Clinical trial

Dopaminergic Therapy for Inflammation-Related Anhedonia in Depression

Name
STUDY00000361
Description
The purpose of this 6-week, double-blind, placebo-controlled, crossover study is to explore new treatment options for people with depression who have high inflammation and anhedonia. Thirty-five male and female participants with depression, between the ages of 25-55 years of age, will be randomized to two study tracks (A and B) to receive both placebo and three doses of L-DOPA, given in different orders. Increases or decreases in each dose will occur gradually over 6 weeks of the study. Participants will complete lab tests, medical and psychiatric assessments, neurocognitive testing and functional MRI (fMRI) scans as part of the study. The total length of participation is about 2 months.
Trial arms
Trial start
2021-01-29
Estimated PCD
2023-10-11
Trial end
2023-10-11
Status
Completed
Phase
Early phase I
Treatment
Carbidopa Levodopa
Patients will receive L-DOPA at doses ranging from 150 to 450 mg administered at a ratio of 1 mg carbidopa for every 4 mg L-DOPA. Starting dose is 150 mg/day with dose escalation 150 mg/day per week to a final dose of 450 mg/day
Arms:
Carbidopa Levodopa followed by Placebo, Placebo followed by Carbidopa Levodopa
Other names:
Sinemet, L-DOPA
Placebo
A placebo is a sugar pill that has no therapeutic effect and will be administered orally. Participants will receive 1 placebo tablet matching the Carbidopa Levodopa tablet.
Arms:
Carbidopa Levodopa followed by Placebo, Placebo followed by Carbidopa Levodopa
Other names:
Placebo tablet
Size
20
Primary endpoint
Change in targeted ventral striatum to ventromedial prefrontal cortex (VS-vmPFC) connectivity
Baseline, 1-week of placebo, and 1-week at each dose of L-DOPA
Eligibility criteria
Inclusion Criteria: * willing and able to give written informed consent; * men or women, 25-55 years of age * a primary diagnosis of DSM-V MD, current, as diagnosed by the SCID-I; * score \>10 on the Patient Health Questionnaire \[PHQ\]-9 * off all antidepressant or other psychotropic therapy (e.g. mood stabilizers, antipsychotics, anxiolytics, and sedative hypnotics) for at least 4 weeks prior to baseline visit (8 weeks for fluoxetine) * CRP ≥2 mg/L * Score \>/=2 on the anhedonia question of Patient Health Questionnaire \[PHQ\]-9 Exclusion Criteria: * history or evidence (clinical or laboratory) of an autoimmune disorder ; * history or evidence (clinical or laboratory) of hepatitis B or C infection or human immunodeficiency virus infection; - history of any type of cancer requiring treatment with more than minor surgery; * unstable cardiovascular, endocrinologic, hematologic, hepatic, renal, or neurologic disease (as determined by physical examination, EKG and laboratory testing); * history of any (non-mood-related) psychotic disorder; active psychotic symptoms of any type; history or current bipolar disorder; history or current gambling disorder; substance abuse/dependence within 6 months of study entry (as determined by SCID); * active suicidal plan as determined by a score \>3 on item #3 on the HAM-D; g. an active eating disorder (except for patients with binge eating disorder in whom binging is clearly associated with worsening of mood symptoms) ; * a history of a cognitive disorder * pregnancy or lactation; * chronic use of non-steroidal anti-inflammatory agents (NSAIDS) (excluding 81mg of aspirin), glucocorticoid containing medications or statins; * use of NSAIDS, glucocorticoids, or statins at any time during the study; * urine toxicology screen is positive for drugs of abuse, * any contraindication for MRI scanning; n. intolerance, sensitivity or contraindication to carbidopa-levodopa (including history of narrow-angle glaucoma, melanoma, gastric and/or duodenal ulcers, bleeding disorders, or frequent migraines).
Protocol
{'studyType': 'INTERVENTIONAL', 'phases': ['PHASE4'], 'designInfo': {'allocation': 'RANDOMIZED', 'interventionModel': 'CROSSOVER', 'primaryPurpose': 'TREATMENT', 'maskingInfo': {'masking': 'DOUBLE', 'whoMasked': ['PARTICIPANT', 'INVESTIGATOR']}}, 'enrollmentInfo': {'count': 20, 'type': 'ACTUAL'}}
Updated at
2024-01-23

1 organization

1 product

1 drug

2 indications

Organization
Emory University
Indication
Anhedonia