Adding an Insulin-Sensitizing Medication to Depression Treatment for People Who Are Depressed and Overweight
Overview[ - collapse ][ - ]
Purpose | This study will determine whether the drug metformin improves the effects of traditional antidepressant medications in people who are overweight. |
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Condition | Depression |
Intervention | Drug: Sertraline Drug: Metformin |
Phase | Phase 4 |
Sponsor | National Institute of Mental Health (NIMH) |
Responsible Party | National Institute of Mental Health (NIMH) |
ClinicalTrials.gov Identifier | NCT00834652 |
First Received | February 2, 2009 |
Last Updated | September 18, 2009 |
Last verified | September 2009 |
Tracking Information[ + expand ][ + ]
First Received Date | February 2, 2009 |
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Last Updated Date | September 18, 2009 |
Start Date | September 2007 |
Estimated Primary Completion Date | December 2012 |
Current Primary Outcome Measures | Treatment of major depressive disorder (MDD) (acute phase) and prevention of MDD recurrence (maintenance phase) [Time Frame: Measured over 40 weeks] [Designated as safety issue: No] |
Current Secondary Outcome Measures |
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Descriptive Information[ + expand ][ + ]
Brief Title | Adding an Insulin-Sensitizing Medication to Depression Treatment for People Who Are Depressed and Overweight |
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Official Title | Improving Depression Treatment Outcomes With an Insulin-Sensitizing Agent |
Brief Summary | This study will determine whether the drug metformin improves the effects of traditional antidepressant medications in people who are overweight. |
Detailed Description | Current depression treatments are not effective for approximately one-half of overweight people, and depression eventually returns in approximately one-third of those overweight people whose initial treatment is effective. One possible reason for these treatment failures is that overweight people often experience a condition called insulin resistance (IR), which can lead to type 2 diabetes, an associated disease that might also affect depression treatment. IR results in elevated blood sugar levels that may interfere with medications used to treat depression. Metformin, a medication commonly used to treat diabetes, reduces blood sugar levels. This study will examine whether taking metformin with the antidepressant medication sertraline will enhance the effectiveness of sertraline in people who are overweight and depressed. Participation in this study will be divided into two phases lasting a total of 40 weeks. Phase 1 will last 16 weeks and include baseline testing and seven scheduled study visits. During this phase, participants will be randomly assigned to receive either sertraline and metformin or sertraline and placebo on a daily basis. The baseline visit will include the following tests and measures: an electrocardiogram (EKG), which will measure the electrical activity in the heart; an oral glucose tolerance test (OGTT), which will measure how a person's body breaks down glucose; a blood test, which will measure lipids, hemoglobin A1C, and other cardiometabolic risk factors; a dual energy x-ray absorptimetry (DEXA) scan, which will measure body fat; a pregnancy test for women; measurements of vital signs, height, weight, waist-to-hip ratio, and waist circumference; and questionnaires concerning health, medication use, physical activity, diet, and mood. Some of the questionnaires will be administered through interviews with a researcher. During the study visits, which will occur every 2 weeks, participants will complete questionnaires, unused medication will be collected, and new medication will be handed out. At Week 8, participants will provide an additional blood sample by finger stick. At the end of Phase 1, participants will undergo repeat baseline testing. Participants whose depression has improved after Phase 1 will be eligible to continue to Phase 2 of the study, which will determine the longer term effects of taking metformin with sertraline. Phase 2 of the study will last 24 weeks, with study visits occurring monthly. During the study visits, participants will complete questionnaires again, and medication will be collected and handed out. At Weeks 24 and 32, participants will provide blood samples by finger stick. After completing Phase 2, participants will again undergo repeat baseline testing. |
Study Type | Interventional |
Study Phase | Phase 4 |
Study Design | Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment |
Condition | Depression |
Intervention | Drug: Sertraline 50 mg once a day, which may be increased to 200 mg once a day Other Names: ZoloftDrug: Metformin Starting dose of 500 mg daily and increasing by 500 mg every 2 weeks to a total of 2,000 mg daily |
Study Arm (s) |
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Recruitment Information[ + expand ][ + ]
Recruitment Status | Recruiting |
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Estimated Enrollment | 200 |
Estimated Completion Date | December 2012 |
Estimated Primary Completion Date | May 2012 |
Eligibility Criteria | Inclusion Criteria: - Body mass index (BMI) greater than 28.7 - Positive screening for depression - Must live within 100 miles of the St. Louis metropolitan area Exclusion Criteria: - Pregnant or breastfeeding - Known hypersensitivity to sertraline or metformin - Recent history of heart attack or unstable heart disease - Severe liver disease or kidney impairment, defined by a serum creatine level above 3 mg/dL - Psychiatric disorder thought to affect management, such as schizophrenia, or alcohol or drug dependence |
Gender | Both |
Ages | 20 Years |
Accepts Healthy Volunteers | No |
Contacts | Contact: Billy D. Nix 314-362-3201 NIXD@WUSTL.EDU |
Location Countries | United States |
Administrative Information[ + expand ][ + ]
NCT Number | NCT00834652 |
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Other Study ID Numbers | R01 MH081150 |
Has Data Monitoring Committee | No |
Information Provided By | National Institute of Mental Health (NIMH) |
Study Sponsor | National Institute of Mental Health (NIMH) |
Collaborators | Not Provided |
Investigators | Principal Investigator: Patrick J. Lustman, PhD Washington University School of Medicine |
Verification Date | September 2009 |
Locations[ + expand ][ + ]
Washington University School of Medicine | St. Louis, Missouri, United States, 63110 Recruiting |
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