Are Two Antidepressants a Good Initial Treatment for Depression? - Full Text View

Purpose

Relatively drug naive patients will receive two antidepressant medications as initial treatment.

Condition	Intervention	Phase
Major Depression Dysthymia Depression NOS	Drug: Escitalopram Drug: Bupropion	Phase IV

MedlinePlus related topics:

Antidepressants Depression

Drug Information available for:

Escitalopram Benzetimide Citalopram Citalopram hydrobromide Dexetimide Escitalopram oxalate Bupropion hydrochloride Bupropion

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Efficacy Study

Official Title:	Combined Escitalopram/Bupropion as First Line Treatment for Depression, a Replication.

Further study details as provided by New York State Psychiatric Institute:

Primary Outcome Measures:

Hamilton Depression Scale (HAM-D) [ Time Frame: 10 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Beck Depression Inventory (BDI) [ Time Frame: 10 weeks ] [ Designated as safety issue: No ]
Clinical Global Impression Scale (CGI) [ Time Frame: 10 weeks ] [ Designated as safety issue: No ]
Patient Global Impression Scale (PGI) [ Time Frame: 10 weeks ] [ Designated as safety issue: No ]
Arizona Sexual Experience Scale (ASEX) [ Time Frame: 10 weeks ] [ Designated as safety issue: No ]

Enrollment:	55
Study Start Date:	February 2005
Primary Completion Date:	July 2006 (Final data collection date for primary outcome measure)

Intervention Details:

Day 1-4: 10 mg; day 1-5: 20 mg; day 9-12: 30 mg; day 13-56: 40 mg.

day 1-4: 150 mg; day 5-8: 300 mg; day 9-12: 300 mg; day 13-56: 450 mg.

Detailed Description:

While antidepressant medications are often effective in relieving depressive symptoms, at least 60% of patients do not remit with the first agent tried. This pilot study will assess whether giving two standard medications simultaneously (i.e., Escitalopram and Bupropion) is both tolerated and improves response while decreasing drop outs. This is a replication of a previous study.

Eligibility

Ages Eligible for Study:	18 Years to 65 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Currently depressed (DSM-IV Major Depression, Dysthymia or Depression NOS)
HAMD-D (21-Item) > 9

Exclusion Criteria:

Prior ineffective adequate trial on either study medication ($ 4 weeks on either escitalopram $20 mg/d or bupropion $300 mg/d; $4 weeks on citalopram $40 mg/d)
History suggesting increased risk for Seizures (e.g., prior Seizure as an adult, diagnosed Seizure Disorder, taking medication known to increase seizure risk, history of significant head trauma, history of Bulimia or Anorexia)
History of intolerance to either study medication unless patient and M.D. agree side effect is probably manageable
Alcohol and/or drug abuse/dependence during past year
Major medical problems that are not well controlled (e.g., untreated hypertension or diabetes)
Bipolar I, Bipolar II
History of Psychosis, or current Psychosis
Currently taking antidepressants or mood stabilizers, which is judged unwise to discontinue (occasional sleep medication or benzodiazepine for Anxiety is allowed)
Not currently depressed (whether considered due to current treatment or not)
Active suicidal risk (history of suicide attempts will be evaluated on a case by case basis)

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00296712

Locations


United States, New York
	Depression Evaluation Service - New York State Psychiatric Institute
	New York, New York, United States, 10032

Sponsors and Collaborators

New York State Psychiatric Institute

Investigators


Principal Investigator:	Jonathan W. Stewart, MD.	New York State Psychiatric Institute - Columbia University Department of Psychiatry

More Information

Depression Evaluation Service - official website This link exits the ClinicalTrials.gov site

New York State Psychiatric Institute - official website This link exits the ClinicalTrials.gov site

Responsible Party:	New York State Psychiatric Institute ( Jonathon W. Stewart, M.D. )
Study ID Numbers:	IRB4653
First Received:	February 24, 2006
Last Updated:	January 14, 2008
ClinicalTrials.gov Identifier:	NCT00296712
Health Authority:	United States: Institutional Review Board

Keywords provided by New York State Psychiatric Institute:

Major Depression

Dysthymia

Depression NOS

Escitalopram

Bupropion

Dual Therapy

Combination Therapy

Study placed in the following topic categories:

Dopamine

Depression

Mental Disorders

Bupropion

Mood Disorders

Dysthymic Disorder

Depressive Disorder, Major

Dexetimide

Depressive Disorder

Citalopram

Serotonin

Behavioral Symptoms

Additional relevant MeSH terms:

Dopamine Uptake Inhibitors

Parasympatholytics

Neurotransmitter Uptake Inhibitors

Neurotransmitter Agents

Molecular Mechanisms of Pharmacological Action

Cholinergic Antagonists

Anti-Dyskinesia Agents

Physiological Effects of Drugs

Psychotropic Drugs

Antiparkinson Agents

Cholinergic Agents

Serotonin Uptake Inhibitors

Pharmacologic Actions

Muscarinic Antagonists

Serotonin Agents

Autonomic Agents

Therapeutic Uses

Dopamine Agents

Peripheral Nervous System Agents

Antidepressive Agents, Second-Generation

Central Nervous System Agents

Antidepressive Agents

ClinicalTrials.gov processed this record on November 30, 2008

Sponsored by:	New York State Psychiatric Institute
Information provided by:	New York State Psychiatric Institute
ClinicalTrials.gov Identifier:	NCT00296712