Depression in Older Adults - Full Text View

Sponsor:	Cedars-Sinai Medical Center
Collaborator:	Forest Laboratories
Information provided by:	Cedars-Sinai Medical Center
ClinicalTrials.gov Identifier:	NCT00643162

Purpose

Depression is a common and disabling condition which represents a substantial public health concern, especially with the aging of the population in general. In fact, one to four percent of the older population has major depression. Although medication is the main treatment for depression, studies show that only 50% of patients show a significant response to treatment. The response might actually be less in older subjects, and with more adverse side effects due to changes in the metabolism of the older population as well as drug interaction. For these reasons (changes in metabolism and possible drug interactions) the starting dose of the antidepressant Lexapro will be 5mg, instead of 10mg.

To combat the incomplete response to medication, many combined and augmentation strategies have been developed. Examples of this would be an antidepressant medication plus a neuroleptic medication; or an antidepressant medication plus talk therapy. One non-medication treatment that is being considered is massage therapy. Recent data suggest that massage therapy can be useful for the treatment of depression.

This study proposes to perform a controlled trail to assess the effects of massage therapy on symptoms of depression in older subjects with major depression. All of the subjects will receive Lexapro, which is an FDA approved medication for the treatment of depression. Half of the subjects will receive Swedish massage for one hour, twice a week, and the other half will receive light touch for one hour, twice per week for eight weeks. Standardized rating scales that evaluate depression will be used to evaluate the subjects mood.

Condition	Intervention
Depression	Drug: Lexapro Behavioral: Light touch Behavioral: Massage

Study Type:	Interventional
Study Design:	Treatment, Randomized, Open Label, Parallel Assignment, Efficacy Study
Official Title:	Combination Lexapro and Massage for Treatment in Depression in Older Subjects

Resource links provided by NLM:

MedlinePlus related topics: Antidepressants Depression

Drug Information available for: Benzetimide Dexetimide Citalopram hydrobromide Citalopram Escitalopram Escitalopram oxalate

U.S. FDA Resources

Further study details as provided by Cedars-Sinai Medical Center:

Primary Outcome Measures:

Hamilton Depression Scale (HAM-D) [ Time Frame: 9 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Beck Depression Inventory [ Time Frame: 9 weeks ] [ Designated as safety issue: No ]
Hamilton Anxiety Scale (HAM-A) [ Time Frame: 9 weeks ] [ Designated as safety issue: No ]

Estimated Enrollment:	40
Study Start Date:	June 2006
Estimated Study Completion Date:	June 2010
Estimated Primary Completion Date:	June 2010 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
1: Experimental Adding massage twice a week, for 8 weeks, and Lexapro in the treatment of depression.	Drug: Lexapro 5mg-10mg of lexapro, daily, for 9 weeks for all study participants. Behavioral: Massage Massage twice a week, for 8 weeks.
2: Placebo Comparator Adding light touch twice a week, for 8 weeks, and Lexapro in the treatment of depression.	Drug: Lexapro 5mg-10mg of lexapro, daily, for 9 weeks for all study participants. Behavioral: Light touch Light touch twice a week, for 8 weeks

Eligibility

Ages Eligible for Study:	60 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

> 60 years of age
Unipolar major depression as defined by Structured Clinical Interaction DSM-IV (SCID)
HAM-D score of > 17 (21-item scale)]]
Not taking antidepressants for at least two weeks, 2 months for fluoxetine and MAOIs]]
Capable of giving informed consent.

Exclusion Criteria:

Unable to provide informed consent (e.g. severe cognitive impairment)
Acute medical condition or exacerbation of chronic medical condition associated with significant distress (pain, protracted fevers, etc.) and requiring active medical treatment.
High risk of suicide or violence as assessed by the investigator
Current or past history of psychosis or bipolar disorder
Use of psychotropic medication and/or psychotherapy outside of the study
(Exposure to treatment of fluoxetine or MAOIs in the previous two months; chronic use of benzodiazepine and non-benzodiazepine sedatives, antipsychotics, psychostimulants, mood stabilizing agents, codeine, steroids, anti-inflammatory agents.
Alternative medicine use in the preceding 30 days (e.g. acupuncture, herbs, etc.)
History of intolerance to massage or contraindication to massage (e.g. skin lesions that prevent direct contact by the therapist)
Diagnosis of schizophrenia, schizophreniform disorder, schizoaffective disorder, schizotypal disorder, psychotic depression or bipolar disorders;
MMSE less than 22
Alzheimer's Disease Assessment Scale-Cognitive Subscale ³ greater than 12
Current drug or alcohol abuse or dependence or history of drug or alcohol abuse or dependence within the past 6 months
Unstable medical or neurological conditions that are likely to interfere with the treatment of depression
Currently on psychotropic medications including antidepressants or neuroleptics
Active suicidal ideation or other safety issues determined by the clinician to not be suitable for inclusion in the study

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00643162

Contacts

Contact: Andrew Berg

310.423.6515

psychiatryresearch@cshs.org

Locations

United States, California
Cedars-Sinai Medical Center Department of Psychiatry and Behavioral Neurosciences	Recruiting
Los Angeles, California, United States, 90048

Sponsors and Collaborators

Cedars-Sinai Medical Center

Forest Laboratories

Investigators

Principal Investigator:

Robert Cohen, Ph.D., M.D.

Cedars-Sinai Medical Center

More Information

Additional Information:

Department Website This link exits the ClinicalTrials.gov site

No publications provided

Responsible Party:	Cedars-Sinai Medical Center Department of Psychiatry and Behavioral Neurosciences ( Dr. Robert Cohen )
Study ID Numbers:	8648, 00008648
Study First Received:	March 20, 2008
Last Updated:	November 19, 2009
ClinicalTrials.gov Identifier:	NCT00643162 History of Changes
Health Authority:	United States: Institutional Review Board

Keywords provided by Cedars-Sinai Medical Center:

Depression
Massage
Lexapro
Alternative Therapy
Anti-depressant

Additional relevant MeSH terms:

Parasympatholytics
Neurotransmitter Uptake Inhibitors
Neurotransmitter Agents
Cholinergic Antagonists
Molecular Mechanisms of Pharmacological Action
Anti-Dyskinesia Agents
Physiological Effects of Drugs
Psychotropic Drugs
Antiparkinson Agents
Cholinergic Agents
Mental Disorders
Therapeutic Uses
Dexetimide
Antidepressive Agents, Second-Generation

Antidepressive Agents
Depression
Depressive Disorder
Citalopram
Serotonin Uptake Inhibitors
Pharmacologic Actions
Behavioral Symptoms
Muscarinic Antagonists
Serotonin Agents
Autonomic Agents
Mood Disorders
Peripheral Nervous System Agents
Central Nervous System Agents

ClinicalTrials.gov processed this record on February 08, 2010