- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01047254
Bupropion for the Treatment of Apathy in Alzheimer's Dementia (APA-AD)
A 12-week, Multicenter, Randomized, Double-blind, Placebo-controlled Trial of Bupropion for the Treatment of Apathy in Alzheimer's Dementia(Apa-AD)
Apathy in dementia prevents successful application of non-pharmacological treatments, accelerates cognitive and functional decline and increases disease-related costs by earlier need for full-time care. Apathy is a distinct entity and occurs independently of other neuropsychiatric syndromes, like depression.
Today, there is no high-level evidence for any effective treatment of apathy in AD. In contrast to other neuropsychiatric syndromes in AD, like psychosis and depression, and despite its high prevalence and clinical relevance, apathy has never been the primary outcome in a clinical trial. Basic and clinical research has provided a distinct model of the pathophysiology of apathy with dopamine and norepinephrine as the key neurotransmitter systems involved. The antidepressant Bupropion is a dopamine and norepinephrine reuptake inhibitor. There is evidence from case-series, that Bupropion reduces apathy in patients with organic brain disorders. This study will test the efficacy and safety of Bupropion in the treatment of apathy in AD in a 12-week multicenter doubleblind placebo controlled trial. Secondary endpoints will be quality of life of patients, caregivers' distress, ability of patients to perform activities of daily living,utilization of healthcare resources by patients and by caregivers, and cognitive functions.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
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Bonn, Germany, 53105
- Department of Psychiatry, University Bonn
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Mild to moderate Alzheimer's dementia, male and female (NINCDS/ADRDA criteria)
- Presence of clinically relevant apathy defined by the Neuropsychiatric Inventory (NPI) apathy item (score of >/= 4 points) and the Marin/Starkstein criteria for apathy
- MMSE: 10-25
- Outpatient status, not institutionalized
- Presence of reliable caregiver
- Stable treatment with antidementia drugs for at least three months prior to entry or no treatment with antidementia drugs
Exclusion Criteria:
- Other Dementia (e.g. vascular dementia, Lewy-body dementia, fronto-temporal dementia)
- Presence of a clinically relevant depression defined by either the NPI depression item (score >/= 4 points) or DSM-IV criteria for major depressive episode (with depressed mood)
- Alcoholism and Benzodiazepine addiction
- Current treatment with antipsychotics and antidepressants (including St. John's wart)
- Current treatment with dopaminergic agents or Amantadin
- Current treatment with benzodiazepines
- Current treatment with MAO inhibitor (Bupropion contraindication)
- Known sensibility to Bupropion treatment
- Severe psychiatric disease (including hospitalization) in the last 6 months, suicide attempt, acute psychotic symptoms
- Severe physical illness, that do not allow a participation in a 12-week period of treatment
- Medical history with seizures
- Medical history with tumors of the central nervous system
- Severe craniocerebral injury and medical history with cerebral substance defect
- Clinically relevant renal disease, liver insufficiency
- Simultaneous treatment, which reduces the seizure threshold (e.g. antipsychotics, antidepressants, antimalarial agents, Tramadol, Theophyllin, systemic steroids in higher dose, Chinolone, sedative antihistamines)
- Simultaneous treatment, which is metabolized through Cytochrom P450-Isoenzym 2D6 (e.g. these beta blockers: Metoprolol, Proanolol, Timolol, Carvediol, Nebivolol, Typ-1C-Antiarrhyhtmics for e.g. Propafenon, Flecinid) (except Donepezil and Galantamin)
- Simultaneous treatment with drugs, which may interfere with the metabolization of Bupropion (e.g. Carbamazepin, Phenytoin, Valproat, Ritonavir, Lopinavir)
- Diabetes mellitus, which is therapeutically poorly regulated and treated by medication
- Treatment with stimulants and appetite depressants
- Participation in other clinical trials with in the last 3 months
- Suicidal tendency
- Known lactose intolerance
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Bupropion
Buproprion 150-300 mg in a flexible dose
|
flexible dose of Bupropion 150-300 mg
|
Placebo Comparator: placebo capsule
Placebo
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Change in Apathy Evaluation Scale (AES) score
Time Frame: 12 weeks
|
12 weeks
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
NPI total score;NPI caregivers' distress total score;ADCS-ADL; QoL-AD; RUD;ADAScog;MMSE
Time Frame: 12 weeks
|
12 weeks
|
Collaborators and Investigators
Sponsor
Collaborators
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2007-005352-17
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 Apathy in Dementia
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Cerevel Therapeutics, LLCRecruitingApathy in DementiaUnited States, Canada
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RIVAGESRecruitingNeurocognitive Disorders | Virtual Reality | Aged | Apathy in DementiaFrance
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Massachusetts General HospitalNot yet recruitingAlzheimer Disease | Apathy in Dementia
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Sunnybrook Health Sciences CentreRecruiting
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Central Arkansas Veterans Healthcare SystemCompletedApathy | Alzheimer's DementiaUnited States
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Zurich University of Applied SciencesUnknown
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VA Office of Research and DevelopmentCompletedDementia | Alzheimer's Disease | ApathyUnited States
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University Hospital, Strasbourg, FranceRecruiting
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St. Louis UniversityTerminatedDementia | Apathy | Accidental FallsUnited States
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Federal University of Minas GeraisUnknownAlzheimer's Disease | ApathyBrazil
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