IMProving Executive Function Study

NCT ID: NCT03187353

Last Updated: 2023-11-18

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE4
• Total Enrollment: 69 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2017-09-22
• Study Completion Date: 2022-04-30

Brief Summary

This is a double-blind, placebo-controlled, crossover study testing whether Vyvanse (lisdexamfetamine; LDX) improves executive functioning (EF) in 100 postmenopausal women who report onset of EF difficulties after oophorectomy. This study involves magnetic resonance imaging (MRI) to see how LDX affects brain chemistry while undergoing two 6-week trials of the study drug and placebo capsules.

UPDATE: We have recently updated this protocol (09/2020) to offer a remote version of the study that can be completed entirely from the participant's home. This alternate version of the study eliminates travel, the MRI, and blood draws.

Detailed Description

Following a medically induced menopause, many women report difficulty in remembering things, focusing and concentrating. The purpose of this study is to examine the effects of a stimulant medication called Vyvanse® (lisdexamfetamine; LDX) on executive functioning, such as attention, processing, organization, and memory, in women who are experiencing executive functioning difficulties after having undergone a risk-reducing bilateral salpingo-oophorectomy (RRSO). This study involves magnetic resonance imaging (MRI) to see how LDX affects brain chemistry while undergoing two 6-week trials of the study drug and placebo capsules.

Individuals wishing to participate in this study are medically healthy women between the ages of 35-58 years old who have undergone a risk-reducing bilateral salpingo-oophorectomy (RRSO) within the previous 15 years. Participants must have been premenopausal before undergoing RRSO (meaning they were having regular periods). They also must not have undergone radiation or chemotherapy in the past year.

Furthermore, participants must not suffer from a mental illness, including Attention Deficit Hyperactivity Disorder (ADHD), and must not have a recent history of drug abuse. Additionally, participants must not suffer from a fear of small, enclosed spaces (claustrophobia), and not have any implanted medical devices such as a pacemaker, orthodontic braces, or shrapnel. They must not have a history of seizures, uncontrolled hypertension or known renal impairment.

Conditions

Cognitive Impairment; RRSO

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: CROSSOVER
• Primary Study Purpose: TREATMENT
• Blinding Strategy: TRIPLE

Study Groups

Lisdexamfetamine, then Placebo

Participants will have a 50% chance of first receiving the active study medication. They will begin at 20 mg/d and will increase up to 60 mg/d after 4 weeks, if well tolerated. Total time on the study drug is up to 6 weeks. After a washout period of 2 weeks they will begin with 1 sugar pill and will increase up to 3 pills after 4 weeks. Maximum time for taking the placebo is 6 weeks.

Group Type: EXPERIMENTAL

Lisdexamfetamine

Intervention Type: DRUG

Stimulant medications are used to reduce interruptive behavior, fidgeting, and other hyperactive symptoms, as well as help a person finish tasks and improve his or her relationships for adults who have ADHD. Please note that the FDA has not approved the use of Vyvanse® for the treatment of memory and concentration difficulties related to medically induced menopause.

Placebo oral capsule

Intervention Type: DRUG

The placebo capsule will be filled with microcellulose.

Placebo, then Lisdexamfetamine

Participants will have a 50% chance of first receiving the placebo, beginning with 1 sugar pill and increasing up to 3 pills after 4 weeks. Maximum time for taking the placebo is 6 weeks. After a washout period of 2 weeks, they will begin active study medication at 20 mg/d and will increase up to 60 mg/d after 4 weeks, if well tolerated. Total time on the study drug is up to 6 weeks.

Group Type: EXPERIMENTAL

Lisdexamfetamine

Intervention Type: DRUG

Stimulant medications are used to reduce interruptive behavior, fidgeting, and other hyperactive symptoms, as well as help a person finish tasks and improve his or her relationships for adults who have ADHD. Please note that the FDA has not approved the use of Vyvanse® for the treatment of memory and concentration difficulties related to medically induced menopause.

Placebo oral capsule

Intervention Type: DRUG

The placebo capsule will be filled with microcellulose.

Interventions

Lisdexamfetamine

Stimulant medications are used to reduce interruptive behavior, fidgeting, and other hyperactive symptoms, as well as help a person finish tasks and improve his or her relationships for adults who have ADHD. Please note that the FDA has not approved the use of Vyvanse® for the treatment of memory and concentration difficulties related to medically induced menopause.

Intervention Type: DRUG

Placebo oral capsule

The placebo capsule will be filled with microcellulose.

Intervention Type: DRUG

Other Intervention Names

Vyvanse; sugar pill

Eligibility Criteria

Inclusion Criteria

• Female;
• Age 35-58;
• Have undergone risk-reducing bilateral salpingo-oophorectomy (RRSO) within the previous 15 years AND were premenopausal at the time of RRSO;
• Score of ≥ 20 on the Brown Attention Deficit Disorder Scale (BADDS);
• Onset of executive function difficulties occurred post RRSO;
• Clean urine drug screen (nicotine and marijuana are permissible);
• Are fluent in written and spoken English;
• Are able to give written informed consent (obtained at screening visit);
• Have a high school diploma or equivalent degree (i.e., GED), as per subject report;
• If using aromatase inhibitors or tamoxifen: Must have been on a stable dose for at least 6 months;
• If completing visits remotely: Must have access to a telecommunications application (i.e., Skype), email, scanner/fax machine, and a private area that enables the protection of participant confidentiality.

Exclusion Criteria

• Current, untreated psychiatric disorder;
• Substance use disorder within the previous 3 years;
• Lifetime history of ADHD or psychotic disorder including bipolar disorder, schizoaffective disorder, and schizophrenia;
• Lifetime history of stimulant abuse or dependence;
• Regular use of psychotropic medications except selective serotonin reuptake inhibitors (SSRI), serotonin noradrenergic reuptake inhibitors (SNRI), bupropion, zolpidem, gabapentin, or buspirone;
• Chemotherapy within the past year;
• Previous history of sensitivity or adverse reaction to lisdexamfetamine (LDX);
• History of seizures or unstable medical condition;
• Known heart disease or clinically significant abnormal electrocardiogram during screening as determined by the study MD;
• Uncontrolled hypertension;
• Presence of a metallic implant contraindicative to scanning at the 7T level;
• Claustrophobia.
• Consistent systolic blood pressure of >145mm Hg or diastolic blood pressure >90 mm Hg after three readings at time of screening;
• Known renal impairment and End Stage Renal Disease (ESRD).

• Minimum Eligible Age: 35 Years
• Maximum Eligible Age: 58 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: Yes

Sponsors

University of Pennsylvania

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

C. Neill Epperson, MD

Role: PRINCIPAL_INVESTIGATOR

University of Pennsylvania

Locations

3535 Market Street

Philadelphia, Pennsylvania, United States

Countries

United States

References

Shanmugan S, Loughead J, Nanga RP, Elliott M, Hariharan H, Appleby D, Kim D, Ruparel K, Reddy R, Brown TE, Epperson CN. Lisdexamfetamine Effects on Executive Activation and Neurochemistry in Menopausal Women with Executive Function Difficulties. Neuropsychopharmacology. 2017 Jan;42(2):437-445. doi: 10.1038/npp.2016.162. Epub 2016 Aug 23.

Reference Type: BACKGROUND

PMID: 27550732 (View on PubMed)

Epperson CN, Shanmugan S, Kim DR, Mathews S, Czarkowski KA, Bradley J, Appleby DH, Iannelli C, Sammel MD, Brown TE. New onset executive function difficulties at menopause: a possible role for lisdexamfetamine. Psychopharmacology (Berl). 2015 Aug;232(16):3091-100. doi: 10.1007/s00213-015-3953-7. Epub 2015 Jun 11.

Reference Type: BACKGROUND

PMID: 26063677 (View on PubMed)

Brown, T. E. 1996. Brown attention deficit disorder scales for adolescents and adults, San Antonio, TX: The Psychological Corporation.

Reference Type: RESULT

Provided Documents

Document Type: Study Protocol and Statistical Analysis Plan

View Document

Related Links

http://www.med.upenn.edu/womenswellness/studies.html

Research at the Penn Center for Women's Behavioral Wellness

Other Identifiers

826981

Identifier Type: -

Identifier Source: org_study_id