Fact CheckerSign in

NCT06675851RecruitingPhase 4

Reward-specific Changes of the Chemical Messenger Dopamine in the Brain of Healthy and Depressed People

Reward-specific Changes of Cerebral Dopamine Synthesis in Healthy Volunteers and Depressed Patients

Source: ClinicalTrials.gov · Last updated 5 Nov 2024 · Not updated for over 12 months - ask the site whether it is still open

Brief summary (registry, in English)

Major depressive disorder was shown to be associated with pathological alterations within neurotransmitter systems of the brain. Based on earlier study results, it is assumed that the neurotransmitter dopamine is relevant for several symptoms of depression, e.g., loss of interest or pleasure and lack of motivation. Thus, it is assumed that the synthesis of dopamine in the brain of depressed individuals could be impaired. The specific effect of common antidepressants on the human reward system in depression has not yet been sufficiently investigated. In particular, it is unclear whether depressed patients exhibit reward-specific changes of dopamine synthesis, and whether or not these changes can be differentially affected by diverse types of antidepressants. Neurotransmitter systems can be visualized in the brain using positron emission tomography (PET). Additionally, brain structure and function can be studied using magnetic resonance imaging (MRI). For the visualization of dopamine synthesis in the brain, the radioligand \[18F\]FDOPA can be used in PET measurements. To assess task-relevant changes of diverse radioligands and thus specific metabolic processes in the brain during specific tasks, a recently developed PET-approach can be used which has already been successfully applied in a pilot study with healthy volunteers. In the present project, 60 depressed subjects and 30 healthy controls will undergo PET/MR-imaging twice. Depressed subjects will be assigned to 1 of 2 treatment groups. 30 depressive subjects will receive bupropion, the other 30 patients will be treated with escitalopram. After a treatment period of 6 weeks, the 2nd PET measurement will be performed in all participants, aiming to detect potential reward-specific changes of dopamine synthesis. The investigators hypothesize that reward-specific changes of dopamine synthesis will be lower in depressed subjects than in healthy controls, that reward-specific changes of dopamine synthesis will be significantly higher in the bupropion group than in the escitalopram group, and that the changes of dopamine synthesis will be associated with functional changes in the brain (measured by simultaneous functional MRI scans). This will be the first study comparing the effects of escitalopram and bupropion on task-specific dopamine synthesis and thus on the human reward system. The study is expected to yield new insights for individual treatment concepts in the therapy of depression.

Status (registry)
Recruiting
Phase (registry)
Phase 4
Study type
Interventional
Enrollment
120 (estimated)
First submitted
31 Oct 2024
Start date
1 Dec 2022
Primary completion date
Dec 2026
Lead sponsor
Medical University of Vienna
Diseases
Depression
NCT number
NCT06675851
EU CT number
2024-518226-32-00
EudraCT number
2019-004880-33

What you commit to

  • Study type: Interventional · Phase 4
  • Planned participants: 120
  • From 1 Dec 2022 to the primary completion date, Dec 2026
  • 1 site in 1 country
  • Visits and tests: ask the trial team, the registry does not list them

Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.

Who cannot take part

Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.

Prior treatment

  • Presence of any metallic implant in the head
  • Ingestion of antidepressants or other psychotropic agents within the last 6 months Previous escitalopram- or bupropion intake
  • Antidepressive trials wit DBS, electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS) or Ketamine
  • Participation in any clinical investigation within 12 weeks prior to dosing
  • Significant radiation exposure (\>5 mSv) in the frame of participation in trials within the past 10 years

Other illness

  • Depressed patients: Presence of any severe / unstable neurological, somatic or psychiatric comorbidity
  • Healthy controls: Any psychiatric disease or any severe / unstable neurological or somatic disease
  • History of clinically significant drug allergy; history of atopic allergy (asthma, urticaria, eczematous dermatitis). A known hypersensitivity to one of the study drugs or multiple study drugs (known hypersensitivity to bupropion, escitalopram)
  • Current smoking, substance abuse including alcohol, drugs of abuse, or any medication in a manner which is indicative of substance-related disorders (e.g. substance dependency) according to DSM-IV
  • Failure to comply with the study protocol or follow the instructions of the investigators
  • MRI scan that shows evidence of stroke, infarct, or other space occupying lesion or structural abnormality
  • History of any other drug or alcohol abuse or misuse

Lab values

  • Other clinically significant abnormality on physical, neurological, or laboratory examination or on electrocardiogram (ECG) that, in the opinion of the investigator precludes the patient from the study

Other

  • Presence of psychotic symptoms
  • Acute suicidality
  • Any contraindication for magnetic resonance or PET imaging
  • Positive urine pregnancy test
  • Known pregnancy or lactation
  • Evidence from an Allen test of incomplete communication between the radial and ulnar artery, in either hand

Who the study is looking for

  • Male and female subjects aged between 18-65 years of age
  • Depressive patients: DSM-IV diagnosis of MDD following SCID I, HDRS29, MADRS and BDI-II
  • Satisfactory general health as determined by past medical history, physical examination, vital signs at screening
  • Vital signs measured after 3 minutes resting in the supine position must be within the following ranges: oral body temperature between 35.0-37.5 °C, systolic blood pressure 90-140 mmHg, diastolic blood pressure 50-90 mm Hg, pulse rate 40-100 bpm
  • Subjects must weigh 50-100 kg to participate in this study with a BMI within 19-26.
  • Sufficient visual and auditory performance for neuropsychological testing
  • Written informed consent will be obtained prior to the start of any study procedures. Therefore, willingness and competence to sign the informed consent form is needed.
  • Potential patients must be able to communicate well with the investigator and comply with the requirements of the study
  • Only participants who are legally authorized to give informed consent will be included in the present study.

Age in the registry: 18 years to 65 years · Sex: All · Accepts healthy volunteers

Full criteria on ClinicalTrials.gov

Sites (1)

Sites in registry order. Pick your city on the disease page to sort them by distance.

SiteCityCountrySite status
Medical University of Vienna
Coordinator of this site? Confirm its status
ViennaAustriaRecruiting

This page is information, not medical advice. Discuss any trial with your doctor.