Prophylactic Effects of Agomelatine for Poststroke Depression (PRAISED)
A Multicenter, Randomized, Double-blind, Placebo-controlled Study Evaluating the Efficacy and Safety of Agomelatine in the Prevention of Poststroke Depression
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Contact
Study Contact
- Name: Jinsheng Zeng
- Phone Number: 13322800657
- Email: zengjs@pub.guangzhou.gd.cn
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- aged 18~75 years;
- within 7 days after stroke onset;
- CT or MRI showed lesions involving the frontal lobe;
- mRS≤2 before onset for recurrent ischemic stroke;
- HAMD-17<8 before enrollment;
- NIHSS<16;
- be consious and able to complete the relevant assessment scales.
Exclusion Criteria:
- hemorrhagic stroke;
- with major depressive disorder, or have taken antidepressants within 30 days before stroke onset, or HAMD-17 ≥8;
- with other mental illnesses;
- history of drug abuse or alcohol dependence in the past 1 year
- with life-threatening illnesses or disorders which may affect the completion of the relevant assessment scale (e.g., hearing, language, visual impairment, etc.)
- with cognitive impairment who cannot complete the relevant assessment scale
- with serious neurodegeneration diseases (such as Parkinson's disease, Alzheimer's disease, etc.)
- infection or carriers of hepatitis B virus (HBV) or hepatitis C virus (HCV)
- serum ALT level ≥ 2 times of the upper limit of the reference interval or TBIL level > 1.5 times of the upper limit of the reference interval
- renal dysfunction (creatinine clearance < 90 ml/min/1.73 m2)
- allergic to or contra-indicated to agomelatine
- lactose intolerance
- pregnant or breast-feeding women
- withdraw from other clinical trials within 4 weeks or participating in other clinical trials
- unsuitable for inclusion considered by the investigators
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Agomelatine
The Agomelatine group will be received agomelatine (25 mg/day) for 180 days.
|
agomelatine 25 mg/day for 180 days
Other Names:
|
|
Placebo Comparator: Placebo
The Placebo group will be received placebo (25 mg/day) for 180 days.
|
placebo 25 mg/day for 180 days
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
rate of PSD within 180 days
Time Frame: 180 days
|
PSD is defined as Hamilton Depression Rating Scale-17 (HAMD-17) ≥7 or diagnosis of depression by DSM-V.
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180 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
rate of recurrence of ischemic stroke within 90 days
Time Frame: 90±7 days
|
|
90±7 days
|
|
variation of HAMD-17 score from baseline
Time Frame: 14±3 days, 28±3 days, 90±7 days, and 180±7 days
|
range from 0 to 50; the higher, the worse
|
14±3 days, 28±3 days, 90±7 days, and 180±7 days
|
|
rate of sleep disorder
Time Frame: 180 days
|
range from 0 to 21; > 7, having sleep disorder
|
180 days
|
|
variation of Pittsburgh Sleep Quality Index (PSQI) score from baseline
Time Frame: 14±3 days, 28±3 days, 90±7 days and 180±7 days
|
range from 0 to 21; the higher, the worse; > 7, having sleep disorder
|
14±3 days, 28±3 days, 90±7 days and 180±7 days
|
|
variation of Stroke Specific Quality of Life (SS-QOL) score from baseline
Time Frame: 28±3 days, 90±7 days, and 180±7 days
|
range from 50 to 248; the higher, the better
|
28±3 days, 90±7 days, and 180±7 days
|
|
variation of Modified Rankin Scale (mRS) score from baseline
Time Frame: 28±3 days, 90±7 days and 180±7 days
|
range from 0 to 5; the higher, the worse
|
28±3 days, 90±7 days and 180±7 days
|
|
variation of National Institutes of Health Stroke Scale (NIHSS) from baseline
Time Frame: 28±3 days, 90±7 days and 180±7 days
|
range from 0 to 42; the higher, the worse
|
28±3 days, 90±7 days and 180±7 days
|
|
variation of Montreal Cognitive Assessment (MOCA) from baseline
Time Frame: 28±3 days, 90±7 days, and 180±7 days
|
range from 0 to 30; the lower, the worse
|
28±3 days, 90±7 days, and 180±7 days
|
|
variation of Mini Mental State Examination (MMSE) score from baseline
Time Frame: 28±3 days, 90±7 days, and 180±7 days
|
range from 0 to 30; the lower, the worse
|
28±3 days, 90±7 days, and 180±7 days
|
|
variation of Epworth Sleepiness Scale (ESS) from baseline
Time Frame: 28±3 days, 90±7 days, and 180±7 days
|
range from 9 to 63; the higher, the worse
|
28±3 days, 90±7 days, and 180±7 days
|
|
rate of all-caused mortality
Time Frame: 180 days
|
death due to all causes
|
180 days
|
|
variation of Fatigue Severity Scale (FSS) from baseline
Time Frame: 28±3 days, 90±7 days, and 180±7 days
|
range from 0 to 24; >=24, having drowsiness tendency
|
28±3 days, 90±7 days, and 180±7 days
|
|
rate of vascular events
Time Frame: 180 days
|
defined as the composite of stroke, transient ischemic attack (TIA), myocardial infarction and vascular death
|
180 days
|
|
rate of liver injury
Time Frame: 28±3 days, 90±7 days
|
defend as the level of ALT 2 times higher than the upper limit of normal range
|
28±3 days, 90±7 days
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Chair: Jinsheng Zeng, First Affiliated Hospital, Sun Yat-Sen University
Publications and helpful links
General Publications
- Zhao FY, Yue YY, Li L, Lang SY, Wang MW, Du XD, Deng YL, Wu AQ, Yuan YG. Clinical practice guidelines for post-stroke depression in China. Braz J Psychiatry. 2018 Jul-Sep;40(3):325-334. doi: 10.1590/1516-4446-2017-2343. Epub 2018 Feb 1.
- Hackett ML, Pickles K. Part I: frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies. Int J Stroke. 2014 Dec;9(8):1017-25. doi: 10.1111/ijs.12357. Epub 2014 Aug 12.
- Robinson RG, Jorge RE. Post-Stroke Depression: A Review. Am J Psychiatry. 2016 Mar 1;173(3):221-31. doi: 10.1176/appi.ajp.2015.15030363. Epub 2015 Dec 18.
- Villa RF, Ferrari F, Moretti A. Post-stroke depression: Mechanisms and pharmacological treatment. Pharmacol Ther. 2018 Apr;184:131-144. doi: 10.1016/j.pharmthera.2017.11.005. Epub 2017 Nov 9. Review.
- Feng C, Fang M, Liu XY. The neurobiological pathogenesis of poststroke depression. ScientificWorldJournal. 2014 Mar 4;2014:521349. doi: 10.1155/2014/521349. eCollection 2014. Review.
- Gu J, Huang H, Chen K, Huang G, Huang Y, Xu H. Are they necessary? Preventive therapies for post-stroke depression: A meta-analysis of RCTs. Psychiatry Res. 2020 Feb;284:112670. doi: 10.1016/j.psychres.2019.112670. Epub 2019 Oct 31. Review.
- Kim JS, Lee EJ, Chang DI, Park JH, Ahn SH, Cha JK, Heo JH, Sohn SI, Lee BC, Kim DE, Kim HY, Kim S, Kwon DY, Kim J, Seo WK, Lee J, Park SW, Koh SH, Kim JY, Choi-Kwon S; EMOTION investigators. Efficacy of early administration of escitalopram on depressive and emotional symptoms and neurological dysfunction after stroke: a multicentre, double-blind, randomised, placebo-controlled study. Lancet Psychiatry. 2017 Jan;4(1):33-41. doi: 10.1016/S2215-0366(16)30417-5.
- FOCUS Trial Collaboration. Effects of fluoxetine on functional outcomes after acute stroke (FOCUS): a pragmatic, double-blind, randomised, controlled trial. Lancet. 2019 Jan 19;393(10168):265-274. doi: 10.1016/S0140-6736(18)32823-X. Epub 2018 Dec 5.
- Williams LS, Kroenke K, Bakas T, Plue LD, Brizendine E, Tu W, Hendrie H. Care management of poststroke depression: a randomized, controlled trial. Stroke. 2007 Mar;38(3):998-1003. doi: 10.1161/01.STR.0000257319.14023.61. Epub 2007 Feb 15.
- Robinson RG, Jorge RE, Moser DJ, Acion L, Solodkin A, Small SL, Fonzetti P, Hegel M, Arndt S. Escitalopram and problem-solving therapy for prevention of poststroke depression: a randomized controlled trial. JAMA. 2008 May 28;299(20):2391-400. doi: 10.1001/jama.299.20.2391. Erratum In: JAMA. 2009 Mar 11;301(10):1024.
- Almeida OP, Waterreus A, Hankey GJ. Preventing depression after stroke: Results from a randomized placebo-controlled trial. J Clin Psychiatry. 2006 Jul;67(7):1104-9.
- Chollet F, Tardy J, Albucher JF, Thalamas C, Berard E, Lamy C, Bejot Y, Deltour S, Jaillard A, Niclot P, Guillon B, Moulin T, Marque P, Pariente J, Arnaud C, Loubinoux I. Fluoxetine for motor recovery after acute ischaemic stroke (FLAME): a randomised placebo-controlled trial. Lancet Neurol. 2011 Feb;10(2):123-30. doi: 10.1016/S1474-4422(10)70314-8. Epub 2011 Jan 7. Erratum In: Lancet Neurol. 2011 Mar;10(3):205.
- Tsai CS, Wu CL, Chou SY, Tsang HY, Hung TH, Su JA. Prevention of poststroke depression with milnacipran in patients with acute ischemic stroke: a double-blind randomized placebo-controlled trial. Int Clin Psychopharmacol. 2011 Sep;26(5):263-7. doi: 10.1097/YIC.0b013e32834a5c64.
- Niedermaier N, Bohrer E, Schulte K, Schlattmann P, Heuser I. Prevention and treatment of poststroke depression with mirtazapine in patients with acute stroke. J Clin Psychiatry. 2004 Dec;65(12):1619-23.
- Berg A, Palomäki H, Lehtihalmes M, Lönnqvist J, Kaste M. Poststroke depression: an 18-month follow-up. Stroke. 2003 Jan;34(1):138-43.
- Quera-Salva MA, Lemoine P, Guilleminault C. Impact of the novel antidepressant agomelatine on disturbed sleep-wake cycles in depressed patients. Hum Psychopharmacol. 2010 Apr;25(3):222-9. doi: 10.1002/hup.1112. Review.
- Chern CM, Liao JF, Wang YH, Shen YC. Melatonin ameliorates neural function by promoting endogenous neurogenesis through the MT2 melatonin receptor in ischemic-stroke mice. Free Radic Biol Med. 2012 May 1;52(9):1634-47. doi: 10.1016/j.freeradbiomed.2012.01.030. Epub 2012 Feb 10.
Study record dates
Study Major Dates
Study Start (Anticipated)
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
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
- Behavioral Symptoms
- Mental Disorders
- Cardiovascular Diseases
- Vascular Diseases
- Cerebrovascular Disorders
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Mood Disorders
- Stroke
- Depression
- Depressive Disorder
- Ischemic Stroke
- Physiological Effects of Drugs
- Central Nervous System Depressants
- Hypnotics and Sedatives
- S 20098
Other Study ID Numbers
Other Study ID Numbers
- PRAISED
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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