Multicenter Study of Lumateperone as Adjunctive Therapy in the Treatment of Patients With Major Depressive Disorder

Prior treatment

• In the opinion of the Investigator, the patient has a significant risk for suicidal behavior during participation in the study or:
  • At Screening, the patient scores "yes" on Suicidal Ideation Items 4 or 5 of the Columbia-Suicide Severity Rating Scale (C-SSRS) within 6 months prior to Screening, or at Baseline, the patient scores "yes" on Suicidal Ideation Items 4 or 5 since the Screening Visit;
  • At Screening, the patient has had 1 or more suicide attempts within 2 years prior to Screening;
  • At Screening or Baseline, the patient scores ≥ 5 on MADRS Item 10 (Suicidal Thoughts), or
  • The patient is considered to be in imminent danger to him/herself or others.

Other illness

• Within the patient's lifetime, has a confirmed DSM-5 psychiatric diagnosis other than MDD, including:
  • Schizophrenia, Schizoaffective Disorder, Schizophreniform Disorder or other psychotic disorder;
  • Bipolar Disorder;
• Within 6 months of Screening, has a confirmed DSM-5 psychiatric diagnosis other than MDD including:
  • Anxiety disorders such as Panic Disorder or Generalized Anxiety Disorder; Obsessive-compulsive Disorder; Posttraumatic Stress Disorder as primary diagnoses.
  • Eating disorder;
  • Substance use disorders (excluding nicotine);
  • Personality disorder of sufficient severity to have a major impact on the patient's psychiatric status;
  • Within 12 months of Screening, has had any other psychiatric condition (other than MDD) that has been the main focus of treatment;

Age

• The patient has a first MDE at age 60 years or older.

Other

• The patient experiences a ≥ 25% decrease in the MADRS total score between Screening and Baseline;
• The patient experiences a ≥ 25% decrease in the QIDS-SR-16 total score between Screening and Baseline;

• Male or female patients between the ages of 18 and 65 years, inclusive;
• Meets DSM-5 criteria for MDD (MDD with psychotic features will be acceptable) as confirmed by the Investigator or Sponsor-approved rater using the MINI and meets all of the following criteria:
  • The start of the current major depressive episode (MDE) is at least 8 weeks but not more than 18 months prior to Screening;
  • Has at least moderate severity of illness based on rater-administered MADRS total score ≥ 24 at Screening and at Baseline;
  • Has at least moderate severity of illness based on CGI-S score ≥ 4 at Screening (Visit 1) and at Baseline;
  • Has a Quick Inventory of Depressive Symptomatology-Self Report-16 item (QIDS-SR-16) score ≥ 14 at Screening and at Baseline;
  • Has sufficient history and medical record confirmation verifying the ADT and the current MDE is causing clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• Currently having an inadequate response to ADT (less than 50% improvement) as confirmed by the Investigator and taking at least the minimum effective dose (per package insert) of one of the following antidepressants as monotherapy treatment for at least 6 weeks duration:
  • citalopram/escitalopram
  • fluoxetine
  • paroxetine
  • sertraline
  • duloxetine
  • levomilnacipran/milnacipran (if locally approved for MDD)
  • venlafaxine/desvenlafaxine
  • bupropion
  • vilazodone
  • vortioxetine