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Efficacy and Safety Study of SPD489 in Combination With an Antidepressant in the Treatment of Adults With Major Depressive Disorder

This study has been completed.
Information provided by (Responsible Party):
Shire Identifier:
First received: September 15, 2011
Last updated: November 6, 2014
Last verified: November 2014

This study will examine SPD489 in subjects aged 18-65 with major depressive disorder (MDD) who are taking certain types of antidepressants but continue to have residual depression symptoms. Eligible patients will remain on their antidepressant but will be randomized to either receive supplemental SPD489 or placebo (i.e. sugar pill). The purpose of this study is to help answer the following questions:

  • How safe is SPD489 for the supplemental treatment of depression and what are the side effects that might be related to it?
  • Can supplemental SPD489 help patients who still have residual depression symptoms while taking an antidepressant?
  • How much SPD489 should be given to patients with depression who are also taking an antidepressant?
  • How does SPD489 compare to placebo in depressed patients who are also taking an antidepressant?

Condition Intervention Phase
Major Depressive Disorder
Drug: Antidepressant + SPD489 (Lisdexamfetamine dimesylate )
Drug: Antidepressant + Placebo
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: The SPD489-323 Phase 3, Multicenter, Randomized, Double-blind, Parallel-group, Placebo-controlled, Flexible Dose Titration, Efficacy and Safety Study of SPD489 in Combination With an Antidepressant in the Treatment of Adults With Major Depressive Disorder With Inadequate Response to Prospective Treatment With an Antidepressant

Resource links provided by NLM:

Further study details as provided by Shire:

Primary Outcome Measures:
  • Mean Change From Baseline in Montgomery-Asberg Depression Rating Scale (MADRS) Total Score at 8 Weeks [ Time Frame: 8 weeks ]
    MADRS is a validated, 10-item rating scale with each item being scored on a scale from 0-6 with a total score ranging from 0-60. Lower scores indicate a decreased severity of depression.

Secondary Outcome Measures:
  • Mean Change From Baseline in Sheehan Disability Scale (SDS) Total Score at 8 Weeks [ Time Frame: 8 weeks ]
    Designed to evaluate the extent to which illness symptoms impact a subject's life in 3 areas: work/school, social, and family/home. Each area is scored on a scale from 0 (no impairment) to 10 (highly impaired) with a total score ranging from 0 (unimpaired) to 30 (highly impaired). Lower scores translate into less impairment.

  • Percentage of Participants Achieving a 25% Response on the MADRS [ Time Frame: Up to 8 weeks ]
    The percentage of subjects who achieved a 25% response (i.e. ≥25% reduction in MADRS total score from the Lead-in Baseline, Visit 2).

  • Percentage of Participants Achieving a 50% Response on the MADRS [ Time Frame: Up to 8 weeks ]
    The percentage of subjects who achieved a 50% response (i.e. ≥50% reduction in MADRS total score from the Lead-in Baseline, Visit 2).

  • Percent of Participants Achieving Remission on the MADRS [ Time Frame: Up to 8 weeks ]
    MADRS remission was defined as a MADRS total score of ≤10.

  • Mean Change From Baseline Over Time in MADRS Total Score [ Time Frame: Up to 8 weeks ]
    MADRS is a validated, 10-item rating scale with each item being scored on a scale from 0-6 with a total score ranging from 0-60. Lower scores indicate a decreased severity of depression.

  • Mean Change From Baseline in Abbreviated Brief Assessment of Cognition Affective Disorders (ABAC-A) Composite T-Scores [ Time Frame: up to 8 weeks ]
    The ABAC-A is a rater-administered series of activities designed to be sensitive to the critical cognitive deficits in affective disorders and schizophrenia. There are 6 subtests of the ABAC-A: List Learning (verbal memory); Digit Sequencing Task (working memory); Token Motor Task (motor speed); Verbal Fluency; Symbol Coding (attention and processing speed); and Tower of London Test (executive functions). The ABAC-A Composite T-score change from Augmentation Baseline Visit (Visit 8; Week 8) at Visit 14/Early Termination (ET) (Week 16/ET) was analyzed.

  • Mean Change From Baseline in the Short Form-12 Health Survey V2 (SF-12V2) [ Time Frame: Up to 8 weeks ]
    Total score ranges from 0 (lowest level of health) - 100 (highest level of health) on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability (i.e. a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability). Higher scores are associated with better quality of life.

  • Mean Change in Sexual Functioning Questionnaire - 14 Item Scale (CSFQ-14) Total Score Male [ Time Frame: Up to 8 weeks ]
    The CSFQ-14 is a short-form interview/questionnaire that measures illness- and medication-related changes in sexual functioning. A 5-point Likert scale is used ranging from 1 (never) to 5 (always). The CSFQ-14 total score can range from 14 to 70, with lower scores being associated with worsened sexual functioning.

  • Mean Change in Sexual Functioning Questionnaire - 14 Item Scale (CSFQ-14) Total Score Female [ Time Frame: Up to 8 weeks ]
    The CSFQ-14 is a short-form interview/questionnaire that measures illness- and medication-related changes in sexual functioning. A 5-point Likert scale is used ranging from 1 (never) to 5 (always). The CSFQ-14 total score can range from 14 to 70, with lower scores being associated with worsened sexual functioning.

  • Clinical Global Impressions - Global Improvement (CGI-I) [ Time Frame: Up to 8 weeks ]
    Clinical Global Impression-Improvement (CGI-I) consists of a 7-point scale ranging from 1 (very much improved) to 7 (very much worse). Improvement is defined as a score of 1 (very much improved) or 2 (much improved) on the scale.

  • Mean Change From Baseline in the Multidimensional Assessment of Fatigue (MAF) Global Fatigue Index (GFI) [ Time Frame: Up to 8 weeks ]
    MAF contains 16 items scored on a scale from 1 (not at all) to 10 (a great deal). Answers are converted to a Global Fatigue Index with total scores ranging from 1 (no fatigue) to 50 (severe fatigue). Lower scores indicate less fatigue.

  • Columbia Suicide Severity Rating Scale (C-SSRS) [ Time Frame: Up to 8 weeks ]
    C-SSRS is a semi-structured interview that captures the occurence, severity, and frequency of suicide-related thoughts and behaviors during the assessment period. The interview includes definitions and suggested questions to solicit the type of information needed to determine if a suicide-related thought or behaviour occurred. The assessment is done by the nature of the responses, not by a numbered scale.

  • Amphetamine Cessation Symptom Assessment (ACSA) - Total Aggregate Score [ Time Frame: 8 weeks ]
    ACSA scale has 16 symptom items rated on a scale from 0 (not at all) to 4 (extremely) with a possible total score range of 0 to 64. Higher scores indicate greater withdrawal symptom severity.

Enrollment: 1105
Study Start Date: October 2011
Study Completion Date: December 2013
Primary Completion Date: December 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Antidepressant + SPD489 Drug: Antidepressant + SPD489 (Lisdexamfetamine dimesylate )
Antidepressant (either escitalopram oxalate, sertraline hydrochloride, venlafaxine hydrochloride extended release or duloxetine hydrochloride) oral, once daily + SPD489 (oral, 20, 30, 50 or 70 mg, once daily) for 8 weeks
Other Name: Vyvanse
Placebo Comparator: Antidepressant + Placebo Drug: Antidepressant + Placebo
Antidepressant (either escitalopram oxalate, sertraline hydrochloride, venlafaxine hydrochloride extended release or duloxetine hydrochloride) oral, once daily + Placebo (oral, once daily) for 8 weeks


Ages Eligible for Study:   18 Years to 65 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria

  1. Subject is able to provide written, personally signed, and dated informed consent to participate in the study before completing any study-related procedures.
  2. Subject is between 18 and 65 years of age.
  3. Subject has a primary diagnosis of non-psychotic MDD.
  4. Subject has a MADRS total score >/=24.
  5. Subject is willing and has an understanding and ability to fully comply with study procedures and restrictions defined in this protocol.
  6. Subject, who is female, must have a negative serum beta human chorionic gonadotropin (B-HCG) pregnancy test and a negative urine pregnancy test and agrees to comply with any applicable contraceptive requirements of the protocol.
  7. Subject is able to swallow a capsule.

Exclusion Criteria:

  1. Subject whose current episode of MDD has not responded to an adequate treatment regimen with 2 or more approved single antidepressant agents.
  2. Subject who has a lifetime history of treatment resistant depression, defined as having not responded to adequate treatment with 2 or more treatment regimens.
  3. Subject has a current co-morbid psychiatric disorder that is either controlled with medications prohibited in this study or is uncontrolled and associated with significant symptoms.
  4. Subject has been hospitalized (within the last 12 months) for their current MDD episode.
  5. Subject has a current or lifetime history of attention-deficit/hyperactivity disorder (ADHD).
  6. Subject has a first degree relative that has been diagnosed with bipolar I disorder.
  7. Subject has a recent history (within the last 6 months) of suspected substance abuse or dependence disorder.
  8. Subject is considered a suicide risk, has previously made a suicide attempt within the past 3 years, or is currently demonstrating active suicidal ideation.
  9. Subject has a concurrent chronic or acute illness or unstable medical condition.
  10. Subject has a history of seizures (other than infantile febrile seizures), any tic disorder, or a current diagnosis and/or a known family history of Tourette's Disorder, serious neurological disease, history of significant head trauma, dementia, cerebrovascular disease, Parkinson's disease, or intracranial lesions.
  11. Subject has known history of symptomatic cardiovascular disease, advanced arteriosclerosis, structural cardiac abnormality, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease, or other serious cardiac problems.
  12. Subject has a history of thyroid disorder that has not been stabilized on thyroid medication or treatment within 3 months prior to the Screening Visit.
  13. Subject has a known family history of sudden cardiac death or ventricular arrhythmia.
  14. Subject has glaucoma.
  15. Subject has any clinically significant ECG or clinical laboratory abnormalities.
  16. Subject has a history of moderate to severe hypertension.
  17. Current use of any other medications (including over-the-counter [OTC], herbal or homeopathic preparations) that have central nervous system effects.
  18. Subject has the potential need to initiate or modify frequency of psychotherapy or to continue or initiate other treatments for depression, outside of those allowed in this protocol.
  19. Subject has had electroconvulsive therapy (ECT) for the current depressive episode 3 months prior to the Lead-in Baseline Visit.
  20. The subject has a known or suspected intolerance or hypersensitivity to the investigational product.
  21. The subject has a known or suspected intolerance, hypersensitivity, or contraindications to their assigned antidepressant treatments (escitalopram oxalate, sertraline HCl, venlafaxine HCl extended release, or duloxetine HCl).
  22. Subject has a positive urine drug result.
  23. Subject has a body mass index (BMI) of <18.5 or >40.
  24. Subject is female and is pregnant or nursing.
  Contacts and Locations
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Please refer to this study by its identifier: NCT01436162

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United States, Arizona
ResearchOne, Inc.
Scottsdale, Arizona, United States, 85251
United States, Arkansas
K&S Professional Research Services, LLC
Little Rock, Arkansas, United States, 72201
United States, California
ATP Clinical Research, Inc.
Costa Mesa, California, United States, 92626
Diligent Clinical Trials
Downey, California, United States, 90241
Synergy Clinical Reserach Center of Escondido
Escondido, California, United States, 92025
Pacific Research Partners, LLC
Oakland, California, United States, 94612
Anderson Clinical Research
Redlands, California, United States, 92374
BreakThrough Clinical Trials, LLC
San Bernardino, California, United States, 92408
United States, Colorado
MCB Clinical Research Centers
Colorado Springs, Colorado, United States, 80910
United States, Florida
Florida Clinical Research Center, LLC
Bradenton, Florida, United States, 34201
Scientific Clinical Research, Inc.
North Miami, Florida, United States, 33161
Clinical Neuroscience Solutions, Inc.
Orlando, Florida, United States, 32806
Comprehensive NeuroScience, Inc.
St. Petersburg, Florida, United States, 33716
Janus Center for Psychiatric Research
West Palm Beach, Florida, United States, 33407
United States, Georgia
Atlanta Center for Medical Research
Atlanta, Georgia, United States, 30308
Atlanta Institute of Medicine & Research
Atlanta, Georgia, United States, 30328
United States, Indiana
Pedia Research
Newburgh, Indiana, United States, 47630
United States, Kansas
Heartland Research Associates
Wichita, Kansas, United States, 67207
United States, Louisiana
Louisiana Clinical Research, LLC
Shreveport, Louisiana, United States, 71115
United States, Missouri
Comprehensive Psychiatric Associates
Gladstone, Missouri, United States, 64118
The Center for Pharmaceutical Research
Kansas City, Missouri, United States, 64114
Mercy Health Research
St. Louis, Missouri, United States, 63141
United States, New Jersey
Bio Behavioral Health
Toms River, New Jersey, United States, 08755
United States, New York
Brooklyn Medical Institute
Brooklyn, New York, United States, 11214
Medical & Behavioral Health Research, PC
New York, New York, United States, 10023
United States, Ohio
Midwest Clinical Research Center
Dayton, Ohio, United States, 45417
North Star Medical Research, LLC
Middleburg Heights, Ohio, United States, 44130
United States, Oklahoma
Sooner Clinical Research
Oklahoma City, Oklahoma, United States, 73112
United States, Pennsylvania
Lehigh Center for Clinical Research
Allentown, Pennsylvania, United States, 18104
Belmont Center for Comprehensive Treatment
Philadelphia, Pennsylvania, United States, 19131
United States, South Carolina
Medical University South Carolina Anxiety Disorder Program
North Charleston, South Carolina, United States, 29406
United States, Tennessee
Psychiatric Consultants, PC
Franklin, Tennessee, United States, 37067
Research Strategies of Memphis, LLC
Memphis, Tennessee, United States, 38119
United States, Texas
KRK Medical Research
Dallas, Texas, United States, 75230
Future Search Trials of Dallas, LP
Dallas, Texas, United States, 75231
Clinical Trials of Texas, Inc.
San Antonio, Texas, United States, 78229
Dr Lieven De Weirdt
Sint Niklaas, Belgium, 9100
Czech Republic
Saint Anne s.r.o.
Brno, Czech Republic, 60200
Psychiatricka ambulance
Brno, Czech Republic, 615 00
Medicana s.r.o.
Horovice, Czech Republic, 268 01
Psychiatrie s.r.o.
Kutna Hora, Czech Republic, 284 01
Bialbi s.r.o.
Litomerice, Czech Republic, 41201
Clintrial s.r.o.
Prague 10, Czech Republic, 10000
Psychiatry Trial s.r.o.
Prague 5, Czech Republic, 15800
Prague Medical Services s.r.o.
Prague 6, Czech Republic, 160 00
Ricany s.r.o.
Ricany, Czech Republic, 251 01
Parnu Hospital, Psychiatric Clinic
Parnu, Estonia, 80012
North Estonia Medical Centre Foundation Psychiatry Clinic
Tallinn, Estonia, 10614
Marienthal Psychiatry and Psychology Center
Tallinn, Estonia, 10617
Jaanson & Laane OU
Tartu, Estonia, 50406
Tartu University Hospital Psychiatric Clinic
Tartu, Estonia, 50417
ARTES Psykiatrinen Palvelukeskus Oy
Helsinki, Finland, 00100
Satucon Oy
Kuopio, Finland, 70100
Satakunnan Psykiatripalveiu Oy at Mentoria Oy
Tampere, Finland, 26200
Puutorin Psykiatripalvelu
Turku, Finland, 20100
Gemeinschafstpraxis für Neurologie und Psychiatrie, Psychotherapie
Achim, Germany, 28832
Private Praxis Dr. Jana Thomsen
Berlin, Germany, 10245
emovis GmbH
Berlin, Germany, 10629
Alexander Schulze, MD
Berlin, Germany, 13156
Private Practice Drs. Bitter/Schumann
Bochum, Germany, 44805
University Hospital Carl Gustav Carus
Dresden, Germany, 01307
ZSL Zentrum fuer medizinische Studien in Leipzig
Leipzig, Germany, 04157
Studienzentrum Muenchen
Muenchen, Germany, 80333
Universitaetsklinikum Munster
Muenster, Germany, 48149
Studienzentrum Klinikum Nuernberg
Nuernberg, Germany, 90419
Somni bene GmbH
Schwerin, Germany, 19053
Private Practice: Eugen Schlegel
Siegen, Germany, 57072
Studiezentrum Nord-West
Westerstede, Germany, 26655
Medizinisches Studienzentrum Wuerzburg
Wuerzburg, Germany, 97070
Semmelweis Univ. Dept.of Psychiatry
Budapest, Hungary, 1083
Debrecent Egyetem Orvos es Egeszsegtudomanyl Centrum Pszichiatrai
Nagyerkei, Hungary, H-4032
Santha Kalman Mentalis Egeszsegkozpont es Szakkorhaz
Nagykallo, Hungary, 4320
Josa Andras Teaching Hospital
Nyiregyhaza, Hungary, H-4400
Pecsi Tudomanyegyeiem Pszichiatriai es Pszichoterapias Klinika
Sziget, Hungary
Prywatne Gabinety Lekarskie "Promedicus"
Bialystok, Poland, 15-879
NZOZ Centrum Kultury, Higieny i Zdrowia Psychicznego
Bydgoszcz, Poland, 85-156
Zespol Opieki Zdrowotnej w Chelmnie
Chelmno, Poland, 86-200
Centrum Badan Klinicznuch Pl-House sp. z.o.o.
Gdansk, Poland, 80-546
Klinika Chorob Psychicznych i Zaburzen Nerwicowych
Gdansk, Poland, 80-952
Centrum Psychiatrii i Psychoterapli
Gorlice, Poland, 38-300
NZOZ Syntonia, Poradnia Zdrowia Psychicznego
Kielce, Poland, 25-317
Osrodek Badafi Klinicznych Prof dr hab n med Meszek Szczepanski Prywatna Praktyka Lekarska
Lublin, Poland, 20-022
Samodzielny Publiczny Zespol Zakladow Opieki Zdrowotnej w Zurominie
Zuromin, Poland, 09-300
Spitatul Clinic Judetean de Urgenta Arad, Clinica de Psihiatrie
Arad, Romania, 310022
Stefi-Dent SRL
Botosani, Romania, 710107
Spitalui Clinic de Psihiatrie "Prof. Dr. Alexandru Obregia" Sectia Clinica Psihiatrie I
Bucaresti, Romania, 041915
Crucea Alba
Oradea, Romania, 410163
Lorentina 2201 SRL
Targoviste, Romania, 130081
Spitalul Clinic Judetean Mures
Targu Mures, Romania, 540095
South Africa
Cape Trial Centre
Bellville, Cape Town, South Africa, 7530
Flexivest Fourteen Research Centre
Bellville, Cape Town, South Africa, 7530
Private Practice - Gerta Brink
Johannesburg, Gauten, South Africa, 2195
Somerset West Clinical Research
Somerset West, Western Cape, South Africa
Vista Clinic
Centurion, South Africa, 0046
George Medi Clinic Extension
George, South Africa, 6529
SU/ Affektiva 1
Göteborg, Sweden, 41685
ProbarE i Lund AB
Lund, Sweden, 22222
Ekdahl Medical AB
Malmo, Sweden, 21153
INM Psykiatrisk Mottagning
Malmo, Sweden, 21153
Medinstructor Lippitz AB
Stockholm, Sweden, 11486
Dr. Wahlstedts mottagning
Uppsala, Sweden, 75310
Sponsors and Collaborators
Principal Investigator: Madhukar H Trivedi, M.D. University of Texas Southwestern Medical School, Dallas, Texas 75235
  More Information

Responsible Party: Shire Identifier: NCT01436162     History of Changes
Other Study ID Numbers: SPD489-323
2011-003006-25 ( EudraCT Number )
Study First Received: September 15, 2011
Results First Received: October 31, 2014
Last Updated: November 6, 2014

Additional relevant MeSH terms:
Depressive Disorder
Depressive Disorder, Major
Pathologic Processes
Mood Disorders
Mental Disorders
Behavioral Symptoms
Lisdexamfetamine Dimesylate
Duloxetine Hydrochloride
Venlafaxine Hydrochloride
Antidepressive Agents
Central Nervous System Stimulants
Physiological Effects of Drugs
Dopamine Uptake Inhibitors
Neurotransmitter Uptake Inhibitors
Membrane Transport Modulators
Molecular Mechanisms of Pharmacological Action
Dopamine Agents
Neurotransmitter Agents
Psychotropic Drugs
Serotonin and Noradrenaline Reuptake Inhibitors
Antidepressive Agents, Second-Generation
Sensory System Agents
Peripheral Nervous System Agents
Serotonin Uptake Inhibitors
Serotonin Agents processed this record on April 28, 2017