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
Descripción general del estudio
Estado
Estado
Condiciones
Condiciones
Intervención / Tratamiento
Intervención / Tratamiento
Descripción detallada
Tipo de estudio
Tipo de estudio
Inscripción (Estimado)
Inscripción
Fase
Fase
- No aplica
Contactos y Ubicaciones
Estudio Contacto
Estudio Contacto
- Nombre: Rituparna Maiti, M.D.
- Número de teléfono: 9438884191
- Correo electrónico: pharm_rituparna@aiimsbhubaneswar.edu.in
Ubicaciones de estudio
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Odisha
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Bhubaneswar, Odisha, India, 751019
- Reclutamiento
- All India Institute of Medical Sciences (AIIMS)
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Contacto:
- RITUPARNA MAITI, MD
- Número de teléfono: 9438884191
- Correo electrónico: rituparnamaiti@gmail.com
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Contacto:
- BISWA R MISHRA, MD
- Correo electrónico: brm1678@gmail.com
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Criterios de participación
Criterio de elegibilidad
Criterio de elegibilidad
Edades elegibles para estudiar
- Adulto
- Adulto Mayor
Acepta Voluntarios Saludables
Descripción
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.
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Triple
Número de brazos
Armas e Intervenciones
Grupo de participantes/brazoGrupo de participantes/brazo |
Intervención / TratamientoIntervención / Tratamiento |
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Comparador de placebos: 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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Experimental: 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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¿Qué mide el estudio?
Medidas de resultado primarias
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Change in Montgomery-Åsberg Depression Rating Scale (MADRS) score
Periodo de tiempo: 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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Medidas de resultado secundarias
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Change in Hamilton Anxiety Rating Scale (HAM-A) score
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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)
Periodo de tiempo: 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)
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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)
Periodo de tiempo: 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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Colaboradores e Investigadores
Patrocinador
Patrocinador
Investigadores
Investigadores
- Silla de estudio: Debasish Hota, D.M., AIIMS, Bhubaneswar
Publicaciones y enlaces útiles
Publicaciones Generales
- 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.
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Actual)
Inicio del estudio
Finalización primaria (Estimado)
Finalización primaria
Finalización del estudio (Estimado)
Finalización del estudio
Fechas de registro del estudio
Enviado por primera vez
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Publicado por primera vez
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización publicada
Última actualización enviada que cumplió con los criterios de control de calidad
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Última verificación
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
Otros números de identificación del estudio
- IEC/AIIMSBBSR/PGTh/2026-27/01
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Descripción del plan IPD
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
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