Magnesium Bisglycinate in Major Depressive Disorder (DReAM-BiG)
Efficacy and Safety of Add-on Magnesium Bisglycinate in Major Depressive Disorder: A Randomized, Double-Blind, Placebo-Controlled Trial
Přehled studie
Postavení
Postavení
Podmínky
Podmínky
Intervence / Léčba
Intervence / Léčba
Detailní popis
Typ studie
Typ studie
Zápis (Odhadovaný)
Zápis
Fáze
Fáze
- Nelze použít
Kontakty a umístění
Studijní kontakt
Studijní kontakt
- Jméno: Rituparna Maiti, M.D.
- Telefonní číslo: 9438884191
- E-mail: pharm_rituparna@aiimsbhubaneswar.edu.in
Studijní místa
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Odisha
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Bhubaneswar, Odisha, Indie, 751019
- Nábor
- All India Institute of Medical Sciences (AIIMS)
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Kontakt:
- RITUPARNA MAITI, MD
- Telefonní číslo: 9438884191
- E-mail: rituparnamaiti@gmail.com
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Kontakt:
- BISWA R MISHRA, MD
- E-mail: brm1678@gmail.com
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Kritéria účasti
Kritéria způsobilosti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dospělý
- Starší dospělý
Přijímá zdravé dobrovolníky
Popis
Inclusion Criteria:
- Patients with a diagnosis of Major Depressive Disorder (MDD) as per DSM-5 criteria.
- Patients of either sex within the age group of 18-65 years.
- Mild to severe depression, defined as a baseline MADRS score ≥7.
- Currently receiving a stable dose of antidepressant monotherapy (SSRI or SNRI) in equivalent doses.
- Willing and able to provide written informed consent.
Exclusion Criteria:
- Known hypersensitivity or allergy to magnesium supplements or glycine.
- History of renal impairment (previous history of AKI, CKD, currently on dialysis).
- Diagnosis of bipolar affective disorder, schizoaffective disorder, schizophrenia, or any other psychotic disorder.
- Active suicidal ideation with intent or a recent suicide attempt (within the past 6 months), as assessed by the treating psychiatrist.
- Current substance use disorder (except nicotine, alcohol and caffeine), as per DSM-5 criteria.
- Pregnancy, lactation, or women of childbearing potential not using adequate contraception.
- Concurrent use of magnesium-containing supplements, antacids, or laxatives.
- History of significant severe medical comorbidity, including uncontrolled hypothyroidism, Cushing's syndrome, active malignancy, myasthenia gravis, or severe hepatic impairment.
- Use of medications with significant pharmacokinetic interactions with magnesium (e.g., tetracyclines, fluoroquinolones, bisphosphonates, diuretics) that cannot be temporally separated by ≥2 hours.
- Electroconvulsive therapy (ECT) received within the past 3 months.
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Trojnásobný
Počet zbraní
Zbraně a zásahy
Skupina účastníků / ArmSkupina účastníků / Arm |
Intervence / LéčbaIntervence / Léčba |
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Komparátor placeba: Control arm
The control arm will receive an add-on placebo (microcrystalline cellulose capsules) once daily along with Standard of care (SSRI/SNRI) for 8 weeks.
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The placebo capsules will contain Microcrystalline cellulose (inactive excipient) and will be of similar colour, shape and size as of magnesium bisglycinate capsules and will be given once daily for 8 weeks.
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Experimentální: Test arm
The test arm will receive add-on Magnesium bisglycinate (220 mg elemental magnesium per day) once daily along with Standard of care (SSRI/SNRI) for 8 weeks.
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Magnesium Bisglycinate (220 mg elemental mangnesium and 1350 mg glycine) per day for 8 weeks
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Co je měření studie?
Primární výstupní opatření
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
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Change in Montgomery-Åsberg Depression Rating Scale (MADRS) score
Časové okno: Baseline (week 0) and follow-up (week 8)
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The Montgomery-Åsberg Depression Rating Scale (MADRS) is a clinician-administered instrument used to assess the severity of depressive symptoms.
It consists of 10 items, each scored from 0 to 6, yielding a total score ranging from 0 to 60, where higher scores indicate greater severity of depression.
MADRS scores are commonly interpreted as 0-6 (normal or symptom absent), 7-19 (mild depression), 20-34 (moderate depression), and ≥35 (severe depression).
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Baseline (week 0) and follow-up (week 8)
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Sekundární výstupní opatření
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Change in Hamilton Anxiety Rating Scale (HAM-A) score
Časové okno: Baseline (week 0) and follow-up (week 8)
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The Hamilton Anxiety Rating Scale (HAM-A) is a clinician-administered instrument used to assess the severity of anxiety symptoms.
It consists of 14 items, each scored from 0 (absent) to 4 (very severe), yielding a total score ranging from 0 to 56, with higher scores indicating greater anxiety severity.
HAM-A scores are commonly interpreted as <17 (mild anxiety), 18-24 (mild-to-moderate anxiety), 25-30 (moderate-to-severe anxiety), and >30 (severe anxiety).
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Baseline (week 0) and follow-up (week 8)
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Change in Pittsburgh Sleep Quality Index (PSQI) score
Časové okno: Baseline (week 0) and follow-up (week 8)
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The Pittsburgh Sleep Quality Index (PSQI) is a validated self-administered questionnaire used to assess sleep quality and sleep disturbances over the previous month.
It consists of 19 items that generate seven component scores, which are summed to produce a global score ranging from 0 to 21, with higher scores indicating poorer sleep quality.
A global PSQI score of ≤5 is generally considered indicative of good sleep quality, whereas a score >5 suggests clinically significant sleep disturbance or poor sleep quality.
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Baseline (week 0) and follow-up (week 8)
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Change in Epworth Sleepiness Scale (ESS) score
Časové okno: Baseline (week 0) and follow-up (week 8)
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The Epworth Sleepiness Scale (ESS) is a self-administered questionnaire used to measure a person's general level of daytime sleepiness and the likelihood of falling asleep in common daily situations.
It consists of 8 items, each scored from 0 (would never doze) to 3 (high chance of dozing), resulting in a total score ranging from 0 to 24, with higher scores indicating greater daytime sleepiness.
ESS scores are commonly interpreted as 0-10 (normal daytime sleepiness), 11-12 (mild excessive daytime sleepiness), 13-15 (moderate excessive daytime sleepiness), and 16-24 (severe excessive daytime sleepiness).
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Baseline (week 0) and follow-up (week 8)
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Change in Clinical Global Impression Severity (CGI-S) score
Časové okno: Baseline (week 0) and follow-up (week 8)
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The Clinical Global Impression-Severity (CGI-S) scale is a clinician-rated instrument used to assess the overall severity of a patient's illness at a specific point in time.
It consists of a single item scored on a 7-point scale ranging from 1 (normal, not at all ill) to 7 (among the most extremely ill patients), with higher scores indicating greater illness severity.
CGI-S scores are commonly interpreted as 1 (normal), 2 (borderline ill), 3 (mildly ill), 4 (moderately ill), 5 (markedly ill), 6 (severely ill), and 7 (among the most extremely ill patients).
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Baseline (week 0) and follow-up (week 8)
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Clinical Global Impression Improvement (CGI-I)
Časové okno: Week 8
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The Clinical Global Impression-Improvement (CGI-I) scale is a clinician-rated instrument used to assess the degree of change in a patient's clinical condition relative to baseline following treatment.
It consists of a single item scored on a 7-point scale ranging from 1 (very much improved) to 7 (very much worse), with lower scores indicating greater clinical improvement.
CGI-I scores are interpreted as 1 (very much improved), 2 (much improved), 3 (minimally improved), 4 (no change), 5 (minimally worse), 6 (much worse), and 7 (very much worse).
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Week 8
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Change in serum brain-derived neurotrophic factor (BDNF)
Časové okno: Baseline (week 0) and follow-up (week 8)
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Serum brain-derived neurotrophic factor (BDNF) will be estimated as a biomarker of neuroplasticity and neuronal function.
Blood samples collected at baseline and Week 8 will be processed to obtain serum, and BDNF concentrations will be quantified using a commercially available enzyme-linked immunosorbent assay (ELISA) kit according to the manufacturer's instructions.
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Baseline (week 0) and follow-up (week 8)
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Change in serum magnesium
Časové okno: Baseline (week 0) and follow-up (week 8)
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Serum magnesium concentration will be estimated as a biochemical marker of magnesium status.
Blood samples collected at baseline and Week 8 will be processed to obtain serum, and magnesium levels will be measured using an autoanalyzer.
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Baseline (week 0) and follow-up (week 8)
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Change in serum glycine
Časové okno: Baseline (week 0) and follow-up (week 8)
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Blood samples collected at baseline and Week 8 will be processed to obtain serum, and glycine levels will be quantified using a commercially available enzyme-linked immunosorbent assay (ELISA) kit according to the manufacturer's instructions.
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Baseline (week 0) and follow-up (week 8)
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Incidence of Treatment-emergent adverse events (TEAEs)
Časové okno: week 4 and week 8
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During the telephonic interview at 4 weeks or the follow-up visit at 8 weeks, patients can directly contact the investigators to report any adverse events they experience.
Whether previously known or not, all adverse events will be recorded with their descriptions, intensities, durations, actions taken, and outcomes.
Treatment-emergent adverse events will be evaluated and managed according to severity using the Hartwig-Siegel scale.
Causality assessment will be done for adverse drug reactions by using the WHO-UMC system.
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week 4 and week 8
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Spolupracovníci a vyšetřovatelé
Sponzor
Sponzor
Vyšetřovatelé
Vyšetřovatelé
- Studijní židle: Debasish Hota, D.M., AIIMS, Bhubaneswar
Publikace a užitečné odkazy
Obecné publikace
- Riemann D, Krone LB, Wulff K, Nissen C. Sleep, insomnia, and depression. Neuropsychopharmacology. 2020 Jan;45(1):74-89. doi: 10.1038/s41386-019-0411-y. Epub 2019 May 9.
- Tripathi A, Shukla R, Kar SK, Gupta S, Saran P, Pattojoshi A, Rao T. Clinical practice guideline for assessment and management of depression in India. Indian J Psychiatry. 2026 Jan;68(1):68-93. doi: 10.4103/indianjpsychiatry_1321_25. Epub 2026 Jan 27.
- Wichniak A, Wierzbicka A, Walecka M, Jernajczyk W. Effects of Antidepressants on Sleep. Curr Psychiatry Rep. 2017 Aug 9;19(9):63. doi: 10.1007/s11920-017-0816-4.
- Meng Y, Liu S, Yu M, Liang H, Tong Y, Song J, Shi J, Cai W, Wu Q, Wen Z, Wang J, Guo F. The Changes of Blood and CSF Ion Levels in Depressed Patients: a Systematic Review and Meta-analysis. Mol Neurobiol. 2024 Aug;61(8):5369-5403. doi: 10.1007/s12035-023-03891-x. Epub 2024 Jan 8.
- Pochwat B, Szewczyk B, Sowa-Kucma M, Siwek A, Doboszewska U, Piekoszewski W, Gruca P, Papp M, Nowak G. Antidepressant-like activity of magnesium in the chronic mild stress model in rats: alterations in the NMDA receptor subunits. Int J Neuropsychopharmacol. 2014 Mar;17(3):393-405. doi: 10.1017/S1461145713001089. Epub 2013 Sep 26.
- Pochwat B, Sowa-Kucma M, Kotarska K, Misztak P, Nowak G, Szewczyk B. Antidepressant-like activity of magnesium in the olfactory bulbectomy model is associated with the AMPA/BDNF pathway. Psychopharmacology (Berl). 2015 Jan;232(2):355-67. doi: 10.1007/s00213-014-3671-6. Epub 2014 Jul 16.
- Moabedi M, Aliakbari M, Erfanian S, Milajerdi A. Magnesium supplementation beneficially affects depression in adults with depressive disorder: a systematic review and meta-analysis of randomized clinical trials. Front Psychiatry. 2023 Dec 22;14:1333261. doi: 10.3389/fpsyt.2023.1333261. eCollection 2023.
- Kawai N, Sakai N, Okuro M, Karakawa S, Tsuneyoshi Y, Kawasaki N, Takeda T, Bannai M, Nishino S. The sleep-promoting and hypothermic effects of glycine are mediated by NMDA receptors in the suprachiasmatic nucleus. Neuropsychopharmacology. 2015 May;40(6):1405-16. doi: 10.1038/npp.2014.326. Epub 2014 Dec 23.
- Pardo MR, Garicano Vilar E, San Mauro Martin I, Camina Martin MA. Bioavailability of magnesium food supplements: A systematic review. Nutrition. 2021 Sep;89:111294. doi: 10.1016/j.nut.2021.111294. Epub 2021 Apr 28.
- Schuster J, Cycelskij I, Lopresti A, Hahn A. Magnesium Bisglycinate Supplementation in Healthy Adults Reporting Poor Sleep: A Randomized, Placebo-Controlled Trial. Nat Sci Sleep. 2025 Aug 30;17:2027-2040. doi: 10.2147/NSS.S524348. eCollection 2025.
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Začátek studia
Primární dokončení (Odhadovaný)
Primární dokončení
Dokončení studie (Odhadovaný)
Dokončení studie
Termíny zápisu do studia
První předloženo
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
První zveřejněno
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Poslední zveřejněná aktualizace
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Naposledy ověřeno
Více informací
Termíny související s touto studií
Další relevantní podmínky MeSH
Další identifikační čísla studie
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