Please select the eligibility criteria that correspond to the clinical trial below.
Title: Switching to Duloxetine From Other Antidepressants: A Regional Multicentre Trial Comparing Two Switching Techniques
Brief Summary: A multicentre, randomised, open label study of out-patients with major depression who have failed to respond adequately to antidepressant treatment for their current episode of depression. The study compares outcomes associated with two methods of switching from current antidepressant to duloxetine


Options:
A: Inclusion Criteria:

* The patient is being treated with a serotonin reuptake inhibitor (SRI) antidepressant (monotherapy) that was prescribed to treat Major Depressive Episode (DSM-IV-TR criteria)
* The response to the current SRI treatment is inadequate and patient agrees to discontinue the current SRI at the baseline
* Montgomery Åsberg Depression Rating Scale (MADRS) total score ≥22 at the Screening Visit and Baseline
* The patient, if a woman, must: agree not to try to become pregnant during the study, AND use adequate, highly effective contraception

Exclusion Criteria:

* The patient has any current Axis I disorders (DSM-IV criteria) other than Major Depressive Disorder (MDD), General Anxiety Disorder (GAD) and Social Anxiety Disorder (SAD)
* The patient is at significant risk of suicide
* The patient is currently receiving formal psychotherapy or other psychoactive medications

Other protocol-defined inclusion and exclusion criteria may apply.
B: Inclusion Criteria:

* Male or female subjects between 18 and 65 years of age, with diagnosis of major depressive disorder, as defined by DSM-IV-TR criteria
* The current depressive episode must be equal to or greater than 8 weeks in duration
* Subjects must report a history for the current depressive episode of an inadequate response to no more than three adequate antidepressant treatments

Exclusion Criteria:

* Females who are breast-feeding and/or who have a positive pregnancy test result prior to receiving study drug
* Subjects who report an inadequate response to more than three adequate trials of antidepressant treatments during current depressive episode at a therapeutic dose for an adequate duration
* Subjects with a current Axis I (DSM-IV-TR) diagnosis of: Delirium, dementia, amnestic or other cognitive disorder, Schizophrenia, schizoaffective disorder, or other psychotic disorder, Bipolar I or II disorder
* Subjects with a clinically significant current Axis II (DSM-IV-TR) diagnosis of borderline, antisocial, paranoid, schizoid, schizotypal or histrionic personality disorder
C: Inclusion Criteria:

* Male and female outpatients of at least 18 years of age, who meet criteria for Major Depressive Disorder (MDD)
* Currently non- or only partially-responsive to an SSRI antidepressant after at least 5 weeks of treatment

Exclusion Criteria include:

* Current primary Axis I disorder other than MDD
* Previous diagnosis of bipolar disorder, schizophrenia, or other psychotic disorders
* Patients judged to be at serious suicidal risk.
* Serious medical illness
D: Inclusion Criteria:

1. Male or female subjects, age 18-65
2. A current primary diagnosis of unipolar major depression based on certain criteria
3. Have a score of \> 18 on the 17-item Hamilton Depression scale
4. A history of prior failure of at least one adequate trial of an FDA-approved antidepressant. The antidepressant failure must have occurred within the current episode of major depression
5. Females of childbearing potential will be allowed as long as they are taking adequate contraceptive precautions

Exclusion Criteria:

1. A primary Axis I diagnosis other than primary unipolar major depression
2. A history suggestive of hypomania or mania during the current episode or during the person's lifetime
3. A history of psychosis, dementia, organic affective disorders or alcohol and/or substance abuse in the previous six months

   * Individuals with a current or past diagnosis of schizoid, schizotypal, borderline or antisocial or any other current or past severe personality disorder
   * Individuals with a current or past diagnosis of schizophrenia or schizoaffective disorder
4. A history of failure to respond to electroconvulsive therapy during the current or any prior lifetime episode of major depression
5. A history of failure of a prior adequate trial of paroxetine or paroxetine-CR for the treatment of Major Depression
6. Significant, coexisting medical conditions that might make it unsafe to take either of the study medications, or in which any average reasonable clinician would assume that the medical condition may, in fact, be exacerbating the current episode of depression or impede the person's ability to recover fully from their depressive illness
7. Presence of significant medical abnormalities on baseline laboratory values or physical examination, including vital signs

   * Individuals with any significant abnormalities of thyroid function
   * Subjects on thyroid supplementation must have been on a stable dose for six months prior to the screening visit
8. Individuals who will require concomitant psychotropic medications, including benzodiazepines

   * Subjects with severe insomnia will be allowed to take a maximum of 10 mg of zolpidem on two nights weekly at the investigator's discretion.
   * Zolpidem may not be taken on the night before the study visit.
   * Each dose of zolpidem should be listed on the concurrent medication case report form
9. Medications likely to cause significant effects on mood and anxiety are also excluded
10. Individuals with a positive urine drug screen for drugs of abuse at the screening visit
11. Use during the time of the study of any medications known to affect the metabolism of lamotrigine

    * Individuals on valproate and carbamazepine will be specifically excluded
    * Investigators should be aware that oral contraceptives have been reported to lower the levels of lamotrigine, but any change in dosing is left to the judgment of the investigator
12. Subjects who have taken other psychoactive drugs within certain time frames of the screening visit
13. The presence of significant risk of suicide
14. Pregnant females or those who are breastfeeding infants
15. A history of hypersensitivity or intolerance to either of the study medications, lamotrigine or paroxetine or paroxetine-CR
16. Subjects initiating or terminating psychotherapy within 12 weeks of the screening visit
17. Individuals who are currently on disability for a psychiatric disorder, or who are in any other way likely to experience considerable secondary gain from the persistence of their psychiatric illness, such as pending legal litigation of any type
18. Individuals who in the opinion of the investigator would not be able to understand or comply with the study requirements

Answer: C