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Sponsored by: |
National Institute of Mental Health (NIMH) |
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Information provided by: | National Institute of Mental Health (NIMH) |
ClinicalTrials.gov Identifier: | NCT00655057 |
This study will examine changes in brain dopamine transporter activity before and after antidepressant therapy.
Condition | Intervention | Phase |
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Depression |
Drug: S-citalopram Behavioral: Cognitive behavioral therapy (CBT) Procedure: TRODAT-1 single photon emission computed tomographic (SPECT) imaging |
Phase II Phase III |
Study Type: | Interventional |
Study Design: | Randomized, Open Label, Active Control, Parallel Assignment |
Official Title: | SPECT Brain Imaging as a Bio-Marker of Major Depression |
Estimated Enrollment: | 66 |
Study Start Date: | October 2005 |
Estimated Study Completion Date: | September 2008 |
Estimated Primary Completion Date: | September 2008 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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1: Active Comparator
Healthy participants will undergo TRODAT-1 SPECT imaging.
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Procedure: TRODAT-1 single photon emission computed tomographic (SPECT) imaging
Participants' striatal dopamine transporter (DAT) levels will be measured using [99mTc]TRODAT-1 SPECT with magnetic resonance imaging (MRI) co-localization on two separate occasions. Participants with depression will undergo TRODAT-1 SPECT imaging immediately before and after 12 weeks of their assigned treatment. Healthy participants will undergo TRODAT-1 SPECT imaging at baseline and 12 weeks later.
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2: Experimental
Participants with depression will undergo TRODAT-1 SPECT imaging and treatment with s-citalopram.
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Drug: S-citalopram
Participants will take 10 to 30 mg of s-citalopram daily for 12 weeks.
Procedure: TRODAT-1 single photon emission computed tomographic (SPECT) imaging
Participants' striatal dopamine transporter (DAT) levels will be measured using [99mTc]TRODAT-1 SPECT with magnetic resonance imaging (MRI) co-localization on two separate occasions. Participants with depression will undergo TRODAT-1 SPECT imaging immediately before and after 12 weeks of their assigned treatment. Healthy participants will undergo TRODAT-1 SPECT imaging at baseline and 12 weeks later.
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3: Active Comparator
Participants with depression will undergo TRODAT-1 SPECT imaging and treatment with cognitive behavioral therapy.
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Behavioral: Cognitive behavioral therapy (CBT)
Participants will attend twice weekly CBT sessions for 2 weeks and then once weekly sessions for 10 weeks. Sessions will focus on modifying thoughts and behaviors that may contribute to depression.
Procedure: TRODAT-1 single photon emission computed tomographic (SPECT) imaging
Participants' striatal dopamine transporter (DAT) levels will be measured using [99mTc]TRODAT-1 SPECT with magnetic resonance imaging (MRI) co-localization on two separate occasions. Participants with depression will undergo TRODAT-1 SPECT imaging immediately before and after 12 weeks of their assigned treatment. Healthy participants will undergo TRODAT-1 SPECT imaging at baseline and 12 weeks later.
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Depression is a serious psychiatric disorder that affects about 10% of the adult population in the United States in a given year. Common symptoms of depression include a persistent down mood and disinterest in previously enjoyed activities, often causing strain on work, social, and family life. A person's depression can be attributed to a variety of causes, including physiological and sociological factors. Among physiological factors, dopamine (DA), a chemical associated with feelings of happiness and pleasure, may play a key role in the onset of depression and may also be involved in the beneficial effect of antidepressant medication. Recent studies have found that people with depression have increased DA transporter (DAT) levels in a specific region of the inner brain called the striatum. The increased DAT levels might reflect alterations in central DA function. Treatment for depression with selective serotonin reuptake inhibitor (SSRI) antidepressant therapy may help in returning DAT levels to normal and in improving depressive symptoms. Using single photon emission computed tomography (SPECT) imaging, this study will examine changes in brain DAT activity in people with depression before and after they receive SSRI antidepressant therapy or cognitive behavioral therapy (CBT).
Participation in this study will last about 14 weeks and will involve participants who are healthy and depressed. All participants will first undergo baseline assessments that will include a medical history, questions about current and past health, a physical exam, a blood draw, a urine sampling, and an electrocardiogram (ECG). After completing the baseline assessments, participants will undergo a TRODAT-1 SPECT scan, which will involve an injection of TRODAT-1 (a radioactive agent to measure DA) and, after a 3-hour break, a 75-minute SPECT scan. If necessary, participants may also be asked to have a magnetic resonance imaging (MRI) brain scan after completing the SPECT scan.
Participants with depression will then be assigned randomly to undergo 12 weeks of treatment with either the antidepressant medication s-citalopram or CBT. Participants assigned to take s-citalopram will return for study visits weekly for 2 weeks, every other week for 6 weeks, and then monthly for 4 weeks. During study visits, participants will receive their medication, answer questions about depression and medication side effects, and occasionally fill out general health questionnaires. Participants receiving CBT will attend twice weekly sessions for 2 weeks and then once weekly sessions for 10 weeks. Sessions will focus on modifying thoughts and behaviors that may contribute to depression. After 12 weeks, all participants will be re-evaluated by a study doctor and, if still in good health, will undergo a repeat TRODAT-1 SPECT scan.
Ages Eligible for Study: | 18 Years to 65 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
Exclusion Criteria:
Contact: Jay D. Amsterdam, MD | 215-662-3462 | jamsterd@mail.med.upenn.edu |
Contact: Maryanne Giampapa, BBA | 215-662-2835 | mgiampap@mail.med.upenn.edu |
United States, Pennsylvania | |
Depression Research Unit - University of Pennsylvania | Recruiting |
Philadelphia, Pennsylvania, United States, 19104 | |
Contact: Jay D. Amsterdam, MD 215-662-3462 jamsterd@mail.med.upenn.edu | |
Contact: Maryanne Giampapa, BBA 215-662-2835 mgiampap@mail.med.upenn.edu | |
Principal Investigator: Jay D. Amsterdam, MD |
Principal Investigator: | Jay D. Amsterdam, MD | University of Pennsylvania |
Responsible Party: | University of Pennsylvania ( Jay D. Amsterdam, MD, Professor ) |
Study ID Numbers: | R34 MH070753, DATR A3-NSS |
Study First Received: | April 7, 2008 |
Last Updated: | August 20, 2008 |
ClinicalTrials.gov Identifier: | NCT00655057 |
Health Authority: | United States: Food and Drug Administration |
Dopamine Transporter Biomarker SPECT Brain Imaging Antidepressant Therapy |
Dopamine Depression Mental Disorders Mood Disorders Depressive Disorder, Major |
Dexetimide Depressive Disorder Citalopram Serotonin Behavioral Symptoms |
Neurotransmitter Agents Neurotransmitter Uptake Inhibitors Serotonin Agents Molecular Mechanisms of Pharmacological Action Therapeutic Uses Physiological Effects of Drugs |
Psychotropic Drugs Antidepressive Agents, Second-Generation Serotonin Uptake Inhibitors Central Nervous System Agents Pharmacologic Actions Antidepressive Agents |