Study of Brain Response to Emotional Pictures Using a Magnetic Resonance Imaging (fMRI) While on Escitalopram
Condition: Major Depression
MeSH terms: Depressive Disorder, Major
Intervention: Escitalopram
Intervention description: 10 mg of Escitalopram by mouth once a day for 8 weeks
Intervention MeSH terms: Escitalopram
Phase: Phase 4
Study type: Interventional
Primary purpose: Treatment
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Enrollment: 17.0
Sex: All
Minimum age: 18 Years
Maximum age: 50 Years
Healthy volunteers: No
Keywords: Escitalopram; Lexapro; fMRI; pictures

Summary:

      The purpose of this study is to find out what parts of the brain have increased or decreased
      activity when people are depressed and how antidepressant medicine changes this activity in
      depressed patients. The genetic samples collected are to look at variation in a gene
      (serotonin transporter gene), which affects the functioning of the chemical serotonin in the
      brain
    

Eligibility criteria:

        Inclusion Criteria:

          -  Ages 18-50 years and able to give voluntary informed consent.

          -  Satisfy criteria for Major Depressive Disorder (MDD) and current depressed episode
             using the Mini International Neuropsychiatric Interview (M.I.N.I.).

          -  17-item Hamilton Depression Rating Scale (HDRS) score > 18.

          -  Satisfy criteria to undergo an MRI scan based on MRI screening questionnaire.

          -  Able to be managed as outpatients for initial assessment and during treatment as
             ascertained by the following -

          -  Symptoms not worsening by more than 10 points on the HDRS during the course of the
             study.

          -  No danger to self or others.

        Exclusion Criteria:

          -  Meeting DSM-IV criteria for schizophrenia, schizophreniform disorder, schizoaffective
             disorder, bipolar disorder, atypical psychosis, mental retardation, or organic mental
             (including organic mood) disorder.

          -  On monoamine oxidase inhibitors in the past 2 weeks.

          -  History of narrow angle glaucoma.

          -  Lack of response of the current episode of depression to two or more adequate courses
             of antidepressant therapy at a clinically appropriate dose for a minimum of 4 weeks
             or, in the judgment of the investigator, the patient meets criteria for
             treatment-resistant depression.

          -  Use of neuroleptic in the past 2 weeks.

          -  Use of antidepressants in the past 2 weeks. If on fluoxetine in the past, then should
             not have been on this medication for 4 weeks.

          -  Use of mood stabilizers in the past 2 weeks.

          -  Use of benzodiazepines in the past 2 weeks.

          -  Acutely suicidal or homicidal or requiring inpatient treatment.

          -  Meeting DSM-IV criteria for other substance dependence within the past year, except
             caffeine or nicotine. The criteria will be evaluated by interview and urinary
             toxicology screening initially and on test days.

          -  Use of alcohol in the past 1 week.

          -  No serious medical or neurological illness as assessed by physical examination and
             laboratory examination including CBC and blood chemistry.

          -  Current pregnancy or breast-feeding.

          -  Metallic implants.

          -  Previously known positive HIV blood test as reported by the subject.