- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00178074
The Effects of Sleep Deprivation on Antidepressant Response
The Effects of Sleep Deprivation on Antidepressant Response in Geriatric Depression: Neurometabolic Substrates Studied With PET
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This study seeks to better understand the effect of sleep deprivation (TSD) on brain function using Positron Emission Tomography (PET). PET is an established research procedure that produces images of the brain. The purpose of these images is to show changes in brain activity associated with sleep deprivation. The neurochemical mechanisms underlying the TSD acceleration of antidepressant efficacy have not been identified. An understanding of these neurochemical processes may lead to the development of pharmacologic strategies that would accelerate antidepressant response or more directly to the development of antidepressant treatments that are more efficacious.
This study will be conducted in collaboration with Dr. Charles Reynolds' ongoing protocol "Geriatric Depression: Neurobiology of Treatment" (IRB #970356). The impetus for the clinical studies is the finding that the clinical response to antidepressant treatment in geriatric depressed patients is delayed, with the median time to remission reported as up to 12 weeks. Thus, the development of a strategy to accelerate treatment response would represent a substantial contribution to the treatment of geriatric depression. One approach that has been reported to accelerate antidepressant response in mid-life depression is one night of total sleep deprivation (TSD) prior to initiating antidepressant treatment. TSD has also been shown to improve mood in depressed patients, the response to TSD may distinguish subsequent treatment responders from non-responders and depressive relapse may occur after naps or a night of recovery sleep. The neurochemical mechanisms underlying the TSD acceleration of antidepressant efficacy have not been identified. An understanding of these neurochemical processes may lead to the development of pharmacologic strategies that would accelerate antidepressant response or more directly to the development of antidepressant treatments that are more efficacious.
Advancements in brain imaging technology and radiotracer chemistry have made it possible to measure metabolic activity and specific neurochemical mechanisms using Positron Emission Tomography (PET). The proposed studies represent the initial step in characterizing the neurochemical alterations produced by TSD and the impact of TSD on antidepressant response by TSD in geriatric depressed patients using PET and a radiotracer for brain glucose metabolism, [18F]-2deoxy-2-fluoro-D-glucose ([18F]-2DG). Having established the regional metabolic alterations associated with sleep deprivation and recovery sleep in patients who are subsequent treatment responders and compared the metabolic changes with treatment non-responders, future studies will be undertaken using neuroreceptor radiotracers to define the specific neurochemical pathways subserving the regional pattern of metabolic alterations. The glucose metabolic response to sleep deprivation in mid-life depression has been investigated at the UPMC PET Facility and at other institutions (e.g. Dube et al., in preparation, Wu et al., 1991, 1992). The studies performed in the geriatric depressed patients will be compared with the PET studies conducted in mid-life depressed patients to assess the contribution of the aging process to the neurometabolic response to sleep.
For information on related studies, please follow these links:
http://clinicaltrials.gov/show/NCT00177294
http://clinicaltrials.gov/show/NCT00178035
Study Type
Enrollment
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
Pennsylvania
-
Pittsburgh, Pennsylvania, United States, 15213
- University of Pittsburgh Medical Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Patients:
- DSM-IV criteria for current major depressive disorder
- Score of 15 or higher on the HRSD (17 item)
- Score of 17 or higher on the Folstein Mini-Mental Status Exam
Control Subjects:
-No history of psychiatric disorder or neurological illness
Exclusion Criteria:
Patients:
- lifetime diagnosis of any psychotic disorder
- bipolar disorder
- alcohol or drug abuse within the last 6 months
- No contraindication to SSRI therapy
- History of seizure disorder
Both Patient and Control Subjects:
-Current diagnosis of diabetes or significantly altered plasma glucose levels
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Non-Randomized
- Interventional Model: Factorial Assignment
- Masking: None (Open Label)
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
---|
To gain an understanding of the neurochemical processes that may lead to development of pharmacologic strategies that would accelerate antidepressant response or more directly to the development of antidepressant treatments.
|
PET study
|
Regional glucose metabolic rates and regional [18F]-altanserin binding
|
MRI scan
|
Secondary Outcome Measures
Outcome Measure |
---|
Hamilton Depression Rating Scale
|
Beck Depression Inventory
|
SCID
|
Profile of Mood States
|
Serum anticholinergicity and paroxetine blood levels
|
Folstein Mini-Mental State Exam
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Charles F Reynolds III, M.D., University of Pittsburgh
Study record dates
Study Major Dates
Study Start
Study Completion
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- R01MH037869-03 (U.S. NIH Grant/Contract)
- DATR A4-GPS
- 980753
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.
Clinical Trials on Unipolar Depression
-
Brown UniversityCompletedMild-moderate Unipolar Depression; Persistent Negative AffectUnited States
-
University GhentUniversity Hospital, GhentCompleted
-
University Hospital, MontpellierAssistance Publique - Hôpitaux de Paris; University Hospital, Clermont-Ferrand and other collaboratorsRecruitingUnipolar Depressed Outpatients | Mild Severity | Without Psychotic FeaturesFrance
-
Massachusetts General HospitalTakedaTerminatedDepressive Disorder | Depression | Major Depression | Depression, UnipolarUnited States
-
University of OxfordNational Institute for Health Research, United KingdomNot yet recruiting
-
The University of New South WalesUniversity of SydneyCompleted
-
University of AarhusTerminatedUnipolar DepressionDenmark
-
Norwegian Institute of Public HealthCompleted
-
University of Medicine and Pharmacy at Ho Chi Minh...Unknown
-
University Hospital TuebingenGerman Federal Ministry of Education and Research; Universität TübingenUnknown
Clinical Trials on total sleep deprivation
-
IRCCS San RaffaeleRecruitingMood Disorders | Sleep Deprivation | Major Depressive DisorderItaly
-
Federal University of São PauloCompleted
-
University Hospital, BordeauxRecruiting
-
Institut de Recherche Biomedicale des ArmeesCompleted
-
University of FloridaCompleted
-
Columbia UniversityNew York UniversityCompletedObesity | Sleep DeprivationUnited States
-
Esther WerthCompletedIdiopathic Hypersomnia | Narcolepsy 1Switzerland
-
Boston University Charles River CampusBrain & Behavior Research Foundation; One Mind; 1907 FoundationRecruiting
-
Yoav GimonCompleted