Determining Optimal Continuation Treatment Duration for Depressed Children and Adolescents
Childhood Depression: Remission and Relapse
研究概览
详细说明
Depression is a serious medical illness that affects all ages and populations. However, it has only been within the last 10 years that sufficient attention has been devoted to researching treatments for depression in children and adolescents. Symptoms of depression in this age group vary, but some common signs include pretending to be sick, refusing to go to school, clinging to a parent, or worrying that a parent may die. Older children may sulk, get into trouble at school, act in a negative or grouchy way, or feel misunderstood. Recent studies on selective serotonin reuptake inhibitors (SSRIs), one class of antidepressant medications, have shown that SSRIs are effective in reducing depression symptoms. The optimal duration of treatment, however, has yet to be established. This study will determine the optimal length of continuation treatment with fluoxetine for children and adolescents with major depressive disorder, as well as the factors that may contribute to positive response during acute and continuation treatment.
Participants in this study will first attend three study visits over a 2-week period to determine eligibility. All eligible individuals will be treated with fluoxetine for 12 weeks. Dosages will be determined by the study physician and will be based on clinical response to treatment. Study visits will occur weekly for the first 4 weeks and biweekly for the remaining 2 months. Depression symptoms, general changes, and adverse reactions will be assessed. Participants whose symptoms have improved will be eligible to enter the discontinuation phase of the study, which will entail random assignment to either fluoxetine or placebo for an additional 24 weeks. Study visits will occur biweekly for 3 months and monthly for the remaining 3 months. Depression symptoms and medication side effects will be assessed at these visits.
研究类型
注册
阶段
- 不适用
联系人和位置
学习地点
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Texas
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Dallas、Texas、美国、75235
- Children's Medical Center at Dallas, Outpatient Psychiatry Clinic
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Currently being treated on an outpatient basis
- Currently attending school
- Diagnosis of non-psychotic major depressive disorder (MDD)
- Duration of illness is at least 4 weeks
- In good general medical health
- Normal intelligence
Exclusion Criteria:
- Lifetime history of any psychotic disorder, including psychotic depression
- Diagnosis of bipolar I or II disorder
- History of alcohol or substance abuse or dependence within 6 months of study entry
- Lifetime history of anorexia nervosa or bulimia
- Pregnant or breastfeeding
- Does not agree to use an effective form of contraception (i.e., IUD, birth control pills, or barrier devices)
- Any chronic medical illness requiring regular medication
- Currently taking medication with psychotropic effects (i.e., anticonvulsants, steroids, etc.), other than stable stimulant treatment
- A first degree relative has bipolar I disorder
- Previous adequate treatment with fluoxetine was ineffective (defined as at least 20 mg/day for 4 weeks)
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:双倍的
研究衡量的是什么?
主要结果指标
结果测量 |
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复发时间
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Measured throughout the study: Relapse
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次要结果测量
结果测量 |
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Measured at Weeks 12 and 36: Functioning
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Baseline characteristics
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合作者和调查者
调查人员
- 首席研究员:Graham J. Emslie, MD、UT Southwestern Medical Center at Dallas
出版物和有用的链接
一般刊物
- Nakonezny PA, Hughes CW, Mayes TL, Sternweis-Yang KH, Kennard BD, Byerly MJ, Emslie GJ. A comparison of various methods of measuring antidepressant medication adherence among children and adolescents with major depressive disorder in a 12-week open trial of fluoxetine. J Child Adolesc Psychopharmacol. 2010 Oct;20(5):431-9. doi: 10.1089/cap.2009.0108.
- Kennard BD, Mayes TL, Chahal Z, Nakonezny PA, Moorehead A, Emslie GJ. Predictors and Moderators of Relapse in Children and Adolescents With Major Depressive Disorder. J Clin Psychiatry. 2018 Mar/Apr;79(2):15m10330. doi: 10.4088/JCP.15m10330.
- Tao R, Emslie G, Mayes T, Nakonezny P, Kennard B, Hughes C. Early prediction of acute antidepressant treatment response and remission in pediatric major depressive disorder. J Am Acad Child Adolesc Psychiatry. 2009 Jan;48(1):71-8. doi: 10.1097/CHI.0b013e318190043e.
- Kennard BD, Hughes JL, Stewart SM, Mayes T, Nightingale-Teresi J, Tao R, Carmody T, Emslie GJ. Maternal depressive symptoms in pediatric major depressive disorder: relationship to acute treatment outcome. J Am Acad Child Adolesc Psychiatry. 2008 Jun;47(6):694-699. doi: 10.1097/CHI.0b013e31816bfff5.
研究记录日期
研究主要日期
学习开始
研究完成
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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