Clinical trial NCT06633497: Evaluating the Role of the Microbiome in Antidepressant Treatment in Adolescents.
Official title: Evaluating the Role of the Microbiome in Antidepressant Treatment in Adolescents.
Study type: OBSERVATIONAL
Overall status: NOT_YET_RECRUITING
Conditions: Depression in Adolescence
Lead sponsor: University of California, San Diego
Sponsor class: OTHER
Collaborators: name: Rady Children's Hospital, San Diego
First posted: 2024-10-09
Enrollment: 100
Sex: ALL
Minimum age (years): 13
Maximum age (years): 17
Standard ages: CHILD
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Adolescents ages 13-17 with depression diagnosis

Brief summary: The goal of this observational study is to learn about the role of the human gut microbiome in antidepressant treatment response in adolescents with Major Depressive Disorder (MDD). Specifically, the study aims to collect microbiota samples of adolescents treated with fluoxetine, over the span of 8-weeks, to:

* determine the influence of the microbiome on the efficacy of fluoxetine to treat adolescent depression.
* test whether the gut microbiome from different timepoints can predict ultimate success of fluoxetine
* investigate the interaction of gut microbiome composition and pharmacogenetic metabolizer status on steady-state plasma concentrations of fluoxetine.

Depression symptom severity will be evaluated upon enrollment and 6-weeks into antidepressant treatment.

Detailed description: For this project the investigators are interested in changes in the gut microbiome associated with adolescent depression and the influence of the microbiome on the efficacy of fluoxetine to treat adolescent depression. It is hypothesized that the composition of the human gut microbiome alters the response to fluoxetine of adolescents with depression. This study aims to collect gut microbiota of adolescents being treated with antidepressants at several timepoints to (1) determine the efficacy of fluoxetine to treat depression, (2) test whether the gut microbiome from different timepoints can predict ultimate success of fluoxetine, and (3) investigate the interaction of gut microbiome composition and pharmacogenetic metabolizer status on steady-state plasma concentrations of fluoxetine. Adolescent patients with clinically significant depressive symptoms who are prescribed fluoxetine, from Rady Children's Hospital San Diego (RCHSD) Inpatient Child and Adolescent Psychiatry Services (CAPS), will be recruited for this study. Up to twelve stool samples are planned to be collected, including prior to start of antidepressant treatment for a baseline measure of gut microbiome composition, daily samples over during the first week of fluoxetine treatment, and then biweekly collections until the end of the 8-week study duration.

Eligibility criteria: Inclusion Criteria:

* Subjects from all ethnic backgrounds will be eligible to participate.
* Having clinically significant depressive symptoms based on a score \>40 on the Children's Depression Rating Scale-Revised
* Prescribed more than 5mg of Fluoxetine (Prozac)
* Has an identifiable legal guardian.

Exclusion Criteria:

* Has been taking a standing psychotropic medication in the past 6 months
* Has been taking antibiotics or metformin during the past 6 months (known strong effects on gut microbiome)
* Admitted to RCHSD CAPS post-overdose (potential strong effects on gut microbiome)
* Currently using nicotine-containing substances (known strong effects on gut microbiome)

Primary outcomes:
measure: Gut microbiome composition
timeFrame: Stool samples will be collected at enrollment (baseline), then following enrollment: daily for the first 7 days and biweekly at weeks 2, 4, 6, and 8.
measure: Efficacy of fluoxetine to treat depression symptoms in adolescents
timeFrame: The CDRS-R will be administered at baseline and week 6.
Secondary outcomes:
measure: Efficacy of fluoxetine to improve self-reported depression symptoms in adolescents
timeFrame: The MFQ will be administered at baseline and week 6.
measure: Efficacy of fluoxetine to treat anxiety symptoms in adolescents
timeFrame: The SCARED will be administered at baseline and week 6.
measure: Pharmacogenetic (PGx) metabolizer status
timeFrame: A saliva sample is collected for pharmacogenetic analysis at baseline
measure: Steady-state plasma concentrations of fluoxetine
timeFrame: Sample collected at week 6
Other outcomes:
Locations:
city: San Diego
country: United States
facility: Rady Children's Hospital San Diego
state: California
Study officials:
affiliation: University of California, San Diego
name: Rob Knight, PhD
role: PRINCIPAL_INVESTIGATOR
References: