Study on the Efficacy, Safety, and Tolerability of Cariprazine Relative to Placebo in Participants With Bipolar I Depression
A Phase 3, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group, Multicenter, Fixed-Dose Clinical Trial Evaluating The Efficacy, Safety And Tolerability Of Cariprazine In Patients With Bipolar I Depression
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
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Burgas, Bulgaria, 8000
- Mental Health Centre 'Prof. Dr. Ivan Temkov', EOOD
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Kardzhali, Bulgaria, 6600
- SPH - Kardzhali, EOOD
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Kazanlak, Bulgaria, 6100
- MHAT "Dr. Hristo Stambolski", EOOD
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Lovech, Bulgaria, 5500
- State Psychiatric Hospital - Lovech
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Pleven, Bulgaria, 5800
- UMHAT 'Dr. Georgi Stranski', EAD
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Plovdiv, Bulgaria, 4000
- UMHAT "Sv. Georgi", EAD
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Ruse, Bulgaria, 7003
- MHC - Ruse, EOOD
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Sofia, Bulgaria, 1431
- UMHAT "Alexandrovska" EAD
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Sofia, Bulgaria, 1113
- MHATNP "Sv.Naum", EAD
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Sofia, Bulgaria, 1606
- Military Medical Academy - MHAT - Sofia
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Sofia, Bulgaria, 1632
- Medical Centre "Doverie" AD
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Targovishte, Bulgaria, 7700
- MHAT-Targovishte, AD
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Varna, Bulgaria, 9020
- DCC "Mladost M" - Varna, OOD
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Tallinn, Estonia, 10617
- Marienthal Center of Psychiatry and Psychology
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Tallinn, Estonia, 13517
- West Tallinn Central Hospital
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Tartu, Estonia, 50417
- Tartu University Hospital
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Kaunas, Lithuania, LT-50009
- Hospital of Lithuanian University of Health Sciences Kaunas Clinics
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Kaunas, Lithuania, 44279
- Romuvos klinika, UAB
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Kaunas, Lithuania, 50185
- Neuromeda, JSC
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Kaunas, Lithuania, 53136
- Republican Kaunas Hospital Psychiatry Clinic Mariu Division, Public Institution
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Vilnius, Lithuania, 10204
- 232Antakalnis Psychiatric Consultation Center, Public Institution
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Białystok, Poland, 15-756
- Podlaskie Centrum Psychogeriatrii
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Bydgoszcz, Poland, 85-080
- Przychodnia Srodmiescie Sp. z o. o.
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Gdańsk, Poland, 80-214
- Uniwersyteckie Centrum Kliniczne
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Leszno, Poland, 64-100
- Niepubliczny Zaklad Opieki Psychiatrycznej MENTIS
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Lublin, Poland, 20-045
- Clinical Best Solutions
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Lublin, Poland, 20-442
- Specjalistyczna Praktyka Lekarska Marek Domanski
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Pruszcz Gdański, Poland, 83-000
- NZOZ Syntonia
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Toruń, Poland, 87-100
- Torunskie Centrum Psychiatrii Neuromed
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San Juan, Puerto Rico, 00918
- INSPIRA Clinical Research
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Arkansas
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Little Rock, Arkansas, United States, 72211
- Arkansas Psychiatric Clinic Clinical Research Trials PA
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California
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Costa Mesa, California, United States, 92626
- ATP Clinical Research, Inc.
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Escondido, California, United States, 92025
- Synergy San Diego
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Glendale, California, United States, 91204
- Integrated Medical and Behavioral Associates
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Long Beach, California, United States, 90813
- Apostle Clinical Trials, Inc.
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Oakland, California, United States, 94612
- Pacific Research Partners, LLC
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San Diego, California, United States, 92103
- Artemis Institute for Clinical Research
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Sherman Oaks, California, United States, 91403
- Schuster Medical Research Institute
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Temecula, California, United States, 92591
- Viking Clinical Research
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Upland, California, United States, 91786
- Pacific Clinical Research Medical Group
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Connecticut
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Norwich, Connecticut, United States, 06360
- Comprehensive Psychiatric Care
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Florida
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Jacksonville, Florida, United States, 32256
- CNS Healthcare
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Orlando, Florida, United States, 32801
- Clinical Neuroscience Solutions, Inc
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Tampa, Florida, United States, 33609
- Olympian Clinical Research
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Georgia
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Atlanta, Georgia, United States, 30328
- Radiant Research
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Decatur, Georgia, United States, 30030
- iResearch Atlanta, LLC
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Marietta, Georgia, United States, 30060
- Northwest Behavioral Research Center
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Smyrna, Georgia, United States, 30080
- Carman Research
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Illinois
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Skokie, Illinois, United States, 60076
- Psychiatric Medicine Associates, L.L.C
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Winfield, Illinois, United States, 60190
- Neuroscience Research Institute Inc.
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Missouri
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Saint Charles, Missouri, United States, 63304
- St. Charles Psychiatric Associates - Midwest Research Group
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Nevada
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Las Vegas, Nevada, United States, 89102
- Altea Research Institute
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New Jersey
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Berlin, New Jersey, United States, 08009
- Hassman Research Institute
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New York
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Cedarhurst, New York, United States, 11516
- Neurobehavioral Research, Inc.
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New York, New York, United States, 10023
- Medical & Behavioral Health Research, PC
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Ohio
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Canton, Ohio, United States, 44718
- Neuro-Behavioral Clinical Research
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Cincinnati, Ohio, United States, 45215
- Patient Priority Clinical Sites
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Columbus, Ohio, United States, 43210
- Ohio State University Department of Psychiatry
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Dayton, Ohio, United States, 45417
- Midwest Clinical Research Center
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Oklahoma
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Oklahoma City, Oklahoma, United States, 73103
- IPS Research Company
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Oklahoma City, Oklahoma, United States, 73112
- Sooner Clinical Research
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Oregon
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Portland, Oregon, United States, 97214
- Oregon Center for Clinical Investigations, Inc.
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Salem, Oregon, United States, 97301
- Oregon Center for Clinical Investigations
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Pennsylvania
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Allentown, Pennsylvania, United States, 18104
- Lehigh Center For Clinical Research
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Rhode Island
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Lincoln, Rhode Island, United States, 02865
- Lincoln Research, LLC
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Tennessee
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Memphis, Tennessee, United States, 38119
- Clinical Neuroscience Solutions
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Texas
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Houston, Texas, United States, 77090
- Red Oak Psychiatry Associates, PA
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Houston, Texas, United States, 77098
- Houston Clinical Trials, LLC
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Plano, Texas, United States, 75093
- Research Across America
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The Woodlands, Texas, United States, 77381
- Family Psychiatry of The Woodlands
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Virginia
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Richmond, Virginia, United States, 23230
- Alliance Research Group
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Washington
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Bellevue, Washington, United States, 98007
- Northwest Clinical Research Center
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Kirkland, Washington, United States, 98033
- Core Clinical Research
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Seattle, Washington, United States, 98104
- Summit Research Network Seattle
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Currently meet the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for bipolar I disorder without psychotic features confirmed by the administration of the Mini International Neuropsychiatric Interview (MINI), with a current major depressive episode of at least 4 weeks and not exceeding 12 months in duration
- Currently treated as an outpatient at the time of enrollment
- A verified previous manic or mixed episode. Verification must include one of the following sources: --Treatment of mania with an anti-manic agent (eg, lithium or divalproate) or antipsychotic medication with an approved indication for mania --Hospital records/Medical records --Participant report corroborated by caretaker or previous or current treating clinician
- 17-item Hamilton Depression Rating Scale (HAMD-17) total score ≥ 20
- HAMD-17 item 1 score ≥ 2
- Clinical Global Impressions-Severity (CGI-S) score ≥ 4
- Negative serum β-human chorionic gonadotropin (β-hCG) pregnancy test (women of childbearing potential only)
- Normal physical examination, clinical laboratory test results, and electrocardiogram (ECG) results or abnormal findings that are judged not clinically significant by the Principal Investigator (PI)
Exclusion Criteria:
- Young Mania Rating Scale (YMRS) total score > 12
- Four or more episodes of a mood disturbance (depression, mania, hypomania, or mixed state) within the 12 months before Visit 1
- Any current axis 1 psychiatric diagnosis other than bipolar disorder with the exception of specific phobias
History of meeting DSM-5 criteria for: ○ Dementia, amnesic, or other cognitive disorder ○ Schizophrenia, schizoaffective, or other psychotic disorder
○ Mental retardation - DSM-5-based diagnosis of borderline or antisocial personality disorder or other axis II disorder of sufficient severity to interfere with participation in this study
- History of meeting DSM-5 criteria for alcohol or substance abuse or dependence (other than nicotine or caffeine) within the 6 months before Visit 1
- Positive result on blood alcohol test or urine drug screen for any prohibited medication. Exception: ○ Participants with a positive cannabinoid on entry may be retested before randomization. If the participant remains positive, the participant is no longer eligible ○ Participants positive for opiates on entry, discussion with Study Physician is required.
- Electroconvulsive therapy in the 3 months before Visit 1
- Previous lack of response to electroconvulsive therapy
- Treatment with a depot antipsychotic drug within 1 treatment cycle before Visit 1
- Treatment with clozapine in a dose of > 50 mg/day in the past 2 years
- Prior participation in any investigational study of RGH-188 or cariprazine within the past 12 months
- Previous treatment with vagus nerve stimulation or transcranial magnetic stimulation within 6 months before Visit 1
- Prior participation with any clinical trials, involving experimental or investigational drugs, within 6 months before Visit 1 or during the study
- Initiation or termination of psychotherapy for depression within the 3 months preceding Visit 1, or plans to initiate, terminate, or change such therapy during the course of the study.
- Pregnant, breastfeeding, or planning to become pregnant or breastfeed during the study
- Gastric bypass or any condition that would be expected to affect drug absorption (lap band procedures are acceptable if there is no problem with absorption)
- Known history of cataracts or retinal detachment
- Known human immunodeficiency virus infection
- Employee, or immediate relative of an employee, of the Sponsor, any of its affiliates or partners, or the study center
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Placebo Comparator: Placebo
Following a 7 to 14 days screening/washout period, placebo-matching cariprazine capsule, one per day, orally for 6 weeks.
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Experimental: Cariprazine 1.5 mg
Following a 7 to 14 days screening/washout period, cariprazine 1.5 milligram (mg) capsule, one per day, orally for 6 weeks.
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Other Names:
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Experimental: Cariprazine 3.0 mg
Following a 7 to 14 days screening/washout period, cariprazine 1.5 mg capsule, one per day for 2 weeks followed by cariprazine 3.0 milligram (mg) capsule, one per day, orally beginning on Day 15 for 4 weeks.
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Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Change From Baseline in the Montgomery-Åsberg Depression Rating Scale (MADRS) Score at Week 6
Time Frame: Baseline (Week 0) to Week 6
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The Montgomery-Åsberg Depression Rating Scale (MADRS) is a 10-item, clinician-rated scale that evaluates the participant's depressive symptomatology during the past week.
Participants were rated on items assessing feelings of sadness, lassitude, pessimism, inner tension, suicidality, reduced sleep or appetite, difficulty in concentration, and lack of interest.
Each of the 10 items was scored on a 7-point scale with a score of 0 reflecting no symptoms and a score of 6 reflecting symptoms of maximum severity for a total possible score of 0 (best) to 60 (worst).
A negative change from Baseline indicates improvement.
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Baseline (Week 0) to Week 6
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Change From Baseline in Clinical Global Impressions-Severity (CGI-S) Score at Week 6
Time Frame: Baseline (Week 0) to Week 6
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The Clinical Global Impressions-Severity (CGI-S) is a clinician-rated scale that measures the overall severity of a participant's illness in comparison with the severity of other participants the physician has observed.
The participant was rated on a scale from 1 to 7, with 1 indicating a "normal state" and 7 indicating "among the most extremely ill participants."
A negative change from Baseline indicates improvement.
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Baseline (Week 0) to Week 6
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Clincial Director, Forest Research Institute, Inc., an affiliate of Allergan, plc
Publications and helpful links
General Publications
- Citrome L, Yatham LN, Patel MD, Barabassy A, Hankinson A, Earley WR. Cariprazine and akathisia, restlessness, and extrapyramidal symptoms in patients with bipolar depression. J Affect Disord. 2021 Jun 1;288:191-198. doi: 10.1016/j.jad.2021.03.076. Epub 2021 Mar 31.
- Thase ME, Harrington A, Calabrese J, Montgomery S, Niu X, Patel MD. Evaluation of MADRS severity thresholds in patients with bipolar depression. J Affect Disord. 2021 May 1;286:58-63. doi: 10.1016/j.jad.2021.02.043. Epub 2021 Feb 20.
- Yatham LN, Vieta E, McIntyre RS, Jain R, Patel M, Earley W. Broad Efficacy of Cariprazine on Depressive Symptoms in Bipolar Disorder and the Clinical Implications. Prim Care Companion CNS Disord. 2020 Sep 17;22(5):20m02611. doi: 10.4088/PCC.20m02611.
- Earley WR, Burgess M, Rekeda L, Hankinson A, McIntyre RS, Suppes T, Calabrese JR, Yatham LN. A pooled post hoc analysis evaluating the safety and tolerability of cariprazine in bipolar depression. J Affect Disord. 2020 Feb 15;263:386-395. doi: 10.1016/j.jad.2019.11.098. Epub 2019 Nov 22.
- Earley W, Burgess MV, Rekeda L, Dickinson R, Szatmari B, Nemeth G, McIntyre RS, Sachs GS, Yatham LN. Cariprazine Treatment of Bipolar Depression: A Randomized Double-Blind Placebo-Controlled Phase 3 Study. Am J Psychiatry. 2019 Jun 1;176(6):439-448. doi: 10.1176/appi.ajp.2018.18070824. Epub 2019 Mar 8.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- RGH-MD-54
- 2016-000757-13 (EudraCT Number)
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.