Effects of Nutrients Supplementation in Antidepressant Treated Depressive Disorder Patients

NCT ID: NCT04179006

Last Updated: 2021-09-10

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

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-11-14

Study Completion Date

2023-12-31

Brief Summary

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This is a randomized, double-blind, placebo-controlled to evaluate the potential role of nutrients supplementation (LF chocolate /Erinacine A-enriched Hericium Erinaceus chocolate) on the therapeutic efficacy of antidepressants in major depressive disorder(MDD).

120 subjects who meet all the inclusion and exclusion criteria will be randomized into three categories, receiving 3 pieces of supplement nutrients-added or plain chocolates per day for a period of 24 weeks in total. The three categories are as follow:

1. LF chocolate
2. Erinacine A-enriched Hericium Erinaceus chocolate
3. Plain chocolate without any supplementary nutrients added (placebo group) These MDD patients will continue their antidepressant regimen throughout the study.

Symptom rating, blood samples for antidepressant-related/depressive disorder-related genome profiles identification, as well as for biomarkers assessment for metabolic indices, questionnaires and tests for psychosocial variables identification and patient's cognitive and social cognitive function or performance determination, will be carried out before and at certain time points within the 24-week tracking period. Patient's fecal samples will be acquired to recognize and to distinguish the alterations of these MDD patients microbiota profiles over the 24-week period.

Detailed Description

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Major depressive disorder (MDD) is a common, severe, and often life-threatening illness that involves the body, mood, and thoughts. Recent reports suggested that immune dysfunction could be linked with cognitive impairment and metabolic comorbidities, and accumulating evidence suggested that the regulation of the microbiota- gut-brain axis has been shown to impact inflammation and to affect brain function.

This randomized, double-blind, placebo-controlled is to evaluate the potential role of nutrients supplementation (LF chocolate /Erinacine A-enriched Hericium Erinaceus chocolate) on the therapeutic efficacy of antidepressants in major depressive disorder(MDD). 120 MDD outpatients (aged 20-70 years) from the National Cheng Kung University Hospital who meet the Diagnostic and Statistical Manual of mental disorders, Fifth Edition (DSM-5) and Hamilton Rating Scale for Depression (HAMD) scores ≥ 7, receiving fluoxetine or venlafaxine so as SSRI or SNRI antidepressants will be enrolled.

Subjects who meet all the inclusion and exclusion criteria will be randomized into three categories, with 40 subjects each, receiving 3 pieces of supplement nutrients-added or plain chocolates (placebo) manufactured by GRAPE KING BIO LTD per day for a period of 24 weeks in total. The three categories are as follow:

1. LF chocolate
2. Erinacine A-enriched Hericium Erinaceus chocolate
3. Plain chocolate without any supplementary nutrients added (placebo group) These MDD patients will continue their antidepressant regimen throughout the study. Follow-up visits will be arranged at week no. 0, 2, 4, 8, 12, 16, 20 and 24, in which week no. 0, 4, 12 and 24 will be the four most important re-visit timing.

Various assessments or tests will be arranged in these 24-week period. Symptom rating with 17-item Hamilton Rating Scale for Depression (HAM-D) by psychiatrist will be done at every visits. Blood samples for antidepressant-related/depressive disorder-related genome profiles identification, as well as for biomarkers assessment for metabolic indices, will be obtained at week no. 0, 4, 12 and 24. Questionnaires aimed for psychosocial variables (environmental factors) identification including social support scales (SSS), quality of life scale (QOLs) and Recent life changes questionnaire (RCLQ) will be self-answered by patients. Continuous Performance Test (CPT), finger-Tapping Test (FPT) and Wisconsin Card Sorting Test (WCST) will be utilized to evaluate their cognitive performance. Mayer-Salovey-Caruso emotional Intelligent Test (MSCEIT) will help in social cognitive function assessment. Patient's fecal samples will be acquired at week no. 0, 4, 12 and 24 to recognize and to distinguish the alterations in MDD patients microbiota profiles.

Conditions

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Depressive Disorder, Major

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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LF chocolate + antidepressant(s)

Participants with LF chocolate add-on to their antidepressants regimen.

Group Type ACTIVE_COMPARATOR

LF/Erinacine A-enriched Hericium/Plain chocolate + antidepressant(s)

Intervention Type DIETARY_SUPPLEMENT

3 pieces per day

Erinacine A-enriched Hericium chocolate + antidepressant(s)

Participants with Erinacine A-enriched Hericium chocolate add-on to their antidepressants regimen.

Group Type ACTIVE_COMPARATOR

LF/Erinacine A-enriched Hericium/Plain chocolate + antidepressant(s)

Intervention Type DIETARY_SUPPLEMENT

3 pieces per day

Plain chocolate + antidepressant(s)

Participants with plain chocolate add-on to their antidepressants regimen.

Group Type PLACEBO_COMPARATOR

LF/Erinacine A-enriched Hericium/Plain chocolate + antidepressant(s)

Intervention Type DIETARY_SUPPLEMENT

3 pieces per day

Interventions

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LF/Erinacine A-enriched Hericium/Plain chocolate + antidepressant(s)

3 pieces per day

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Major depressive disorder (MDD) outpatients meet DSM- criteria
* Hamilton Rating Scale for Depression (HAM-D) ≥ 7
* Start to receive fluoxetine or venlafaxine or those who have received the SSRI or SNRI antidepressants

Exclusion Criteria

* (A) had DSM-5 diagnosis for substance abuse within the past three months;
* (B) had taken monoamine oxidase inhibitors;
* (C) had an organic mental disorder, mental retardation, dementia, or other diagnosed neurological illness;
* (D) had a surgical condition or a major physical illness;
* (E) pregnant or breast-feeding.
Minimum Eligible Age

20 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Grape King Bio Ltd.

INDUSTRY

Sponsor Role collaborator

National Cheng-Kung University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Po-See, Chen

Principal Investigator, Professor, Visiting Staff Psychiatrist of Department of Psychiatry, Professor (joint appointment) of Institute of Behavioral Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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National Cheng-Kung University

Tainan City, , Taiwan

Site Status RECRUITING

Countries

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Taiwan

Central Contacts

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Po-See Chen, Professor

Role: CONTACT

866-6-2353535 ext. 5189

Hui-Hua Chang, Professor

Role: CONTACT

886-6-2353535 ext. 5683

Facility Contacts

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Po-See Chen, Professor

Role: primary

886-6-2353535 ext. 5189

Hui-Hua Chang, Professor

Role: backup

886-6-2353535 ext. 5683

References

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Byers AL, Yaffe K. Depression and risk of developing dementia. Nat Rev Neurol. 2011 May 3;7(6):323-31. doi: 10.1038/nrneurol.2011.60.

Reference Type BACKGROUND
PMID: 21537355 (View on PubMed)

Gorska-Ciebiada M, Saryusz-Wolska M, Ciebiada M, Loba J. Mild cognitive impairment and depressive symptoms in elderly patients with diabetes: prevalence, risk factors, and comorbidity. J Diabetes Res. 2014;2014:179648. doi: 10.1155/2014/179648. Epub 2014 Nov 9.

Reference Type BACKGROUND
PMID: 25431771 (View on PubMed)

Chang HH, Chi MH, Lee IH, Tsai HC, Gean PW, Yang YK, Lu RB, Chen PS. The change of insulin levels after six weeks antidepressant use in drug-naive major depressive patients. J Affect Disord. 2013 Sep 5;150(2):295-9. doi: 10.1016/j.jad.2013.04.008. Epub 2013 May 9.

Reference Type BACKGROUND
PMID: 23664565 (View on PubMed)

Howren MB, Lamkin DM, Suls J. Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosom Med. 2009 Feb;71(2):171-86. doi: 10.1097/PSY.0b013e3181907c1b. Epub 2009 Feb 2.

Reference Type BACKGROUND
PMID: 19188531 (View on PubMed)

Chang HH, Lee IH, Gean PW, Lee SY, Chi MH, Yang YK, Lu RB, Chen PS. Treatment response and cognitive impairment in major depression: association with C-reactive protein. Brain Behav Immun. 2012 Jan;26(1):90-5. doi: 10.1016/j.bbi.2011.07.239. Epub 2011 Aug 4.

Reference Type BACKGROUND
PMID: 21839826 (View on PubMed)

Hiles SA, Baker AL, de Malmanche T, Attia J. Interleukin-6, C-reactive protein and interleukin-10 after antidepressant treatment in people with depression: a meta-analysis. Psychol Med. 2012 Oct;42(10):2015-26. doi: 10.1017/S0033291712000128. Epub 2012 Feb 16.

Reference Type BACKGROUND
PMID: 22336436 (View on PubMed)

Fabbri C, Porcelli S, Serretti A. From pharmacogenetics to pharmacogenomics: the way toward the personalization of antidepressant treatment. Can J Psychiatry. 2014 Feb;59(2):62-75. doi: 10.1177/070674371405900202.

Reference Type BACKGROUND
PMID: 24881125 (View on PubMed)

Antypa N, Drago A, Serretti A. Genomewide interaction and enrichment analysis on antidepressant response. Psychol Med. 2014 Mar;44(4):753-65. doi: 10.1017/S0033291713001554. Epub 2013 Jul 1.

Reference Type BACKGROUND
PMID: 23809733 (View on PubMed)

Biernacka JM, Sangkuhl K, Jenkins G, Whaley RM, Barman P, Batzler A, Altman RB, Arolt V, Brockmoller J, Chen CH, Domschke K, Hall-Flavin DK, Hong CJ, Illi A, Ji Y, Kampman O, Kinoshita T, Leinonen E, Liou YJ, Mushiroda T, Nonen S, Skime MK, Wang L, Baune BT, Kato M, Liu YL, Praphanphoj V, Stingl JC, Tsai SJ, Kubo M, Klein TE, Weinshilboum R. The International SSRI Pharmacogenomics Consortium (ISPC): a genome-wide association study of antidepressant treatment response. Transl Psychiatry. 2015 Apr 21;5(4):e553. doi: 10.1038/tp.2015.47.

Reference Type BACKGROUND
PMID: 25897834 (View on PubMed)

Rogers GB, Keating DJ, Young RL, Wong ML, Licinio J, Wesselingh S. From gut dysbiosis to altered brain function and mental illness: mechanisms and pathways. Mol Psychiatry. 2016 Jun;21(6):738-48. doi: 10.1038/mp.2016.50. Epub 2016 Apr 19.

Reference Type BACKGROUND
PMID: 27090305 (View on PubMed)

Soto M, Herzog C, Pacheco JA, Fujisaka S, Bullock K, Clish CB, Kahn CR. Gut microbiota modulate neurobehavior through changes in brain insulin sensitivity and metabolism. Mol Psychiatry. 2018 Dec;23(12):2287-2301. doi: 10.1038/s41380-018-0086-5. Epub 2018 Jun 18.

Reference Type BACKGROUND
PMID: 29910467 (View on PubMed)

Jiang H, Ling Z, Zhang Y, Mao H, Ma Z, Yin Y, Wang W, Tang W, Tan Z, Shi J, Li L, Ruan B. Altered fecal microbiota composition in patients with major depressive disorder. Brain Behav Immun. 2015 Aug;48:186-94. doi: 10.1016/j.bbi.2015.03.016. Epub 2015 Apr 13.

Reference Type BACKGROUND
PMID: 25882912 (View on PubMed)

Other Identifiers

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B-BR-108-032

Identifier Type: -

Identifier Source: org_study_id

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