- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00642694
Time to Remission of Depressive Symptoms With Combined SSRI and Ramelteon (TAKEDA)
July 3, 2019 updated by: Prabha Sunderajan, University of Texas Southwestern Medical Center
Hypothesis I: Patients in the SSRI + ramelteon treatment group will achieve remission (defined as an IDS-C30 score of 11 or less) more quickly than those in the SSRI + placebo group.
Study Overview
Status
Terminated
Conditions
Intervention / Treatment
Detailed Description
The primary objective of the study is to assess the time to remission in depression with initial insomnia using the SSRI antidepressant escitalopram combined with ramelteon or placebo.
Patients will be assessed at each visit for depressive symptoms and insomnia, using the 30-item Inventory of Depressive Symptoms, Clinician-Rated version (IDS-C30; Rush et al 1986; Rush et al., 1996) as the primary outcome measure.
The IDS self-report version will be used to assess self-reported changes in symptom severity.
The 17 item Hamilton Rating Scale for Depression, (HRSD17; Hamilton, 1960) will also be administered, as it is the most commonly utilized depression symptom severity measure at this time.
Study Type
Interventional
Enrollment (Actual)
29
Phase
- Phase 3
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
-
-
Texas
-
Dallas, Texas, United States, 752390-9119
- University of Texas Southwestern Medical Center at Dallas
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-
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
18 years to 70 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Ability and willingness to provide written informed consent.
- Primary diagnosis of MDD with initial insomnia.
- Age 18-70.
- Screening HRSD17 score greater than or equal to 16 or CGI-S score of at least 4.
- Subjective report of difficulties with initial insomnia with a score of 2 or greater on the IDS-C30 item addressing this symptom (#1). Middle and late insomnia may also be present so long as initial insomnia is present.
Exclusion Criteria:
- Presence of significant comorbid medical condition based on laboratory test, physician information, or evidence at examination; this includes severe sleep apnea, seizure disorder, or chronic obstructive pulmonary disease (COPD).
- Patient report or evidence (based on physical examination or laboratory tests) of significant medical abnormalities; this includes severe sleep apnea, seizure disorder, or COPD.
- Presence of other psychological disorders, including depression due to other comorbid conditions, currently suicidal or high suicide risk, current or past psychotic disorders of any type, bipolar disorder (I, II, or NOS), schizophrenia, or schizoaffective disorder, anorexia, bulimia, obsessive compulsive disorder, alcohol or substance abuse within the last 6 months, or patients with comorbid psychiatric conditions that are relative or absolute contraindications to the use of escitalopram or ramelteon.
- Concomitant (i.e. within 2 weeks; 4 weeks for fluoxetine or MAOIs) pharmacological or psychotherapeutic treatment including but not limited to anxiolytics, neuroleptics, mood stabilizers, sleep aids including over the counter melatonin, and/or other agents without proven antidepressant efficacy, cognitive behavioral therapy; current use of other medications that would be contraindicated with ramelteon or escitalopram,, as determined by the study doctor.
- Failure to respond to 2 adequate courses of SSRI class antidepressant in the current episode (as measured by the Antidepressant Treatment History Form).
- Hospitalization for mental illness within the past year.
- For women, currently pregnant, planning to become pregnant in the next year, or breastfeeding.
- Patient does not speak English. (Patient needs to be fluent in written and oral English because not all assessments are available and/or validated in languages other than English).
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: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: 1
Escitalopram tablets (starting dose of 10 mg with a maximum dose of 20 mg daily) + Ramelteon (One 8 mg capsule at night)
|
Escitalopram 10 or 20mg qd based on symptoms at patient visit
Other Names:
Ramelteon 8 mg qd
Other Names:
|
Placebo Comparator: 2
Escitalopram tablets (starting dose of 10 mg with a maximum dose of 20 mg daily) + Matching Placebo (One capsule at night)
|
Escitalopram 10 or 20mg qd based on symptoms at patient visit
Other Names:
Matching placebo qd
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Percentage of Remitters on IDS-C30 at Week 12
Time Frame: 12 Weeks
|
Remission as defined by a score of <12 on the Inventory of Depressive Symptomatology, Clinician-Rated version (IDS-C30) at Week 12; minimum possible score = 0, maximum possible score = 84; higher scores indicate worse symptom severity
|
12 Weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Sleep Latency
Time Frame: 12 weeks
|
Number of minutes until fell asleep
|
12 weeks
|
Short-Form Health Survey - Version 2 (SF-36)
Time Frame: 12 Weeks
|
The Short-Form Health Survey - version 2 (SF-36) is a self-report inventory measuring different domains of health-related quality of life: Physical Functioning, Physical Role Functioning, Bodily Pain, General Health, Vitality, Social Functioning, Emotional Role Functioning, and Mental Health.
Scores range from 0 to 100, with higher scores indicating better perceived health and functioning.
|
12 Weeks
|
Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q)
Time Frame: 12 Weeks
|
The Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) measures satisfaction and enjoyment in various domains of functioning: physical health, feelings, work, household duties, school/course work, leisure time activities, social relations, and general activities.
The raw score is converted into a percent of the maximum possible score and ranges from 0 to 100.
Higher scores indicate greater enjoyment and satisfaction.
|
12 Weeks
|
Social Adjustment Scale - Self-Report (SAS-SR)
Time Frame: 12 Weeks
|
The Social Adjustment Scale - Self-Report (SAS-SR) is a 54-item self-report measure of instrumental and expressive role performance.
Each item is rated on a 5-point scale, and a mean item score (ranging from 1-5) is obtained, with higher scores indicating greater impairment.
|
12 Weeks
|
Work and Social Adjustment Scale (WSAS)
Time Frame: 12 Weeks
|
The Work and Social Adjustment Scale (WSAS) is 5-item self-report measure designed to identify functional impairment that is attributed to an identified problem or condition.
and has been used in studies of depression and anxiety.
Scores range between 0-40, with higher scores indicating worse functioning.
|
12 Weeks
|
Work Productivity and Activity Impairment Questionnaire (WPAI)
Time Frame: 12 Weeks
|
The Work Productivity and Activity Impairment Questionnaire (WPAI) was used to report impairment while working or performing usual daily activities as a result of health problems.
The activity impairment item (#6 of WPAI) is rated on a scale of 0-10, with higher scores indicating greater impairment.
Scores are multiplied by 10 to obtain percent impairment.
|
12 Weeks
|
Patient Perception of Benefits of Care (PPBC)
Time Frame: 12 Weeks
|
The Patient Perception of Benefits of Care (PPBC) assesses how much patients believe their quality of life will improve in response to medical care or treatment.
Scores range between 10-50, with lower scores indicating greater belief that treatment will improve quality of life.
|
12 Weeks
|
Hamilton Rating Scale for Depression 17-item
Time Frame: 12 Weeks
|
The Hamilton Rating Scale for Depression is a clinician-administered rating scale that assesses severity of depressive symptoms and is one of the most widely used and validated symptom severity measures for depression.
Each of the 17 items is rated by the clinician on either a 3- or a 5 point scale.
Total scores range from 0-52, with higher scores indicating greater depressive symptoms.
|
12 Weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
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.
Helpful Links
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
May 1, 2007
Primary Completion (Actual)
May 1, 2010
Study Completion (Actual)
May 1, 2010
Study Registration Dates
First Submitted
March 19, 2008
First Submitted That Met QC Criteria
March 24, 2008
First Posted (Estimate)
March 25, 2008
Study Record Updates
Last Update Posted (Actual)
July 26, 2019
Last Update Submitted That Met QC Criteria
July 3, 2019
Last Verified
July 1, 2019
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Behavioral Symptoms
- Mental Disorders
- Nervous System Diseases
- Mood Disorders
- Sleep Disorders, Intrinsic
- Dyssomnias
- Sleep Wake Disorders
- Depression
- Depressive Disorder
- Sleep Initiation and Maintenance Disorders
- Depressive Disorder, Major
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Parasympatholytics
- Autonomic Agents
- Peripheral Nervous System Agents
- Muscarinic Antagonists
- Cholinergic Antagonists
- Cholinergic Agents
- Psychotropic Drugs
- Serotonin Uptake Inhibitors
- Neurotransmitter Uptake Inhibitors
- Membrane Transport Modulators
- Serotonin Agents
- Antidepressive Agents
- Antidepressive Agents, Second-Generation
- Antiparkinson Agents
- Anti-Dyskinesia Agents
- Citalopram
- Dexetimide
Other Study ID Numbers
- 06-031R
- 112006-017
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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