The Use Of L-Methylfolate As A Treatment For Depression

June 6, 2023 updated by: University of Florida

The Use Of A Genetic Marker To Predict Response To L-Methylfolate As A Treatment For Depression

This is an open-label study assessing the efficacy of l-methylfolate as monotherapy in patients with mild to moderate major depressive disorder (MDD). The plan is to enroll 75 patients with mild to moderate MDD based on the Structured Clinical Interview for DSM-IV (SCID) that have a Hamilton Depression Rating Scale-24 (HDRS-24) score between 8-24. The investigators will collect genotype data on methylenetetrahydrofolate Reductase (MTHFR), MTR and MTRR in this patient population. Subjects will be able to receive their genotype results, on request, upon completion of the study. The investigators hypothesize that depressed patients will be more likely to have a mutation in the MTHFR gene

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Participation in the study will consist of the following visits and test:

Screening Visit will include being interviewed by a staff member to determine qualification. This interview will involve a thorough diagnostic interview that asks about different psychological feelings and It will also involve several rating scales that ask about depression, anxiety, obsessive compulsive disorder (OCD), and suicidality. The following scales will be conducted at this visit:

Structured Clinical Interview for Diagnostic and Statistical Manual for Mental Disorders-IV (DSM) (SCID-I) is a clinician-administered, semi-structured diagnostic interview for mental health disorders.

Hamilton Depression Rating Scale-24 (HAM-D) is a clinician-administered questionnaire designed to assess the severity of depression in adults.

Hamilton Anxiety Rating Scale (HAM-A) is a clinician-administered questionnaire which assesses the severity of symptoms of anxiety.

Yale-Brown Obsessive Compulsive Scale (YBOCS) is a clinician administered questionnaire to assess the severity of symptoms of obsessive compulsive disorder.

The Montreal Cognitive Assessment (MoCA) is a clinician administered cognitive screening tool to aid in the detection of mild cognitive impairment.

The Columbia-Suicide Severity Rating Scale (C-SSRS) is a clinician-administered rating scale that quantifies the presence and severity of suicidal ideation and behavior.

Clinical Global Impression-Severity (CGI-S) is a 7-point clinician rating of severity of psychopathology.

Next, a physician will conduct a brief medical physical exam which includes: measuring blood pressure, pulse, and body weight, a current and past medical history and blood will be drawn. If you are a female of childbearing potential, a urine pregnancy test will be performed.

Baseline Visit The results of the laboratory tests performed at the screening visit will be reviewed. If eligibility is met, vital signs (blood pressure, heart rate, and weight) will be measured. Then a member of the research team will ask questions about current symptoms. The following scales will be conducted at this visit and at all remaining visits in the study: HAM-D, HAM-A, YBOCS, MoCA, C-SSRS, and the CGI-S.

Clinical Global Impression-Improvement (CGI-I) is a 7-point rating of treatment response anchored by 1 ("very much improved) and 7 ("very much worse").

Blood will be collected including a sample for genetic testing. Then the first week of study drug and instructions on how to take it will be given. Please bring any unused study drug to on the next visit.

Visits 1/End of Week 1, 2/End of Week 2, 3/End of Week 4, 4/End of Week 8, 5/End of Week 12 Vital signs will be measured and a member of the research team will ask questions about current symptoms. Rating scales will be conducted assessing the symptoms.

Any unused study drug from the last visit will be collected and counted. The study doctor will ask about overall health and wellbeing. Please tell the study doctor about any problems encountered during the study. The next week's study drug will be given. Please bring any unused study drug to on the next visit.

Additional blood will be collected at visit 5.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
57

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Florida
      • Gainesville, Florida, United States, 32610
        • Shands Hospital Room HD-G-17

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years to 65 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Diagnosis of Major Depressive Disorder based on Structured Clinical Interview for DSM-IV (SCID)
  • Hamilton Depression Rating Scale-24 (HRSD-24) score of 8-24.
  • No antidepressant medication in past 3 months

Exclusion Criteria:

  • Pregnancy/Breastfeeding/Reproductive age female not using contraception
  • Schizophrenia or other psychotic disorders
  • Bipolar Disorder
  • Cluster B personality disorder
  • Electroconvulsive Therapy (ECT) failure in past
  • Concurrent ECT or repetitive transcranial magnetic stimulation (rTMS)
  • Active substance abuse within past 6 months
  • Use of antiepileptics
  • Thyroid Stimulating Hormone (TSH) greater than 4
  • Untreated Vitamin B12 deficiency (Vitamin B12 less than 400)
  • Neurodegenerative disease or dementia (Mini Mental Status Examination (MMSE) less than or equal to 24)
  • Suicidal ideation

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Other: L-methyfolate
Single-arm open label administration of L-methylfolate 15mg once daily for 90 days
Other: L-methylfolate
L-methylfolate, an FDA approved medical food will be administered in 15 mg capsule form once daily for 90 days
Other Names:
  • Deplin

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Hamilton Depression Rating Scale-24
Time Frame: Week 12
Clinician-administered questionnaire designed to assess the severity of depression in adults. It has been considered the gold standard for rating depression in clinical research.
Week 12

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
University of Florida

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
Pamlab, Inc.

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Gary Kanter, M.D., University of Florida

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
February 1, 2016

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
April 1, 2022

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
April 4, 2023

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
May 6, 2014

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
May 6, 2014

First Posted (Estimated)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
May 8, 2014

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
June 7, 2023

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 6, 2023

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
June 1, 2023

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • IRB201400170

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

Yes

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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