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The Use of Duloxetine for Cognition Improvement in Individuals With Mild Cognitive Impairment (DEMO)

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ClinicalTrials.gov Identifier: NCT02590874
Recruitment Status : Completed
First Posted : October 29, 2015
Last Update Posted : October 11, 2018
Information provided by (Responsible Party):
Leigh Johnson , PhD, LMSW, University of North Texas Health Science Center

Tracking Information
First Submitted Date  ICMJE October 22, 2015
First Posted Date  ICMJE October 29, 2015
Last Update Posted Date October 11, 2018
Actual Study Start Date  ICMJE January 2016
Actual Primary Completion Date July 2017   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: October 27, 2015)
Change in scores for the Repeatable Battery for Neuropsychological Status (RBANS) from baseline to 16 weeks. [ Time Frame: Weeks 0 and 16 ]
RBANS measures immediate memory, visuospatial construction, attention processes and speed of information processing, expressive and receptive language, and delayed memory.
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: October 27, 2015)
Evaluation of the relative dominance of the verbal-reading system from baseline at 16 weeks through the Stroop Color and Word Test [ Time Frame: Weeks 0 and 16 ]
The Stroop is associated with cognitive flexibility, resistance to interference from outside stimuli, creativity, and psychopathology
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
Descriptive Information
Brief Title  ICMJE The Use of Duloxetine for Cognition Improvement in Individuals With Mild Cognitive Impairment
Official Title  ICMJE The Depression and Memory Trial
Brief Summary The purpose of this study is to determine whether Cymbalta (duloxetine) is effective to improve cognition in individuals with Mild Cognitive Impairment.
Detailed Description

The goal of this study is to conduct a proof of concept clinical trial using antidepressant therapy to improve cognition. This study will utilize a randomized, double blinded, placebo - controlled trial design. The investigators will recruit up to 100 patients. Patients will be screened multiple times to determine eligibility. Patients will be randomized into one of two study groups (placebo control group and Duloxetine group). Patients in the Duloxetine group will receive up to 60 mg of an FDA approved antidepressant, Duloxetine. Patients in the control group will receive a placebo that is the exact shape and size of the study drug. The patients, primary investigators, and research personnel will be blinded to the study condition. The investigators will designate one on-site personnel to serve as data and safety monitor. This person will not be blinded and will randomize patients to condition, work with the pharmacy, and can un-blind condition if necessary.

Potential patients will be invited to a screening visit. This visit is designed to ensure that the patients meet study criteria and that it is safe for them to participate in the study. The screening visit will consist of physical examinations, medical and psychological history, cognitive and functional testing, interviews, questionnaires, research/clinical venipuncture, and a meeting with the study doctor. If a patient is accepted to the trial, he/she will be expected to stay in the study for a minimum of 6 months.

After the screening visit, the study team will meet to determine if the patient will continue to remain in the study. If a patient does remain in the study, he/she will be invited to a randomization visit. Patients will be randomized into either the Duloxetine group or the placebo control group. The data and safety monitor will use a randomization software. This program allows the researcher to enter in the number of subject, and condition, and will generate a table of randomly assigned patients to condition. The patients and study personnel will be blinded to the condition. The data safety monitor will randomly assign patients to condition and work with the pharmacy to properly label the study drugs. Only the data monitoring personnel will be un-blinded and will generate the table of random numbers. After randomization, patients will undergo vitals, interviews, testing, and the study drug will be dispensed to them. First dosage will consist of 30 mg of Duloxetine or placebo, and the participant will be asked to take the first dose at this visit.

Patients will be invited to a 2 week post randomization visit that will consist of a meeting with the study doctor to discuss concerns or side effects. Medication dosage will be raised to 60 mg of Duloxetine or placebo.

Patients will be seen monthly for the next three months. During these visits the patients will receive their study drugs, have their vital signs measured, and be questioned about adverse events or any health changes.

One month later, patients will have a follow up visit. This visit will consist of follow up interview and neuropsychological testing, clinical/research blood draw, and study doctor visit. This will be the final data collection study visit. The investigators will reduce the dosage of the study drug to 30 mg at this visit. The patients will be instructed that the investigators will be weaning off the study drug at this time.

The last study visit will be 2 weeks after the follow-up visit. This visit will consist of a study debriefing with the patient. At this visit the investigators will discontinue the study drug. The investigators will also arrange for the data monitoring personnel to un-blind the study at this time. No data will be collected at this visit. The participants will be informed of whether or not they were on the study drug or placebo. If a patient in the study drug group wishes to remain on Duloxetine, the patients will be advised to discuss it with their personal healthcare provider.

Research data will be stored and managed in a secure manner following NIH guidelines and according to state and institutional policies. Only authorized key personnel shall have access to research related documents. All personnel will be properly trained and supervised regarding the management and handling of confidential materials. The Principal Investigator assumes full responsibility for such training, supervision, and conduct.

All data will be stored in locked file cabinets behind locked doors in the PIs research laboratory until entered into the research database. Computer-based data entry will not require hard copy storage. All data collected via paper-pencil will be double entered into the research database by independent research assistants and results checked for quality control (QC). Once all hard copies have been entered, they will be scanned into PDF files for storage; all hard copies will be shredded. We will maintain the original signed consent forms for our records (these documents will not be shredded and will be kept in a locked file cabinet). Electronic scanned files will be stored in password protected files for security purposes. All discrepancies will be validated by chart review before the data are merged into the larger database. The database will contain item-level data to avoid the need for subsequent data entry processes as potential data analyses arise. Periodic QC checks will be conducted by our IT personnel and provided to the PI. All electronic records will be maintained on password protected computers behind locked doors in the PI's office space. All files will be backed up weekly on an independent external hard drive, which is also password protected.

Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 4
Study Design  ICMJE Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary Purpose: Supportive Care
Condition  ICMJE
  • Mild Cognitive Impairment
  • Depression
Intervention  ICMJE
  • Drug: Duloxetine
    Duloxetine 30 mg per day for 2 weeks. Duloxetine 60 mg per day for 4 months. Duloxetine 30 mg per day for 2 weeks.
    Other Name: Cymbalta
  • Drug: Placebo
    Placebo 30 mg per day for 2 weeks. Placebo 60 mg per day for 4 months. Placebo 30 mg per day for 2 weeks.
    Other Name: Avicel
Study Arms  ICMJE
  • Experimental: Duloxetine group
    Active drug group
    Intervention: Drug: Duloxetine
  • Placebo Comparator: Placebo group
    Inactive drug group
    Intervention: Drug: Placebo
Publications *

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
Recruitment Information
Recruitment Status  ICMJE Completed
Actual Enrollment  ICMJE
 (submitted: June 8, 2017)
Original Estimated Enrollment  ICMJE
 (submitted: October 27, 2015)
Actual Study Completion Date  ICMJE October 2018
Actual Primary Completion Date July 2017   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • Male or female, age 50 and up.
  • Female participants must be post-menopausal for at least two consecutive years.
  • Health and Aging Brain Study participant, who provided consent for re-contact
  • Diagnosis of MCI (by Health and Aging Brain Study Consensus Review).
  • Has an elevated DepE score (2 or more). This is calculated by summing scores for five items (Items 14, 16, 17,25 &26) on the Geriatric Depression Scale.

Exclusion Criteria:

  • Inability to provide informed consent by self or by proxy.
  • Pregnant or breast feeding women
  • Uncontrolled narrow angle glaucoma
  • Known hypersensitivity to duloxetine.
  • Participation in a Clinical Trial in the last three months.
  • Other psychiatric disorder like bipolar disorder, schizophrenia, or dementia.
  • Use of antidepressants, anti-psychotics, and mood stabilizers.
  • History of stroke.
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 50 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE United States
Removed Location Countries  
Administrative Information
NCT Number  ICMJE NCT02590874
Other Study ID Numbers  ICMJE UNTHSC IRB#2015-128
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product Not Provided
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Current Responsible Party Leigh Johnson , PhD, LMSW, University of North Texas Health Science Center
Original Responsible Party Same as current
Current Study Sponsor  ICMJE University of North Texas Health Science Center
Original Study Sponsor  ICMJE Same as current
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Principal Investigator: Leigh Johnson, PhD University of North Texas Health Science Center
PRS Account University of North Texas Health Science Center
Verification Date October 2018

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP