- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02376257
Improving Therapeutic Learning in Depression: Proof of Concept
August 22, 2018 updated by: Michael Otto, Boston University Charles River Campus
Despite advances in both pharmacotherapy and psychotherapy for major depression, non-response and partial-response remain relatively common outcomes, motivating the search for new treatments.
This study is concerned with the development of one such novel treatment, the augmentation of exposure-based cognitive-behavior therapy (CBT) with d-cycloserine (DCS).
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Investigators will study the efficacy of DCS for augmenting therapeutic learning relevant for the treatment of depression (i.e., outside the extinction learning where DCS has been shown to have success).
Specifically, the study investigates the role of DCS in enhancing declarative memory in depressed individuals, as evaluated by standardized tests and the retention of cognitive therapy session material.
Investigators will also study an active comparison agent, modafinil, which appears to offer cognitive enhancing effects among both sleep-deprived and non-sleep-deprived individuals, but also appears to have drug-state (e.g., mood and side) effects that are not characteristic of DCS augmentation.
Therefore, drug-context effects may affect memory retention over time.
Hence, the study will evaluate memory enhancement effects both during the period of drug action as well as one week later when no drug is taken.
Overall, investigators will examine cognitive function and memory performance over 4 study sessions in 96 men and women with major depression, who, in a double-blind fashion, will be randomly assigned to either: (1) 250mg DCS, (2) 100mg modafinil, or (3) placebo administered on Study Weeks 2 and 3.
The memory tests include both items unique to a given study week and memory tasks that are repeated over time that allow assessment of memory and retention effects across one-week periods.
Study Type
Interventional
Enrollment (Actual)
36
Phase
- Phase 2
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
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02215
- Boston University
-
-
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 65 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Must have a DSM diagnosis of major depression as determined by structured diagnostic interview
- Must be free of psychotropic medications other than serotonin selective reuptake inhibitors (SSRIs) for at least 2 weeks
- No current suicidal ideation
- Able to speak and understand English
- Must be between the ages of 18 and 65, inclusive
- Must be a male, or a female who is not of childbearing potential (i.e., surgically sterile, postmenopausal for at least 1 year) or who is non-pregnant, non-lactating and using a medically accepted method of contraception. Acceptable methods of contraception include condoms (male or female) with or without a spermicidal agent, diaphragm or cervical cap with spermicide, medically prescribed IUD, hormonal contraceptives. A woman of childbearing potential who is not currently sexually active must agree to use a medically accepted method of contraception should she become sexually active while participating in the trial
Exclusion Criteria:
- A DSM diagnosis of dementia, neurodegenerative disease, or other organic mental disorder; substance use disorder other than nicotine or caffeine in the last 3 months; bulimia or anorexia within the last 3 months; lifetime history of psychotic disorder or, bipolar disorder, or developmental disorder;
- A diagnosis of organic brain syndrome, mental retardation, or other cognitive dysfunction that could interfere with a participants capacity to participate in CBT or to complete safety and efficacy assessments
- A history of seizures (apart from childhood febrile seizures) or head trauma causing ongoing cognitive impairment
- An uncontrolled, unstable clinically significant medical condition (e.g., renal, endocrine, hepatic, respiratory, cardiovascular, hematologic, immunologic or cerebrovascular disease, or malignancy, or poorly controlled hypertension (> 150/90mmHg) that may interfere with the interpretation of safety and efficacy evaluations in the opinion of the study physician or investigator
- Medical illness including hypertension, cardiac disease, liver disease, pulmonary diseases, central nervous system disease, and epilepsy;
- Recent (1 year) suicidal attempts or current suicidal ideation
- For women, currently pregnant, plans to be pregnant in the next 2 months, or currently breastfeeding
- Treatment with phenytoin, isoniazid, or propranolol or known sensitivity to modafinil or cycloserine
- A history of head trauma causing loss of consciousness, seizure or ongoing cognitive impairment
- Use of psychotropic medication (including stimulants) other than SSRIs
- Current daily use of alcohol or regular binge alcohol use as determined on the medical screen
- Insufficient command of the English language (i.e., cannot carry on a conversation with an interviewer in the English language or read associated text)
- Receipt of CBT in the previous five years
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 |
---|---|
Active Comparator: 250 mg DCS
Baseline assessment (week 1), two weekly sessions when 250mg DCS is administered, and final week (week 4) when retention is assessed.
|
Drug
Other Names:
|
Active Comparator: 100 mg modafinil
Baseline assessment (week 1), two weekly sessions when 100 mg modafinil is administered, and final week (week 4) when retention is assessed.
|
Drug
|
Placebo Comparator: Placebo
Baseline assessment (week 1), two weekly sessions when placebo is administered, and final week (week 4) when retention is assessed.
|
Drug
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Recall of Cognitive Therapy Content
Time Frame: Week 2 and Week 3
|
A modified Cognitive Therapy Awareness Scale (CTAS) was used to assess delayed memory for cognitive therapy content from the computerized CBT.
Higher scores indicate better memory for CBT skills.
Scores range from 0 to 40.
|
Week 2 and Week 3
|
1 Week Delayed Recall of Emotional Story Items
Time Frame: Week 2 and Week 3
|
1 Week Delayed Recall of a Threat-Related Story.
Scores can range from 0 to 74, with higher scores reflect greater memory for story items.
|
Week 2 and Week 3
|
1 Week Delayed Recall Logical Memory
Time Frame: Week 2 and Week 3
|
Higher scores reflect greater recall of Wechsler Memory Scale (WMS) Story B content assessed one week after last rehearsal.
Possible scores range from 0 to 25.
|
Week 2 and Week 3
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Logical Memory Immediate Recall
Time Frame: Week 1, Week 2, Week 3
|
Immediate Story Recall from the Wechsler Memory Scale Story B. Higher scores reflect greater recall of the story material from the previous week.
Possible scores range from 0 to 25.
|
Week 1, Week 2, Week 3
|
Immediate Memory Measured by the Hopkins Verbal Learning Task
Time Frame: Baseline, Week 1, Week 2, Week 3
|
The Hopkins Verbal Learning Test (HVLT) consists of a 12-item word list, composed of four words from each of the three semantic categories.
The patient's free recall of the list is recorded.
The same procedure is repeated for two more trials.
The total recall score for the third trial was used as the recorded score and ranged from a minimum of zero to a maximum of 12 correct answers.
|
Baseline, Week 1, Week 2, Week 3
|
Immediate Recall of Emotional Story Items
Time Frame: Week 1, Week 2, Week 3
|
Immediate recall score of items from the Emotional Story presentation.
Scores can range from 0 to 74, with higher scores reflect greater memory for story items.
|
Week 1, Week 2, Week 3
|
Skills of Cognitive Therapy
Time Frame: Week 2 and Week 3
|
This measure assesses the self-reported use of skills from cognitive therapy.
Scores can range from 8 to 40, and higher scores indicate greater use.
|
Week 2 and Week 3
|
Digits Backward
Time Frame: Baseline, Week 1, Week 2, Week 3
|
The examiner reads a list of digits and asks that each digit be read backwards.
The score is the total number of trials completed correctly; scores range from 0 to 16.
Higher scores indicate better performance.
|
Baseline, Week 1, Week 2, Week 3
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Michael W Otto, Ph. D, Boston University
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.
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 (Actual)
September 16, 2014
Primary Completion (Actual)
April 21, 2017
Study Completion (Actual)
May 1, 2017
Study Registration Dates
First Submitted
July 11, 2014
First Submitted That Met QC Criteria
February 25, 2015
First Posted (Estimate)
March 3, 2015
Study Record Updates
Last Update Posted (Actual)
September 19, 2018
Last Update Submitted That Met QC Criteria
August 22, 2018
Last Verified
August 1, 2018
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Mental Disorders
- Mood Disorders
- Depressive Disorder
- Depressive Disorder, Major
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Antimetabolites
- Anti-Bacterial Agents
- Cytochrome P-450 Enzyme Inducers
- Cytochrome P-450 CYP3A Inducers
- Antitubercular Agents
- Central Nervous System Stimulants
- Antibiotics, Antitubercular
- Anti-Infective Agents, Urinary
- Renal Agents
- Wakefulness-Promoting Agents
- Cycloserine
- Modafinil
Other Study ID Numbers
- R21MH102646 (U.S. NIH Grant/Contract)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
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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