Stanford RAD-AT Study (Research on Anxiety and Depression - Anhedonia Treatment)

Study Overview
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Brief Summary
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This research study is aimed at understanding behaviors and brain circuits that relate to anxiety and depression. Our goal is to learn which circuits of the brain are involved in anxiety and how these circuits might affect daily functioning. This study has recently added an additional treatment component: participants undergo a 12 week course of either Pramipexole medication or rTMS therapy (explained below). The ultimate goal of the study is to offer participants experiencing anxiety and depression a treatment that is alternative to ones that have failed them in the past, and to apply the knowledge we gain from investigating the brain circuits involved in anxiety and depression to help personalize treatments. We invite anyone who has recently experienced any symptoms of anxiety and/or depression to participate (no diagnosis is required to participate).

Detailed Description
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If you are eligible and choose to participate, we'll ask you to come in for 2 separate testing visits and 8 weeks of treatment in between. In both the pre-treatment and post-treatment testing visit, you would complete game-like tasks on the computer, undergo a non-invasive MRI brain scan, and answer some questions about your emotional health. The entire visit takes place during 1-2 days at Stanford and lasts about 4-5 hours. We'll also ask you to complete a follow-up 12 weeks later, from home, during which we'll again ask you some questions on your emotional health. The 8-week treatment phase will consist of your choice of either TMS (transcranial magnetic stimulation) or Pramipexole (a medication for depression). You will meet with study coordinators and MDs each week (Pramipexole) or each day (TMS) to receive treatment. You will also be asked to complete weekly online surveys to monitor your mood during the 2-month course of treatment. To inquire more about participation, you can either sign up online or contact us. Sign up online: http://med.stanford.edu/williamslab/research/current/rad.html Contact us: Call or text (650) 600-1609 or email rad-at-study@stanford.edu

Official Title
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Neural Dimensions of Threat Reactivity and Regulation for Understanding Anxiety

Conditions
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Anxiety, Depression

Intervention / Treatment
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* Drug: Pramipexole Oral Tablet


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Recent experiences of anxiety and/or depression Ages 18-65 Exclusion Criteria: Specific psychiatric medications (case-by-case basis) A diagnosis of Bipolar 1 Disorder, Schizophrenia, or Obsessive Compulsive Disorder Any of the following medical conditions: Parkinson's disease; liver or kidney disease; history of epilepsy or seizures; history of cardiovascular disorders (specifically orthostatic hypotension)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Anxiety and mood disorders<br> | Drug: Pramipexole Oral Tablet<br>* Pramipexole is an oral Dopamine agonist.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Assessments of symptoms and daily functioning | General demographics questionnaires, alcohol use questionnaire, substance use questionnaires, Mood and Anxiety Symptom Questionnaire, Penn State Worry Questionnaire, Health at Work Performance Questionnaire, WHO Quality of Life questionnaire, Satisfaction with Life Survey, Emotion Regulation Questionnaire, Brief COPE questionnaire, Early Life Stress questionnaire, Quick Inventory of Depressive Symptomatology, Beck Depression Inventory, PTSD Checklist - Civilian Version, Beck Anxiety Inventory, Barratt Impulsiveness Scale, MINI Neuropsychiatric Interview | 12 weeks | 
| Brain imaging | Non-invasive MRI brain scan to see function and structure of brain. | 12 weeks | 
| Cognitive assessment | WebNeuro is an objective assessment of cognitive strengths and weaknesses. It provides an accurate and objective assessment of person's cognitive function and efficiency. | 12 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Anxiety, Depression, Social Anxiety Disorder, Bipolar disorder II, PTSD, GAD, Phobia