Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Impact of Quetiapine Prolong and Escitalopram on the Hypothalamic-pituitary-adrenocortical (HPA)-Axis Activity in Depressed Patients
Brief Summary: In former studies of the investigators research group the investigators could also demonstrate acute inhibitory effects of the antidepressant mirtazapine on ACTH and cortisol release in normal controls (Schüle et al. 2002), most likely mediated via antagonism at central 5-HT2- and H1-receptors. In contrast to mirtazapine, serotonin or norepinephrine reuptake inhibiting antidepressants acutely stimulate ACTH and cortisol secretion (Schüle 2007). The investigators also performed a study in depressed patients who were treated either with mirtazapine or with reboxetine using serial dexamethasone/CRH tests (week 0, 1, and 5) as a parameter for HPA axis activity. Mirtazapine, but not the norepinephrine reuptake inhibitor reboxetine was able to significantly reduce HPA axis activity already within one week (Schüle et al. 2006). Mirtazapine is known to have an earlier onset of antidepressant action than do SSRIs such as sertraline (Behnke et al. 2003) or antidepressants with dual mechanism of action such as venlafaxine (Benkert et al. 2006), possibly due to its rapid inhibition of HPA axis activity in unipolar depressed patients.

Since mirtazapine and quetiapine have similar effects on the HPA system in healthy male volunteers (i.e. inhibition of ACTH and cortisol secretion), a rapid attenuation of HPA axis activity is also expected during quetiapine XR treatment in depressed patients.

Therefore, in the present study the investigators goal is to investigate whether quetiapine fumarate XR at a dosage of 300 mg per day has an impact on HPA axis activity in unipolar depressed patients, as measured by serial dexamethasone/CRH tests (week 0, 1, and 5) and salivary cortisol profiles and whether putative effects of quetiapine XR on the HPA system are related to its antidepressant efficacy.


Options:
A: Arm Label: Arm I - Placebo; Type: ACTIVE_COMPARATOR; Interventions: Dietary Supplement: Placebo Powder, Drug: Placebo Pill | Arm Label: Arm II - Soy; Type: ACTIVE_COMPARATOR; Interventions: Dietary Supplement: oral soy protein/isoflavones powder, Drug: Placebo Pill | Arm Label: Arm III - Venlafaxine; Type: EXPERIMENTAL; Interventions: Drug: Venlafaxine, Dietary Supplement: Placebo Powder | Arm Label: Arm IV - Soy + Venlafaxine; Type: PLACEBO_COMPARATOR; Interventions: Dietary Supplement: oral soy protein/isoflavones powder, Drug: Venlafaxine | Intervention Type: DIETARY_SUPPLEMENT; Name: oral soy protein/isoflavones powder; Assigned to Arm(s): Arm II - Soy, Arm IV - Soy + Venlafaxine | Intervention Type: DRUG; Name: Venlafaxine; Assigned to Arm(s): Arm III - Venlafaxine, Arm IV - Soy + Venlafaxine | Intervention Type: DIETARY_SUPPLEMENT; Name: Placebo Powder; Assigned to Arm(s): Arm I - Placebo, Arm III - Venlafaxine | Intervention Type: DRUG; Name: Placebo Pill; Assigned to Arm(s): Arm I - Placebo, Arm II - Soy
B: Arm Label: Arm I (management of therapy complications); Type: EXPERIMENTAL; Interventions: Drug: venlafaxine, Other: questionnaire administration, Other: quality-of-life assessment | Arm Label: Arm II (placebo); Type: PLACEBO_COMPARATOR; Interventions: Drug: placebo, Other: questionnaire administration, Other: quality-of-life assessment | Intervention Type: DRUG; Name: venlafaxine; Assigned to Arm(s): Arm I (management of therapy complications) | Intervention Type: DRUG; Name: placebo; Assigned to Arm(s): Arm II (placebo) | Intervention Type: OTHER; Name: questionnaire administration; Assigned to Arm(s): Arm I (management of therapy complications), Arm II (placebo) | Intervention Type: OTHER; Name: quality-of-life assessment; Assigned to Arm(s): Arm I (management of therapy complications), Arm II (placebo)
C: Arm Label: Psilocybin; Type: EXPERIMENTAL; Interventions: Drug: Psilocybin, Drug: Niacin | Arm Label: Niacin; Type: ACTIVE_COMPARATOR; Interventions: Drug: Psilocybin, Drug: Niacin | Intervention Type: DRUG; Name: Psilocybin; Assigned to Arm(s): Niacin, Psilocybin | Intervention Type: DRUG; Name: Niacin; Assigned to Arm(s): Niacin, Psilocybin
D: Arm Label: quetiapine; Type: EXPERIMENTAL; Interventions: Drug: quetiapine | Arm Label: escitalopram; Type: ACTIVE_COMPARATOR; Interventions: Drug: escitalopram | Intervention Type: DRUG; Name: quetiapine; Assigned to Arm(s): quetiapine | Intervention Type: DRUG; Name: escitalopram; Assigned to Arm(s): escitalopram

Answer: D