Feasibility of Conducting a Clinical Trial Assessing Efficacy of Lactate as Adjunctive Therapy in Patients With Major Depressive Disorder

NCT ID: NCT06168175

Last Updated: 2023-12-13

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

NOT_YET_RECRUITING

Clinical Phase

PHASE2

Total Enrollment

46 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-01-31

Study Completion Date

2028-01-31

Brief Summary

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The goal of this clinical trial is to test the efficacy of lactate (a natural substance) in combination with standard antidepressant treatment, in patients hospitalized for a major depressive episode.

The main question\[s\] it aims to answer are:

* does lactate diminishes depression severity when administered in combination with antidepressant ?
* is it feasible to test lactate treatment in a large-scale clinical trial ? Participants will receive lactate intravenously daily (20 min infusion) for 5 days during hospitalisation (together with the standard antidepressant treatment).

Researchers will compare with a group receiving a placebo instead of lactate to see if lactate has antidepressant effects.

Detailed Description

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In case of major depressive disorder (MDD), antidepressant medications are prescribed as standard treatment. The commonly used antidepressants have a delayed onset of therapeutic actions, many side effects and limited efficacy. In this regard, about 30-50% of MDD patients are unresponsive to any currently approved pharmacological treatment, emphasizing the need for novel types of drugs to treat major depression.

Several animal studies have shown that lactate, a substance naturally present in the body, has antidepressant effects.

The aim of this single-center study is to evaluate the feasibility of conducting a future large-scale clinical trial testing the efficacy of "sodium lactate" as an adjunctive treatment to a standardly prescribed antidepressant.

The study is recruiting patients hospitalized for a major depressive episode. Participants are assigned randomly to the "sodium lactate" group or the "placebo" group. The study treatment will be administered intravenously daily (2mmol/kg) for 5 days during hospitalization, in addition to standard antidepressant treatment. Patients will be followed during hospitalization and then on an outpatient basis at 6 and 12 weeks. The therapeutic effect of sodium lactate will be assessed with the MADRS score (depression severity scale) at 1, 2, 3, 6 and 12 weeks. Recruitment, adherence, retention, data completion and blinding maintenance rates will also be assessed to evaluate the feasibility. The effect on anxiety, perceived stress, insomnia, short-term depression remission rate, blood lactate level and length of hospitalization will also be evaluated.

Conditions

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Major Depressive Disorder

Keywords

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Sodium lactate Depression Antidepressant Lactate

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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Lactate

Group Type EXPERIMENTAL

Sodium lactate

Intervention Type DRUG

2 mmol/kg, intravenous, daily for 5 consecutive days

Placebo

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

intravenous, daily for 5 consecutive days

Interventions

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Sodium lactate

2 mmol/kg, intravenous, daily for 5 consecutive days

Intervention Type DRUG

Placebo

intravenous, daily for 5 consecutive days

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Study consent signed
* 18 ≤ age ≤ 65 years old
* Fluent in french
* Recently (no more than 1 week) hospitalized for a primary diagnosis of MDD
* Current major depressive episode as defined by DSM-5
* Current MADRS score ≥18
* Total number of MDD acute episodes ≤ 3
* Total number of psychiatric medications ≤ 3 at admission
* Total number of any medication ≤ 4 at admission
* No signs or evidence indicating difficult intravenous access
* Willing to hold a peripheral blood catheter for 5 days

Exclusion Criteria

* Bipolar depression
* History of panic attacks
* Severe substance use disorders according to DSM-5-TR criteria
* Conditions predisposing to hypernatremia such as:

* adrenocortical insufficiency,
* diabetes type 1 and insulin-dependent type 2
* extensive tissue injury
* Known severe renal insufficiency
* Known hepatic insufficiency (impaired lactate metabolism)
* Known history of heart failure
* Known history of Chronnic Obstructive Pulmonary Disease or respiratory failure
* Known hypersentitivity to lactate
* Hypernatremia with Na+ \> 150 mmol/L (confirmed on 2 blood withdrawals)
* Blood osmolality \> 320 mmol/kg H2O
* Hyperlactatemia \> 2 mmol/l
* Pregnant or lactating
* Forbiden medications : Lithium
* Participation to other clinical trials
* Any medical conditions that could jeopardize patient's health in case of study participation according to the investigator
* Inability to give informed consent (without capacity for discernment) as evaluated by the psychiatrist investigator or by by a delegated physician.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fondation de Préfargier

UNKNOWN

Sponsor Role collaborator

Centre Hospitalier Universitaire Vaudois

OTHER

Sponsor Role lead

Responsible Party

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Sylfa Fassassi

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Pierre Marquet, MD

Role: STUDY_CHAIR

Centre Hospitalier Universitaire Vaudois

Central Contacts

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Sylfa Fassassi,, MD

Role: CONTACT

Phone: +41 21 314 31 11

Email: [email protected]

Other Identifiers

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2023-01702

Identifier Type: OTHER

Identifier Source: secondary_id

Lac-MDD

Identifier Type: -

Identifier Source: org_study_id