Role of the Noradrenergic System in the Regulation of Learning Dynamics: Evaluation of the Effect of a Low-dose Selective Noradrenaline Reuptake Inhibitor (NOISYXETINE) (NOISYXETINE)

Administration of low-dose selective noradrenaline reuptake inhibitor (sNRI) (e.g. atomoxetine) to healthy subjects is a validated model of increasing cortical noradrenaline levels which, combined with computational modelling of behaviour, allows fine-grained analysis of the impact on learning processes of noradrenaline's fluctuations in the human cortex.

The study goal is to characterize the modifications of certain cognitive processes and associated brain circuits under low-dose sNRI using validated computational learning models. The study will be interested in how subjects will modify their learning under the effect of the drug across two separate investigations; one utilizing in a stable evidence accumulation task and one utilising a changing evidence accumulation task. This approach will help to better understand the link between noradrenaline and accumulation of evidence in healthy subjects, and indirectly in some neuropsychiatric pathologies.

The study is a single centre, double-blinded, randomized, placebo-controlled, cross-over study involving evaluable healthy adults separated in 2 cohorts: A for participants having the stable task and B for those having the changing one. Participants will then be randomized in a 1:1 ratio to one of the following treatment sequences:

• Atomoxetine 40 mg - Placebo (Subgroups A1 or B1);
• Placebo - Atomoxetine 40 mg (Subgroups A2 or B2).

Study Overview

• Status: Recruiting
• Conditions: No Disease or Condition is Being Studied; Role of the Noradrenergic System in the Regulation of Learning Dynamics
• Intervention / Treatment: Drug: Atomoxetine; Drug: Placebo

Detailed Description

Hundred and sixty healthy volunteers will be enrolled (80 / task) in 24 months. The maximum duration of participation for each subject is 51 days.

• Study Type: Interventional
• Enrollment (Estimated): 160
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Florent Meyniel, MD, PhD; Phone Number: +33 1 45 65 63 90; Email: florent.meyniel@ghu-paris.fr

Study Locations

• France
  • Paris, France, 75014
    • Recruiting
    • Institut de Neuromodulation
    • Contact: Cécile BULTEZ, MSc; Phone Number: +33 1 45 80 52 70 19; Email: cecile.bultez@ghu-paris.fr
    • Principal Investigator: Philippe Domenech, MD, PhD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Right-handed, assessed by the Edinburgh scale;
• Written signed informed consent;
• Subject covered by a social security regimen.

Exclusion Criteria:

• Pregnant, parturient or breastfeeding woman;
• First-degree family history of axis I disorder (DSM-IV-TR), excepted unipolar mood and anxiety disorders with OCD;
• Personal history of axis I disorder (DSM-IV-TR) in the 6 months preceding the study entry;
• Dependence on a psychoactive substance in the 12 months preceding the study entry, excluding nicotine, any behavioural disorder incompatible with a 2-hour electroencephalographic recording;
• Neuro/psychotropic treatment ongoing or stopped less than 1 month ago;
• Personal history of neurological pathology (e.g.: congenital malformation, benign or malignant tumour, degenerative disease of the central nervous system (CNS), epilepsy, inflammatory or infectious disease of the CNS, etc.);
• Personal history of chronic disease of infectious, neoplastic, vascular, dysimmune or inflammatory, metabolic or endocrine, degenerative or genetic aetiology. In particular, angle-closure glaucoma, pheochromocytoma, known high blood pressure or measured blood pressure greater than 140/90 mm Hg at baseline, congenital heart disease, known ischemic heart disease, known heart failure, supraventricular or ventricular heart rhythm disorder, nephropathy, known liver disease and any pathology likely to be aggravated by an increase in blood pressure;
• Any medical treatment in the month preceding the study entry, apart from effective contraceptive treatment;
• Subject deprived of liberty by a judicial or administrative decision;
• Person subject to a legal protection measure or unable to express consent;
• Known intolerance to atomoxetine;
• Need to wear glasses and/or lenses to obtain normal vision;
• Subject in an exclusion period or enrolled in an interventional study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Triple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Sequence 1: Atomoxetine 40 mg - Placebo; The participants will receive one cap of atomoxetine 40 mg at V1 and placebo at V2	Drug: Atomoxetine; One single capsule of atomoxetine 40 mg given at one visit according to the sequence randomly allocated. Placebo of atomoxetine will be administered at the other visit for the participant (according to the sequence randomly allocated); Drug: Placebo; One single capsule of placebo given at one visit according to the sequence randomly allocated.
Other: Sequence 2: Placebo - Atomoxetine 40 mg; The participants will receive one cap of placebo at V1 and atomoxetine 40 mg at V2	Drug: Atomoxetine; One single capsule of atomoxetine 40 mg given at one visit according to the sequence randomly allocated. Placebo of atomoxetine will be administered at the other visit for the participant (according to the sequence randomly allocated); Drug: Placebo; One single capsule of placebo given at one visit according to the sequence randomly allocated.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Apparent Learning rate	Paired difference in the apparent learning rates (in both environmental contexts: stable task and changing task), between the sNRI (atomoxetine) and control (placebo) conditions. Apparent learning rate will be calculate with the following formula: αt=(vt- vt-(1) )/(xt- vt-1) according to Foucault and Meyniel (Foucault C, Meyniel F (2024) Two Determinants of Dynamic Adaptive Learning for Magnitudes and Probabilities. Open Mind : Discov Cogn Sci 8:615-638) The learning rate measures the amount of update of the learned value (from vt-(1 to vt) induced by the observation xt in proportion to its deviation from the previously learned value.	From Visit 1 (Day 0) to Visit 2 (Day 7)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of adverse events	Side effects (treatment related adverse events) in all groups between study drug administration at Visit 1 (Day 0) and Visit 2 (Day 7) including vital signs worsening and ECG findings	From Visit 1 (Day 0) to Visit 2 (Day 7)
Change from Visit 1 (Day 0) in the computational modelling of behaviour at Visit 2 (Day 7)	Computational modelling of behaviour at Visit 1 and 2: paired difference in latent behavioral parameters of the computational models that characterize the learning process (in a stable accumulation task and in a dynamic accumulation task), between the sNRI (atomoxetine) and control (placebo) conditions.	From Visit 1 (Day 0) to Visit 2 (Day 7)
Change from Visit 1 (Day 0) in the score of the State Trait Anxiety Inventory (STAI) questionnaire at Visit 2	The scores of the State Trait Anxiety Inventory (STAI) questionnaire (Spielberger et al., 1983) will be compared between Hour 0 and Hour 3 at Visit 1 and 2 to control for the effect of the substance on the subjects' levels of depression and anxiety. The STAI comprises 2 questionnaires of 20 items with the following ranges: STAI-YA (state anxiety): 0-80 with 0 equivalent to no anxiety and 80 the worst possible anxiety; STAI-YB (Trait anxiety): 0-80 with 0 equivalent to no anxiety and 80 the worst possible anxiety	From Visit 1 (Day 0) to Visit 2 (Day 7)
Change from Visit 1 (Day 0) in the score of the Beck Depression Inventory (BDI) questionnaire at Visit 2	The scores of the Beck Depression Inventory (BDI) questionnaire (Beck et al., 1961) will be compared between Hour 0 and Hour 3 at Visit 1 and Visit 2 to control for the effect of the substance on the subjects' levels of depression. The BDI comprises 21 items with the following ranges: 0-63 with 0 equivalent to no depression and 63 the worst possible depression.	From Visit 1 (Day 0) to Visit 2 (Day 7)
Change from Visit 1 (Day 0) in the score of visual analogue scale (VAS) on anxiety at Visit 2	The scores of the VAS-anxiety will be compared between Hour 0 and Hour 3 at Visit 1 and Visit 2 to control for the effect of the substance on the subjects' levels of anxiety. The VAS ranges from 0 (no anxiety) to 100 mm (worst possible anxiety).	From Visit 1 (Day 0) to Visit 2 (Day 7)
Change from Visit 1 (Day 0) in the score of visual analogue scale (VAS) on sadness at Visit 2	The scores of the VAS-sadness will be compared between Hour 0 and Hour 3 at Visit 1 and Visit 2 to control for the effect of the substance on the subjects' levels of sadness. The VAS ranges from 0 (no sadness) to 100 mm (worst possible sadness).	From Visit 1 (Day 0) to Visit 2 (Day 7)
Change from Visit 1 (Day 0) in the score of visual analogue scale (VAS) on fatigue at Visit 2	The scores of the VAS-fatigue will be compared between Hour 0 and Hour 3 at Visit 1 and Visit 2 to control for the effect of the substance on the subjects' levels of fatigue. The VAS ranges from 0 (no fatigue) to 100 mm (maximum imaginable fatigue).	From Visit 1 (Day 0) to Visit 2 (Day 7)

Collaborators and Investigators

• Sponsor: Centre Hospitalier St Anne

Study record dates

Study Major Dates

• Study Start (Actual): November 18, 2025
• Primary Completion (Estimated): November 1, 2027
• Study Completion (Estimated): December 1, 2027

Study Registration Dates

• First Submitted: September 29, 2025
• First Submitted That Met QC Criteria: November 18, 2025
• First Posted (Actual): November 20, 2025

Study Record Updates

• Last Update Posted (Actual): November 20, 2025
• Last Update Submitted That Met QC Criteria: November 18, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Keywords: atomoxetine; healthy subject; noradrenaline; learning dynamics
• Additional Relevant MeSH Terms: Organic Chemicals; Amines; Propylamines; Atomoxetine Hydrochloride
• Other Study ID Numbers: D24-P017

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Sharing Supporting Information Type: ANALYTIC_CODE

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No