12. This is a self-report scale with a range of 0-66, where higher scores indicate higher levels of rumination.

Outcome measures

Outcome measures
Measure
Transdermal Nicotine Patch
n=14 Participants
Transdermal nicotine patch, administered on awakening and removed at bedtime (16h/d). Dosing began at 3.5mg patch/daily, titrated over study to maximum dose of 21mg patch/daily. Dose could be reduced to the prior level or an intermediate level for tolerability. Titration schedule: 3.5mg patch x 1 week, 7mg patch x 2 weeks, 14mg patch x 3 weeks, 21mg patch x 6 weeks. Nicotine: Open-label transdermal nicotine patch
Change in Ruminative Response Scale Total Score
-9.0 units on a scale
Standard Deviation 10.0

SECONDARY outcome

Timeframe: Baseline to 12 weeks

Population: Subject who withdrew early not included due to no 12-week data.

Secondary Mood Outcomes: Change in apathy as measured by the self-report AES, a questionnaire with a range of 0-54, where lower scores indicate greater apathy.

Outcome measures

Outcome measures
Measure
Transdermal Nicotine Patch
n=14 Participants
Transdermal nicotine patch, administered on awakening and removed at bedtime (16h/d). Dosing began at 3.5mg patch/daily, titrated over study to maximum dose of 21mg patch/daily. Dose could be reduced to the prior level or an intermediate level for tolerability. Titration schedule: 3.5mg patch x 1 week, 7mg patch x 2 weeks, 14mg patch x 3 weeks, 21mg patch x 6 weeks. Nicotine: Open-label transdermal nicotine patch
Change in Apathy Evaluation Scale (AES)
7.7 units on a scale
Standard Deviation 5.4

SECONDARY outcome

Timeframe: Baseline to week 12

Population: Subject who withdrew early not included due to no 12-week data.

Secondary cognitive outcome: Change in subjective cognitive performance as measured by MFQ, a self-report scale ranging from 64-448. Higher scores indicate better subjective memory function, while lower scores indicate poorer subjective memory function.

Outcome measures

Outcome measures
Measure
Transdermal Nicotine Patch
n=14 Participants
Transdermal nicotine patch, administered on awakening and removed at bedtime (16h/d). Dosing began at 3.5mg patch/daily, titrated over study to maximum dose of 21mg patch/daily. Dose could be reduced to the prior level or an intermediate level for tolerability. Titration schedule: 3.5mg patch x 1 week, 7mg patch x 2 weeks, 14mg patch x 3 weeks, 21mg patch x 6 weeks. Nicotine: Open-label transdermal nicotine patch
Change in MFQ (Memory Frequency Questionnaire) Score
23.64 units on a scale
Standard Deviation 40.96

SECONDARY outcome

Timeframe: Baseline to week 12

Population: Subject who withdrew early not included due to no 12-week data.

Secondary cognitive outcome, a neuropsychological test measure of attention. We examined the total response time for the CRT. Lower scores indicate better performance.

Outcome measures

Outcome measures
Measure
Transdermal Nicotine Patch
n=14 Participants
Transdermal nicotine patch, administered on awakening and removed at bedtime (16h/d). Dosing began at 3.5mg patch/daily, titrated over study to maximum dose of 21mg patch/daily. Dose could be reduced to the prior level or an intermediate level for tolerability. Titration schedule: 3.5mg patch x 1 week, 7mg patch x 2 weeks, 14mg patch x 3 weeks, 21mg patch x 6 weeks. Nicotine: Open-label transdermal nicotine patch
Change in Choice Reaction Time (CRT) Performance
-16.0 milliseconds
Standard Error 85.9

SECONDARY outcome

Timeframe: Baseline to week 12

Population: Subject who withdrew early not included due to no 12-week data.

Secondary cognitive outcome examining change in speed of responses ton the one-back test, no absolute range. In this variant of the "N-back" task, participants view a series of cards, and indicate whether the card they are currently viewing is identical to the previously viewed card. Lower scores indicate better performance.

Outcome measures

Outcome measures
Measure
Transdermal Nicotine Patch
n=14 Participants
Transdermal nicotine patch, administered on awakening and removed at bedtime (16h/d). Dosing began at 3.5mg patch/daily, titrated over study to maximum dose of 21mg patch/daily. Dose could be reduced to the prior level or an intermediate level for tolerability. Titration schedule: 3.5mg patch x 1 week, 7mg patch x 2 weeks, 14mg patch x 3 weeks, 21mg patch x 6 weeks. Nicotine: Open-label transdermal nicotine patch
Change in One-back Test Performance
-0.040 milliseconds
Standard Deviation 0.065

SECONDARY outcome

Timeframe: Baseline to week 12

Population: Subject who withdrew early not included due to no 12-week data.

Secondary cognitive outcome of a neuropsychological test examining episodic memory performance using the NYU Paragraph Recall test. No absolute range. Higher scores indicate better performance.

Outcome measures

Outcome measures
Measure
Transdermal Nicotine Patch
n=14 Participants
Transdermal nicotine patch, administered on awakening and removed at bedtime (16h/d). Dosing began at 3.5mg patch/daily, titrated over study to maximum dose of 21mg patch/daily. Dose could be reduced to the prior level or an intermediate level for tolerability. Titration schedule: 3.5mg patch x 1 week, 7mg patch x 2 weeks, 14mg patch x 3 weeks, 21mg patch x 6 weeks. Nicotine: Open-label transdermal nicotine patch
Change in NYU (New York University) Paragraph Recall Performance
3.4 Items correct
Standard Error 5.8

Adverse Events

Transdermal Nicotine Patch

Serious events: 0 serious events
Other events: 14 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Transdermal Nicotine Patch
n=15 participants at risk
Transdermal nicotine patch, administered on awakening and removed at bedtime (16h/d). Dosing began at 3.5mg patch/daily, titrated over study to maximum dose of 21mg patch/daily. Dose could be reduced to the prior level or an intermediate level for tolerability. Titration schedule: 3.5mg patch x 1 week, 7mg patch x 2 weeks, 14mg patch x 3 weeks, 21mg patch x 6 weeks. Nicotine: Open-label transdermal nicotine patch
Gastrointestinal disorders
Nausea
46.7%
7/15 • 12 weeks
Adverse events collected through query of subjects about any new or worsening problems or side effects, conducted at each contact.
Nervous system disorders
Dizziness
26.7%
4/15 • 12 weeks
Adverse events collected through query of subjects about any new or worsening problems or side effects, conducted at each contact.
Psychiatric disorders
Anxiety
20.0%
3/15 • 12 weeks
Adverse events collected through query of subjects about any new or worsening problems or side effects, conducted at each contact.
Nervous system disorders
Headache
26.7%
4/15 • 12 weeks
Adverse events collected through query of subjects about any new or worsening problems or side effects, conducted at each contact.
Nervous system disorders
Vivid Dreams
20.0%
3/15 • 12 weeks
Adverse events collected through query of subjects about any new or worsening problems or side effects, conducted at each contact.
Skin and subcutaneous tissue disorders
Patch site reaction
20.0%
3/15 • 12 weeks
Adverse events collected through query of subjects about any new or worsening problems or side effects, conducted at each contact.

Additional Information

Warren D. Taylor, MD

Vanderbilt University Medical Center

Phone: 6153221073

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place