Vilazodone for Corticosteroid-Induced Memory Impairment

Study Overview
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Brief Summary
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The purpose of this study is to examine whether vilazodone attenuates the memory and mood effects of corticosteroids on the human hippocampus in 24 healthy controls.

Detailed Description
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In animals and humans, stress and corticosteroid excess are associated with changes in hippocampal structure and functioning. These findings have important implications to the millions of patients taking prescription corticosteroids and to patients with major depressive disorder or bipolar disorder who have elevated cortisol levels and memory impairment. The investigators believe that vilazodone may be a medication that can block the effects of hydrocortisone on the human hippocampus. The investigators propose to examine whether vilazodone attenuates the effects of corticosteroids in a randomized, double-blind, placebo-controlled pilot study using a within-subject crossover design.

Official Title
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Vilazodone for Corticosteroid-Induced Memory Impairment

Conditions
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Memory Impairment

Intervention / Treatment
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* Drug: Vilazodone
* Drug: Placebo
* Drug: Hydrocortisone


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Healthy men and women age 18-50 years Education of ≥ 12 years and baseline RAVLT total words recalled score ≥ 35 (normal baseline memory) BMI between 18.5-30 (not underweight or obese) Exclusion Criteria: History of major psychiatric illness defined as major depressive disorder, bipolar disorder, posttraumatic stress disorder, panic disorder, schizoaffective disorder, schizophrenia, eating disorders, or drug/alcohol abuse/dependence or current tobacco use History of neurological disorders including seizures, brain surgery, multiple sclerosis, Parkinson's disease Taking CNS-acting medications within 30 days of study History of allergic reaction or medical contraindication to vilazodone or hydrocortisone Significant medical conditions (e.g., myocardial infarction, cancer, diabetes) Vulnerable population including pregnant or nursing women, the incarcerated, and severe cognitive disorders Baseline HRSD (Hamilton Rating Scale for Depression) > 7 or current suicidal ideation or history of suicide attempt History of systemic Corticosteroid (CS) use or recent (past 6 months) inhaled CS use

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Vilazodone and Hydrocortisone, then Placebo and Hydrocortisone<br>Vilazodone titrated to 10 mg x 7 days, 20 mg x 7 days and 40 mg x 5 days (19 days) and hydrocortisone 160 mg x 4 days (days 16-19) following vilazodone pre-treatment. After a 23 day medication washout the procedure will be repeated using placebo daily for 19 days and hydrocortisone 160 mg x 4 days (days 16-19) following placebo pre-treatment. | Drug: Vilazodone<br>* Participants will be randomized to either vilazodone or placebo titrated as follows: 10 mg x 7 days, 20 mg x 7 days and 40 mg x 5 days.<br>* Other names: Viibryd;Drug: Placebo<br> <br> Drug: Hydrocortisone<br>* Participants receive 160 mg x 4 days after vilazodone or placebo pre-treatment<br>|
| Experimental: Placebo and Hydrocortisone, then Vilazodone and Hydrocortisone<br>Placebo daily for 19 days and hydrocortisone 160 mg x 4 days (days 16-19) following placebo pre-treatment. After a 23 day medication washout the procedure will be repeated using Vilazodone titrated to 10 mg x 7 days, 20 mg x 7 days and 40 mg x 5 days (19 days) and hydrocortisone 160 mg x 4 days (days 16-19) following vilazodone pre-treatment. | Drug: Vilazodone<br>* Participants will be randomized to either vilazodone or placebo titrated as follows: 10 mg x 7 days, 20 mg x 7 days and 40 mg x 5 days.<br>* Other names: Viibryd;Drug: Placebo<br> <br> Drug: Hydrocortisone<br>* Participants receive 160 mg x 4 days after vilazodone or placebo pre-treatment<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change From Baseline RAVLT (Rey Auditory Verbal Learning Test) Total T-Score at Day 19 | The Rey Auditory Verbal Learning Test (RAVLT) measures verbal or declarative learning and memory. The test consists of 15 nouns read aloud for five consecutive trials with each trial followed by a free-recall trial. Following the fifth trial, an interference list of 15 different words is presented followed by a free-recall trial of that list. Delayed recall of the first list is tested immediately following the interference list and after a 20-minute delay. Equivalent, alternative versions (different words) were used to minimize practice or learning effects from repeated administration. The raw scores (number of words correct across trials 1-5) are converted to standardized T-scores (M=50; SD=10). This score is used to determine the participant's performance in relation to norm-referenced expectations based on age and sex. Higher score reflects better performance, and the values reflect scores at baseline minus the scores at Day 19. | Baseline and Day 19 |