Galantamine Augmentation of Escitalopram for Treatment of Depression

Galantamine Augmentation of Escitalopram for Treatment of Depression Associated Cognitive Impairment in Outpatients - A Randomized Single Blind Clinical Trial

The purpose of this study is to investigate whether the addition of galantamine to a commonly used antidepressant, escitalopram (Lexapro), will be useful in the treatment of memory and other thinking problems that are frequently seen in depression. At present, galantamine is approved for use in the treatment of Alzheimer's disease or dementia, but not for use for the treatment of depression in younger patients.

Possible genetic effects of depressed individuals will also be studied. This study is involved in collecting blood from patients with depression. DNA, the genetic material in our cells, will be obtained from these blood samples. The DNA will be studied to determine the contribution of different genes to the development of depression. These blood samples are extremely useful to researchers who are trying to determine the genetic risk factors that may lead to depression.

Study Overview

• Status: Terminated
• Conditions: Depression
• Intervention / Treatment: Drug: Escitalopram; Drug: Galantamine

Detailed Description

HYPOTHESES/OBJECTIVES

Aim 1: To investigate whether patients treated with escitalopram in combination with galantamine will show a significantly greater improvement of depression compared to patients treated with escitalopram alone.

H1: Patients treated with escitalopram and galantamine combination will have significantly greater improvement on the Hamilton Depression Rating Scale (HDRS) and Clinical Global Improvement (CGI) scale compared to patients treated with escitalopram and placebo.

Aim 2: To investigate whether treatment with escitalopram in combination with galantamine will lead to a greater improvement of cognitive function in depressed patients compared to escitalopram alone.

H2: Patients treated with escitalopram and galantamine combination will have significantly greater improvement of scores on Selective Reminding Test (SRT) and Trail Making Test (TMT) than patients treated with escitalopram and placebo.

Study Design and Method:

This will be a randomized, single blind, parallel-group, placebo controlled study in which a total of 20 subjects, 10 in each arm: one arm would be escitalopram + galantamine treatment and the other arm will be escitalopram + placebo treatment. The subject will be blinded against the galantamine or placebo, but will be unblinded against escitalopram. The total duration of this study will be 10 weeks. After the baseline visit, patients will complete 8 weeks of the study medication.

• Study Type: Interventional
• Enrollment: 20
• Phase: Phase 4

Contacts and Locations

Study Locations

• United States
  • Indiana
    • Indianapolis, Indiana, United States, 46202
      • IU Adult Psychiatric Clinic

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years to 56 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Age 18 - 60 years of age inclusive
2. Satisfy DSM-IV-TR criteria for Major Depression
3. RAVLT scores decreased from normative mean for age
4. 17 item HDRS rating > 18
5. Give informed consent as approved by local IRB
6. On no antidepressants or wanting to be tapered off current antidepressant medication due to side effects or inefficacy; and
7. Not on monoamine oxidase inhibitors (MAOIs) for 3 weeks before start of the study.

Exclusion Criteria:

1. Comorbid psychotic disorder such as schizophrenia or schizoaffective disorder
2. Significant suicidal or homicidal risk
3. Clinically significant medical illness
4. Allergy or intolerance to escitalopram or galantamine
5. Woman of child bearing age (except if surgically sterile or have had tubal ligation)
6. Satisfy criteria for substance dependence within 6 months prior to start of the study
7. History of intolerance to escitalopram or galantamine; and
8. On any medication with significant adverse interaction with either escitalopram or galantamine.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Decrease in depression symptoms measured by Hamilton Depression Rating Scale and Clinical Global Improvement Scale
Improvement of cognitive measures scores:Selective Reminding Test, Trail Making Test and others

Collaborators and Investigators

• Sponsor: Indiana University School of Medicine
• Investigators: Principal Investigator: Amit Anand, MD, University

Study record dates

Study Major Dates

• Study Start: November 1, 2003
• Study Completion: September 1, 2005

Study Registration Dates

• First Submitted: September 14, 2005
• First Submitted That Met QC Criteria: January 17, 2007
• First Posted (Estimate): January 18, 2007

Study Record Updates

• Last Update Posted (Estimate): January 18, 2007
• Last Update Submitted That Met QC Criteria: January 17, 2007
• Last Verified: January 1, 2007

More Information

Terms related to this study

• Keywords: Depression; Cognitive Impairment
• Additional Relevant MeSH Terms: Behavioral Symptoms; Mental Disorders; Mood Disorders; Depression; Depressive Disorder; Physiological Effects of Drugs; Neurotransmitter Agents; Molecular Mechanisms of Pharmacological Action; Autonomic Agents; Peripheral Nervous System Agents; Cholinergic Agents; Enzyme Inhibitors; Psychotropic Drugs; Serotonin Uptake Inhibitors; Neurotransmitter Uptake Inhibitors; Membrane Transport Modulators; Serotonin Agents; Antidepressive Agents; Antidepressive Agents, Second-Generation; Nootropic Agents; Cholinesterase Inhibitors; Parasympathomimetics; Citalopram; Galantamine
• Other Study ID Numbers: 0301-35; 45-869-96