Clinical trial NCT01422213: Efficacy Study of Vortioxetine on Cognitive Dysfunction in Adult Patients With Major Depressive Disorder
Official title: Randomised, Double-blind, Parallel-group, Placebo-controlled, Fixed Dose Study on the Efficacy of [Vortioxetine] Lu AA21004 on Cognitive Dysfunction in Adult Patients With Major Depressive Disorder (MDD)
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE3
Conditions: Major Depressive Disorder
Keywords: MDD
Cognitive dysfunction
Lead sponsor: H. Lundbeck A/S
Sponsor class: INDUSTRY
First posted: 2011-08-23
Enrollment: 598
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Major Depressive Disorder (MDD) is a severe and common psychiatric disorder. Although MDD primarily involves mood disturbances, patients also usually present alterations in cognitive function (attention, memory, executive functioning and psychomotor speed). Even though antidepressants are suggested in the literature to potentially improve cognitive dysfunction in patients with MDD to some degree, there is a lack of adequate and well-controlled studies to investigate this effect. This study will evaluate the efficacy, safety and tolerability of a new antidepressant Vortioxetine versus placebo on cognitive dysfunction in adult patients with MDD.


Eligibility criteria: Inclusion Criteria:

* The patient is an inpatient in a psychiatric hospital or an outpatient at a psychiatric setting at the time of the study entry.
* The patient is diagnosed with recurrent MDD according to DSM-IV-TR™ criteria (classification code 296.3x). The current Major Depressive Episode (MDE) should be confirmed using the Mini International Neuropsychiatric Interview (MINI).
* The patient has received prescribed treatment for a previous episode of depression.
* The patient has a MADRS total score ≥26.
* The reported duration of the current MDE is at least 3 months.

Exclusion Criteria:

* The patient has a score ≥70 on the DSST (number of correct symbols), or ≥42 on the RAVLT (learning) or ≥14 on the RAVLT (memory) at the Baseline Visit.
* The patient has any current Axis I disorder (DSM-IV-TR™ criteria) other than MDD, confirmed using the MINI.
* The patient has a current diagnosis or history of manic or hypomanic episode, schizophrenia or any other psychotic disorder, including major depression with psychotic features.
* The patient suffers from personality disorders, mental retardation, pervasive development disorder, attention-deficit/hyperactivity disorder, organic mental disorders, or mental disorders due to a general medical condition (DSM-IV-TR™ criteria).
* The patient has physical, cognitive, or language impairment of such severity as to adversely affect the validity of the data derived from the neuropsychological tests.
* The patient is diagnosed with reading disability (dyslexia).
* The patient is at significant risk of suicide or has a score ≥5 on Item 10 (suicidal thoughts) of the MADRS, or has attempted suicide \<6 months prior to the Screening Visit.
* The patient has received electroconvulsive therapy \<6 months prior to the Screening Visit.
* The current depressive symptoms are considered by the investigator to have been resistant to 2 adequate antidepressant treatments of at least 6 weeks duration each at the recommended dose.
* The patient has a history of moderate or severe head trauma (for example, loss of consciousness for more than 1 hour) or other neurological disorders or systemic medical diseases that are, in the opinion of the investigator, likely to affect central nervous system functioning.
* The patient has a history of cancer, other than basal cell or Stage 1 squamous cell carcinoma of the skin, that has not been in remission for \>5 years prior to the first drug dose.
* The patient has a clinically significant unstable illness, for example:
* cardiovascular disease
* seizure disorder or encephalopathy
* congestive heart failure
* cardiac hypertrophy
* arrhythmia
* bradycardia (pulse \<50 bpm)
* respiratory disease
* hepatic impairment or renal insufficiency
* metabolic disorder
* endocrinological disorder
* gastrointestinal disorder
* haematological disorder
* infectious disorder
* any clinically significant immunological condition
* dermatological disorder
* venereal disease
* The patient has, at the Screening Visit, an abnormal ECG that is, in the investigator's opinion, clinically significant.
* The patient is, in the investigator's opinion, unlikely to comply with the protocol or is unsuitable for any reason.
* The patient has previously been exposed to Vortioxetine.

Other protocol-defined inclusion and exclusion criteria may apply.

Primary outcomes:
measure: Change From Baseline to Week 8 in DSST (Number of Correct Symbols) and RAVLT (Acquisition and Delayed Recall) Using the Composite Z-score Defined as the Weighted Sum of the Individual Patient Z-scores
timeFrame: Baseline and Week 8
Secondary outcomes:
measure: Change From Baseline to Week 8 in DSST (Number of Correct Symbols)
timeFrame: Baseline and Week 8
measure: Change From Baseline to Week 8 in RAVLT (Acquisition)
timeFrame: Baseline and Week 8
measure: Change From Baseline to Week 8 in RAVLT (Delayed Recall)
timeFrame: Baseline and Week 8
measure: Change From Baseline to Week 8 in the TMT A (Speed of Processing)
timeFrame: Baseline and Week 8
measure: Change From Baseline to Week 8 in the TMT B (Executive Function)
timeFrame: Baseline and Week 8
measure: Change From Baseline to Week 8 in Congruent STROOP Time to Complete (Executive Function)
timeFrame: Baseline and Week 8
measure: Change From Baseline to Week 8 in Incongruent STROOP Time to Complete (Executive Function)
timeFrame: Baseline and Week 8
measure: Change From Baseline to Week 8 in the SRT (Speed of Processing)
timeFrame: Baseline and Week 8
measure: Change From Baseline to Week 8 in the CRT (Attention)
timeFrame: Baseline and Week 8
measure: Change From Baseline to Week 8 in MADRS Total Score
timeFrame: Baseline and Week 8
measure: Change From Baseline to Week 8 in CGI-S Score
timeFrame: Baseline and Week 8
measure: Clinical Status Using CGI-I Score at Week 8
timeFrame: Week 8
measure: Proportion of Responders at Week 8 (Response Defined as a >=50% Decrease in the MADRS Total Score From Baseline
timeFrame: Baseline and Week 8
measure: Proportion of Remitters at Week 8 (Remission is Defined as a MADRS Total Score <=10)
timeFrame: Week 8
measure: Change From Baseline to Week 1 Using the MADRS Total Score and the Composite Z-score
timeFrame: Baseline and Week 1
measure: Change From Baseline to Week 8 Using the MADRS Total Score and the Composite Z-score
timeFrame: Baseline and Week 8
measure: Risk of Suicidality Using C-SSRS Scores
timeFrame: Up to 8 weeks
Other outcomes:
Locations:
Study officials:
affiliation: LundbeckClinicalTrials@lundbeck.com
name: Email contact via H. Lundbeck A/S
role: STUDY_DIRECTOR
References:
citation: Nohr AK, Lindow M, Forsingdal A, Demharter S, Nielsen T, Buller R, Moltke I, Vitezic M, Albrechtsen A. A large-scale genome-wide gene expression analysis in peripheral blood identifies very few differentially expressed genes related to antidepressant treatment and response in patients with major depressive disorder. Neuropsychopharmacology. 2021 Jun;46(7):1324-1332. doi: 10.1038/s41386-021-01002-9. Epub 2021 Apr 8.
citation: McIntyre RS, Florea I, Tonnoir B, Loft H, Lam RW, Christensen MC. Efficacy of Vortioxetine on Cognitive Functioning in Working Patients With Major Depressive Disorder. J Clin Psychiatry. 2017 Jan;78(1):115-121. doi: 10.4088/JCP.16m10744.
citation: McIntyre RS, Lophaven S, Olsen CK. A randomized, double-blind, placebo-controlled study of vortioxetine on cognitive function in depressed adults. Int J Neuropsychopharmacol. 2014 Oct;17(10):1557-67. doi: 10.1017/S1461145714000546. Epub 2014 Apr 30.