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Ramelteon for Sleep Initiation Insomnia in Individuals With Panic Disorder Who Are Also on Escitalopram for Anxiety

This study has been terminated.
(Funding for continuation was not received.)
Takeda Pharmaceuticals North America, Inc.
Information provided by (Responsible Party):
Ravi Singareddy, Penn State University Identifier:
First received: September 2, 2008
Last updated: September 14, 2015
Last verified: September 2015
Almost 80% of panic disorder patients report difficulty sleeping. Sleep disturbances in turn may exacerbate underlying anxiety/panic attacks. Moreover, individuals with insomnia (sleep disturbance) are at higher risk of developing a new anxiety disorder. Therefore it is expected that improving sleep quality with medications along with other medications to treat anxiety component of panic disorder might be helpful. However, there is lack of pharmacological studies examining the effects of improving sleep disturbances with medications in panic disorder patients, which is a critical problem for providing optimal care to these patients. The objective of this proposal is to determine the effects of ramelteon (FDA approved for insomnia) on sleep disturbances in Panic disorder patients who are on escitalopram for underlying anxiety.

Condition Intervention
Panic Disorder Insomnia Drug: Placebo and Escitalopram Drug: Ramelteon and Escitalopram

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: Ramelteon for Sleep Initiation Insomnia in Panic Disorder Who Are Also on Escitalopram for Anxiety: A Double Blind, Randomized Clinical Trial

Resource links provided by NLM:

Further study details as provided by Ravi Singareddy, Penn State University:

Primary Outcome Measures:
  • Evaluate the Effects of Ramelteon on Sleep Quality in Panic Disorder Patients Who Are Also Treated With Escitalopram. [ Time Frame: 10 weeks ]

Secondary Outcome Measures:
  • Evaluate the Association of Improving Sleep Quality (With Ramelteon) on Improvement in Severity of Panic Disorder/Anxiety. [ Time Frame: 10 weeks ]

Enrollment: 11
Study Start Date: August 2008
Study Completion Date: July 2010
Primary Completion Date: July 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: 1
Subjects will be randomly assigned to receive either Ramelteon and Escitalopram OR Placebo and Escitalopram.
Drug: Ramelteon and Escitalopram
Ramelteon 8 mg and Escitalopram (5-40 mg)
Placebo Comparator: 2
Subjects will be randomly assigned to receive either Ramelteon and Escitalopram OR Placebo and Escitalopram.
Drug: Placebo and Escitalopram
Placebo and Escitalopram (5 to 40 mg)


Ages Eligible for Study:   18 Years to 50 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • 1) Clinical diagnosis of panic disorder
  • 2) Difficulty initiating sleep (subjective sleep latency (SL) of >30 minutes) for at least 3 times per week in the preceding month.

Exclusion Criteria:

  • 1)Patients meeting DSM-IV criteria (as determined by MINI) for a current anxiety disorder (other than panic disorder), or current major depressive disorder that is considered by the investigator to be primary (i.e., causing a higher degree of distress or impairment than panic disorder)., Patients with past history of DSM-IV anxiety disorders or depressive disorder will not be excluded.
  • 2) Patients with current psychotic disorder, current bipolar disorder, or substance use disorder (except nicotine dependence) or Subjects with significant suicide risk.
  • 3) Candidates with known sensitivity to any selective serotonin reuptake inhibitors (SSRI) will be excluded.
  • 4) CNS diseases: Candidates with seizure disorder (other than febrile seizure in early childhood), a history of other neurological disorder, and head trauma will be excluded.
  • 5) Cardiovascular and respiratory diseases: Candidates with hypertension (systolic >130; diastolic > 85), arrhythmias, coronary artery disease, cardiac pacemakers, COPD, asthma, and other pulmonary diseases will be excluded.
  • 6) Primary sleep disorders: Candidates with breathing related sleep disorder, restless leg syndrome, circadian rhythm sleep disorders, narcolepsy, and other major primary sleep disorders will be excluded.
  • 7) Systemic diseases: Candidates with other medical problems, such as endocrinopathies, renal or hepatic failure, autoimmune diseases involving the CNS, obesity (BMI > 30 kg/m2), or a history of pheochromocytoma will not be eligible.
  • 8) Consumption of greater than 720 mgs. of caffeine daily.
  • 9) History of shift work (11 PM to 7 AM) in the past 6 months.
  • 10) Reproductive status: Women candidates who are pregnant (based on urine test) are not eligible. Women of child bearing age will be on birth control methods during the study period.
  • 11) Individuals with personality, behavior, or medical disorders likely to interfere with study participation.
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Please refer to this study by its identifier: NCT00746239

United States, Pennsylvania
Penn State Hershey Medical Center
Hershey, Pennsylvania, United States, 17033
Sponsors and Collaborators
Penn State University
Takeda Pharmaceuticals North America, Inc.
Principal Investigator: Ravi Singareddy, MD Penn State College of Medicine/Hershey Medical Center
  More Information

Additional Information:
Responsible Party: Ravi Singareddy, Associate Proffesor, Penn State University Identifier: NCT00746239     History of Changes
Other Study ID Numbers: 07-013R
Study First Received: September 2, 2008
Results First Received: June 18, 2015
Last Updated: September 14, 2015

Keywords provided by Ravi Singareddy, Penn State University:
sleep difficulty
panic disorder
nocturnal panic attacks

Additional relevant MeSH terms:
Sleep Initiation and Maintenance Disorders
Panic Disorder
Pathologic Processes
Sleep Disorders, Intrinsic
Sleep Wake Disorders
Nervous System Diseases
Mental Disorders
Anxiety Disorders
Serotonin Uptake Inhibitors
Neurotransmitter Uptake Inhibitors
Membrane Transport Modulators
Molecular Mechanisms of Pharmacological Action
Neurotransmitter Agents
Serotonin Agents
Physiological Effects of Drugs
Antidepressive Agents, Second-Generation
Antidepressive Agents
Psychotropic Drugs
Antiparkinson Agents
Anti-Dyskinesia Agents
Autonomic Agents
Peripheral Nervous System Agents
Muscarinic Antagonists
Cholinergic Antagonists
Cholinergic Agents processed this record on August 23, 2017