Duloxetine for the Treatment of Dysthymia

April 7, 2009 updated by: Stanford University
The purpose of this study is to test the hypothesis that duloxetine (Cymbalta), in doses of 60 or 120 mg/day, is an effective and tolerable treatment for adult outpatients suffering from dysthymia. Dysthymia is chronic, mild depression characterized by feeling sad or low more days than not for more than 2 years.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The purpose of this research is to obtain information on the safety and effectiveness of duloxetine (Cymbalta) in the treatment of dysthymia. Duloxetine has been approved by the federal Food and Drug Administration for the treatment of depression. The use of duloxetine for treatment of dysthymia is considered experimental.

Dysthymia is defined as chronic, low-grade depression, characterized by feeling low or depressed, that lasts for two or more years. Additional symptoms may include: poor appetite or overeating; insomnia or sleeping too much; low energy or fatigue; low self-esteem; poor concentration or difficulty making decisions; and feelings of hopelessness.

Dysthymia affects 3-6% of the general population, but is an underdiagnosed and undertreated disorder. In double-blind, placebo-controlled clinical trials of antidepressant medications, dysthymia response rates are around 60%, compared to an average placebo response rate of about 30%. Duloxetine has not been studied in the treatment of dysthymia, but has shown results in the treatment of major depression. In a 9-week, double-blind, placebo-controlled study of 257 patients with major depression, 65% responded to duloxetine 60mg/day, compared to 43% to placebo. Based on these results, it is highly likely that duloxetine will be an effective treatment for dysthymia.

This research study is being conducted at Stanford University Medical Center with a total of 24 patients, age 18 and above, with dysthymia.

In the study, subjects will receive duloxetine for 12 weeks. This is an open-label study, which means that every subject receives the study medication.

In total, subjects are seen for 10 visits across 13 weeks. At each visit subjects' heart rate, blood pressure and weight measurements will be obtained. At each visit study personnel will interview subjects about their symptoms, monitor side effects and ask them to complete study questionnaires.

Beginning at the second visit, subjects receive duloxetine 60 mg/day. If they experience side effects, the dose can be decreased to 30 mg/day for several days, but will be increased back to 60 mg/day by the end of the first week. If subjects are unable to tolerate a dose of 60 mg/day due to side effects, they will be withdrawn from the study. At the end of 6 weeks, if they have not responded to the study medication (as determined by doctor ratings based on subjects' reports), the dose of duloxetine will be increased to 120 mg/day, unless subjects are experiencing troubling side effects. Subjects continue on the minimum dose that brings about remission or the maximum tolerated dose for the remaining 6 weeks. Medication dosing will be flexible and determined by tolerance (side effects) and therapeutic effect.

Study Type

Interventional

Enrollment (Anticipated)

24

Phase

  • 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
    • California
      • Stanford, California, United States, 94305
        • Stanford University School of Medicine

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

Ages Eligible for Study

16 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria::

  • Sign an informed consent form
  • 18 years of age or older
  • Females not pregnant or breastfeeding or planning pregnancy and using an acceptable form of contraception
  • Meet DSM-IV criteria for dysthymia
  • A screening IDS-C score of 17 or greater
  • No history of serious or unstable medical disorder
  • Not taking any significant concurrent medications
  • Not currently receiving psychotherapy Exclusion Criteria:- Suffering from DSM-IV defined
  • delirium, dementia, amnestic, or other cognitive disorders
  • mental disorders due to a general medical condition
  • factitious or somatoform disorders
  • mental retardation or developmental disabilities
  • substance or alcohol abuse within the last 3 months
  • depressive disorders with current suicidal risk
  • psychotic disorders including delusional disorder, somatic type
  • dissociative disorder
  • personality disorders sufficiently severe to interfere with study participation
  • History of DSM-IV defined bipolar I or II disorder
  • History of non-response of dysthymia to adequate antidepressant medication
  • History of major depression refractory to two adequate trials of antidepressants

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: Treatment
  • Allocation: Non-Randomized
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Inventory of Depressive Symptomatology (Clinician-Rated)

Secondary Outcome Measures

Outcome Measure
Clinical Global Impressions - Improvement
Zung Self-Rating Depression Scale
Patient Global Improvement
Brief Pain Inventory
WHO-QOL 100

Collaborators and Investigators

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

Sponsor

Stanford University

Collaborators

Eli Lilly and Company

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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

September 1, 2004

Primary Completion (Actual)

April 1, 2006

Study Completion (Actual)

April 1, 2006

Study Registration Dates

First Submitted

September 9, 2005

First Submitted That Met QC Criteria

September 9, 2005

First Posted (Estimate)

September 16, 2005

Study Record Updates

Last Update Posted (Estimate)

April 9, 2009

Last Update Submitted That Met QC Criteria

April 7, 2009

Last Verified

April 1, 2009

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • SUSPO30478

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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