Clinical Trial: Desvenlafaxine vs. Placebo Treatment of Chronic Depression

Study Status: Completed
Recruit Status: Unknown status
Study Type: Interventional

Official Title: Desvenlafaxine (Pristiq) vs. Placebo in the Treatment of Chronic Depression

Brief Summary:

The investigators are studying a new antidepressant medicine, desvenlafaxine, for the treatment of people with chronic depression. Desvenlafaxine (trade name Pristiq) has been approved by the FDA for the treatment of major depression.

The investigators are testing whether this medicine is also effective for adults with a type of chronic depression that is less severe than major depression. This condition is also known as dysthymic disorder or dysthymia. Chronic depression, lasting two or more years, often causes significant suffering and impairment.

In addition, the investigators are using MRI imaging, which uses magnetic signals to make pictures of the brain's structure and also of its functioning. The purpose of MRI imaging in this study is to see whether chronic depression is associated with differences in brain structure or functioning, and whether such differences change after medication or placebo treatment. To test this MRI scans are done at the start of the study and after 12 weeks of medication or placebo treatment. Getting MRI imaging will be an option for participants in this study but is not required.

This study involves a 6 to 12 week double-blind period during which half of the participants will take the new medication and half will take a placebo (an inactive look-alike pill). After the double blind phase, all subjects can be treated for 12 weeks with an FDA-approved antidepressant medication.

Assessments (of depressive symptoms, social functioning, and personality) will be done by study staff and by patients before the study starts, at each study visit for the first 12 weeks, and again after 24 weeks in the study.


Detailed Summary:

The investigators wish to study acute efficacy for 12 weeks on a double blind basis and continued response after open-label treatment at week 24 follow-up. It is important to establish the acute (12 week) efficacy of desvenlafaxine in non-major chronic depression. Also, given that non-major chronic depression is by definition chronic, it is important to demonstrate that benefit persists at follow-up assessment (24 weeks); this is clinically important in trying to alleviate the significant psychosocial morbidity associated with this disorder.

The investigators believe this study will have significant value in the treatment of patients with non-major chronic depression, and will add significantly to what remains an extremely small scientific literature.

The investigators would also like to study the effects of desvenlafaxine on brain structure and function. Learning that a medication reduces symptoms does not teach us how the medication achieves this outcome. Participants in this study can have the opportunity to participate in MRI scanning that will help to understand the mechanisms by with desvenlafaxine is effective. MRI scans are done prior to starting the clinical trial and then again after completing the double blind clinical trial.


Sponsor: New York State Psychiatric Institute

Current Primary Outcome: Hamilton Rating Scale for Depression - 24 item version (HDRS) [ Time Frame: 12 weeks ]

Clinician-rated Depression rating scale


Original Primary Outcome: Hamilton Rating Scale for Depression - 24 item version [ Time Frame: 12 weeks ]

Clinician-rated Depression rating scale


Current Secondary Outcome:

  • Clinical Global Improvement Scale (CGI-I) [ Time Frame: 12 weeks ]
    Assessment of overall improvement
  • Cornell Dysthymia Rating Scale (CDRS) [ Time Frame: 12 weeks ]
    Clinician-rated Depression rating scale for symptoms of chronic low-grade depression
  • Quick Inventory of Depressive Symptomatology-Self-Rated version (QIDS-SR) [ Time Frame: 12 weeks ]
    Patient-rated Depression symptoms
  • Beck Depression Inventory (BDI) [ Time Frame: 12 weeks ]
    Patient-rated Depression symptoms
  • Columbia Suicide Severity Rating Scale (C-SSRS; Posner, et al., 2007) [ Time Frame: 12 weeks ]
    Clinician rated Suicide ideation and behaviors scale


Original Secondary Outcome:

  • Clinical Global Improvement Scale [ Time Frame: 12 weeks ]
    Assessment of overall improvement
  • Cornell Dysthymia Rating Scale [ Time Frame: 12 weeks ]
    Clinician-rated Depression rating scale for symptoms of chronic low-grade depression
  • Quick Inventory of Depressive Symptomatology-Self-Rated version (QIDS-SR) [ Time Frame: 12 weeks ]
    Patient-rated Depression symptoms
  • Beck Depression Inventory (BDI) [ Time Frame: 12 weeks ]
    Patient-rated Depression symptoms
  • Columbia Suicide Severity Rating Scale (C-SSRS; Posner, et al., 2007) [ Time Frame: 12 weeks ]
    Clinician rated Suicide ideation and behaviors scale


Information By: New York State Psychiatric Institute

Dates:
Date Received: February 16, 2012
Date Started: February 2012
Date Completion: June 2016
Last Updated: April 13, 2015
Last Verified: April 2015