An Investigation of the Sleep Architecture and Consequent Cognitive Changes in Olanzapine-Treated Depressed Patients
OBJECTIVES:
Primary Objective:
To assess the objective (polysomnographic) changes in sleep quality before and after introduction of olanzapine in treatment of patients with depression.
Secondary Objectives:
To assess the subjective changes in sleep quality parameters before and at different stages after introduction of olanzapine in treatment, longitudinally, and to correlate these changes with measures of illness severity and changes in cognition.
STUDY DESIGN:
Prospective, double blind, randomized polysomnographic (PSG) study of patients before and after treatment with olanzapine.
PSG recordings will be done three times throughout the study: before starting olanzapine augmentation (baseline), at day 3 to 5 (acute) and day 28 to 31 (chronic). PSG will be completed at patients' homes with a portable PSG. Psychiatric scales, subjective sleep quality scales, and cognition measurements will be completed at each visit.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Fase 4
Kontakter og lokationer
Studiesteder
-
-
Ontario
-
Kingston, Ontario, Canada, K7L 4X3
- Queen's University, Providence Care-Mental Health Services
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- A diagnosis of major depressive disorder or bipolar disorder type 1, 2 or NOS by Diagnostic and Statistical Manual of Mental Disorders- Fourth Edition (DSM-IV)
- Current depressive episode with a HAMD-17 of > 15
- Males or females over age18 years (yrs)
- Inpatients or outpatients
- Female patients of childbearing potential must be using a reliable method of contraception and have a negative urine human chorionic gonadotropin (HCG) test at enrollment
- Able to understand and comply with the requirements of the study
- Provision of written informed consent
Exclusion Criteria:
- Current manic, hypomanic or mixed episode, with YMRS > 12
- Current or past diagnosis of schizophrenia and dementia
- Pregnant women, or women in childbearing age, not willing to use appropriate contraception or women currently nursing
- Patient on any other antipsychotic medication
- Patients who, in the opinion of the investigator, pose an imminent risk of suicide or a danger to self or others
- Known intolerance or lack of response to olanzapine, as judged by the investigator
- Benzodiazepines and all other sleep-aids must be discontinued prior to participation in the study if they have not been at a stable dosage for the 4 weeks previous to entry into the study
- No change to the current medication regime (excluding discontinuation of sleep aids and antipsychotic medications) is allowed 4 weeks prior to the first PSG reading
- Administration of a depot antipsychotic injection within two dosing interval (for the depot) before randomization
- Substance or alcohol dependence at enrolment or in the last three months (except for caffeine or nicotine dependence), as defined by DSM-IV criteria
- Serious, unstable or inadequately treated medical illness as judged by the investigator
- History of epilepsy or uncontrolled seizures
- Involvement in the planning and conduct of the study
- Previous enrolment in the present study
- Participation in another drug trial within 4 weeks prior enrolment into this study or longer in accordance with local requirements
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Tredobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: 1
|
Olanzapine will be taken once daily at 6pm for 1 month.
Dosing will be titrated up to 5mg and then changed as clinically indicated.
|
|
Placebo komparator: 2
|
An inactive form of the treatment will be taken once daily at 6pm for 1 month.
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
Sleep quality as measured by overnight PSG, defined as the change in time spent in slow wave sleep.
Tidsramme: 3 days after baseline and 1 month after baseline
|
3 days after baseline and 1 month after baseline
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
Sleep measures: time in bed, total sleep time, sleep period time, percentage of sleep stages (stage 1, stage 2, slow wave sleep, REM sleep) of sleep period time, sleep latency to stage 1 and 2, REM latency, number of awakenings.
Tidsramme: measure taken at baseline, 3 days after baseline, and 1 month after baseline
|
measure taken at baseline, 3 days after baseline, and 1 month after baseline
|
|
Respiratory events (during PSG): obstructive sleep apneas, mixed apneas, central apneas, total apneas, obstructive hypopneas, mixed hypopneas, central hypopneas, total hypopneas, and apneas + hypopneas (AHI), oxygen saturation, and heart rate.
Tidsramme: Baseline, 3 days and 1 month after baseline
|
Baseline, 3 days and 1 month after baseline
|
|
Subjective sleep experience: visual analogue scale, sleep diary, Epworth Sleep Scale and Pittsburgh Sleep Quality Index.
Tidsramme: Baseline, 3 days and 1 month after baseline
|
Baseline, 3 days and 1 month after baseline
|
|
Changes in weight and blood glucose will be monitored.
Tidsramme: At baseline and 1 month
|
At baseline and 1 month
|
|
Cognition: CANTAB scores
Tidsramme: Baseline, 3 days and 1 month after baseline
|
Baseline, 3 days and 1 month after baseline
|
|
Illness severity: HDRS-17, MADRS, CGI and HamA
Tidsramme: Baseline, 3 days and 1 month after baseline
|
Baseline, 3 days and 1 month after baseline
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Efterforskere
Efterforskere
- Ledende efterforsker: Roumen Milev, M.D., Queen's University, Department of Psychiatry
Publikationer og nyttige links
Datoer for undersøgelser
Studer store datoer
Studiestart
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
- Adfærdsmæssige symptomer
- Psykiske lidelser
- Patologiske processer
- Stemningsforstyrrelser
- Bipolære og relaterede lidelser
- Depression
- Depressiv lidelse
- Sygdom
- Maniodepressiv
- Lægemidlers fysiologiske virkninger
- Neurotransmittermidler
- Molekylære mekanismer for farmakologisk virkning
- Depressive midler til centralnervesystemet
- Autonome agenter
- Agenter fra det perifere nervesystem
- Antiemetika
- Gastrointestinale midler
- Antipsykotiske midler
- Beroligende midler
- Psykotropiske stoffer
- Serotoninoptagelseshæmmere
- Neurotransmitter optagelseshæmmere
- Membrantransportmodulatorer
- Serotoninmidler
- Olanzapin
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- PSIY-263-07
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