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Clinical trial comparing early medication change with treatment as usual in patients with Major Depressive Disorder-EMC

Randomised clinical trial comparing early medication change (EMC) strategy with treatment as usual (TAU) in patients with Major Depressive Disorder – the EMC trial. - EMC

Status
Active, not recruiting
Phases
Unknown
Study type
Interventional
Source
EU CTR
Registry ID
EUCTR2008-008280-96-DE
Enrollment
940
Registered
2009-07-14
Start date
2009-08-10
Completion date
Unknown
Last updated
2014-08-05

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Major Depressive disorder (MDD) MedDRA version: 14.1 Level: LLT Classification code 10025454 Term: Major depressive disorder, recurrent episode System Organ Class: 10037175 - Psychiatric disorders MedDRA version: 14.1 Level: LLT Classification code 10053708 Term: Major depressive disorder with melancholic features System Organ Class: 10037175 - Psychiatric disorders MedDRA version: 14.1 Level: LLT Classification code 10025453 Term: Major depressive disorder NOS System Organ Class: 10037175 -

Interventions

Sponsors

Department of Psychiatry and Psychotherapy, University of Mainz
Lead Sponsor

Eligibility

Sex/Gender
All

Inclusion criteria

Inclusion criteria: • Major Depressive Disorder (MDD), first episode or recurrent, according to DSM-IV • A HAMD17 score of =18 pts. • Age between 18 and 65 years and age = 60 years at the time of the first depressive episode • Ability of subject to understand character and individual consequences of clinical trial • Signed and dated informed consent of the subject must be available before start of any specific trial procedures. Are the trial subjects under 18? no Number of subjects for this age range: 0 F.1.2 Adults (18-64 years) yes F.1.2.1 Number of subjects for this age range 940 F.1.3 Elderly (>=65 years) no F.1.3.1 Number of subjects for this age range

Exclusion criteria

Exclusion criteria: • Acute risk of suicide needing an intervention not comprised by protocol treatment (e.g. electroconvulsive therapy) • Patients with a lifetime DSM-IV diagnosis of dementia, schizophrenia, schizoaffective disorder, bipolar disorder • Patients with a current DSM-IV diagnosis of posttraumatic stress disorder, obsessive-compulsive disorder, anxiety disorder, or eating disorder and the requirement of a treatment not comprised by protocol treatment. • Patients with DSM-IV substance dependency requiring acute detoxification. • Depression due to organic brain disorder, e.g. Multiple Sclerosis and Parkinson’s Disease • Women who are pregnant, breastfeeding or planning to become pregnant during the trial • Women who are not sterile by surgery or for more than two years postmenopausal or women with childbearing potential who not practicing a medically accepted contraception during trial (reliable contraception are systemic contraceptives (oral, implant, injection), diaphragm or condoms with spermicide, sexual abstinence) • A clear history of non-response to an adequate treatment trial in the current major depressive episode to any protocol antidepressant • Patients currently taking antidepressant medication, which has been started within the 2-4 weeks prior to study begin and a continuation of this antidepressant medication is clinically indicated • Medical or psychological condition that contraindicates the use of an investigational drug • History of hypersensitivity to the investigational medicinal product or to any drug with similar chemical structure or to any excipient present in the pharmaceutical form of the investigational medicinal product • Clinically significant or unstable medical or surgical condition that may preclude safe and complete study participation. Such conditions may include gastrointestinal, cardiovascular, vascular disease (particularly brady- and tachyarrhythmia, QT interval prolongation, congenital long QT syndrome, Torsades de pointes, heart failure NYHA class IV, myocardial infarction), pulmonary/respiratory, hepatic impairment, renal, metabolic diseases (particularly hypokalaemia or hypomagnesaemia), endocrinological, neurological, immune-deficiency, hematopoietic disease, or malignancies as determined by medical history, physical examination, or laboratory tests. • Participation in other clinical trials during the present clinical trial or within the last 6 months • Medical or psychological condition that would not permit signing of informed consent

Design outcomes

Primary

MeasureTime frame
Main Objective: The primary objective of the trial is to compare effectiveness of EMC with TAU in the treatment of Major Depressive disorder (MDD) in non-improvers on day 14 (level 1 of The EMC Trial).;Secondary Objective: The secondary objectives of the trial are: • to compare speed of recovery from MDD between EMC and TAU in non-improvers on day 14 (level 1 of The EMC trial) • to compare the side effect profile and safety of EMC and TAU in non-improvers on day 14 (level 1 of The EMC trial). • To compare changes in quality of life under EMC and TAU in non-improvers on day 14 (level 1 of The EMC trial). • to compare effectiveness, speed of recovery from MDD, changes in quality of life and side effect profile in subgroups of improvers on day 14 (levels 2 and 3 of The EMC trial) ;Primary end point(s): Remission from MDD, defined as a HAMD-17 sum score =7 on day 56;Timepoint(s) of evaluation of this end point: after 56 days

Secondary

MeasureTime frame
Secondary end point(s): - Response, defined as a HAMD17 sum score decrease =50% on day 56 - Absolute change of HAMD17 sum score [day 56-day 0] - Remission defined as IDS score = 11 on day 56 - Response defined as IDS score decrease =50% on day 56 - Time to remission and time to response according to IDS and HAMD17 - Remission from MDD, defined as a HAMD17 sum score = 7 on day 56 (subgroups of improvers on day 14) - Absolute change in SF12 subscales "physical component score" and "mental component score" [day 56-day 0] - Occurrence of adverse events, UKU ratings at all visits, relevant laboratory data and deviations from normal ECG;Timepoint(s) of evaluation of this end point: after 56 days

Countries

Germany

Contacts

Public ContactKlaus Lieb

Department of Psychiatry and Psychotherapy, University of Mainz

klaus.lieb@ukmainz.de496131177336

Outcome results

None listed

Source: EU CTR (via WHO ICTRP) · Data processed: Apr 1, 2026