Treatment-resistant depression Treatment-resistant depression
Conditions
Sponsors
Kishi Taro
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. The clinical trial will be described in detail to the individuals, and would be written informed consent will be obtained from all participants and their guardians 2. Individuals age: 18 >= years old and = 4, we will confirm the result from their medical records). If the individuals are receiving the combination therapy with two or more these drugs, we will select a candidate drug that had the highest dose of among the drugs (the Defined Daily Dose (https://www.who.int/tools/atc-ddd-toolkit/about-ddd). If there are two or more drugs that used the same equivalent dose during the same period, we will select one of these drugs for the evaluation of the definition. 5. Individuals who will have a HAM-D17 total score of 20 or higher at baseline
Exclusion criteria
Exclusion criteria: 1. Individuals with metal implants or devices close to the stimulation site (e.g., cochlear implants, surgical clips with magnetic properties, or neurostimulators such as deep brain stimulation or vagus nerve stimulation), individuals with a cardiac pacemaker 2. Individuals with metal implants or devices not close to the stimulation site (e.g., implanted medication pumps), titanium products in their heads, magnetic dentures/implants 3. Individuals with a history of seizures, a history of intracranial lesions at risk for seizures, individuals taking drugs that reduce seizure threshold (methylphenidate or ketamine), individuals with alcohol or stimulant use disorder or withdrawal, pregnant individuals, individuals with severe physical disease 4. Individuals with a history of receiving rTMS in the current depressive episode 5. Individuals diagnosed with dementia, organic or symptomatic mood disorder 6. Individuals with unimproved depressive symptoms due to poor adherence to pharmacological treatment 7. Individuals diagnosed with substance or medication-induced mood disorder 8. Individuals who will answer "yes" at baseline to the following questions: "Do you have any suicidal ideations although you do not have any plans for committing suicide? or "Do you have any suicidal ideations and any plans for committing suicide?" 9. Individuals judged to be inappropriate by researchers
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in depression symptoms (change from baseline to week 4 in MADRS total score) | — |
Secondary
| Measure | Time frame |
|---|---|
| Response* rate at any week of follow-up until week 4 * The definition Participant who will achieve a 50% or greater improvement in MADRS total score from baseline to week 4 Remission* rate at any week of follow-up until week 4 * The definition Participant will achieve a MADRS total score of 10 or less from baseline to week 4 Change in depression symptoms (change from baseline to day 5-7, week 2, and 6 in MADRS total score) Change in depression severity (change from baseline to day 5-7, week 2, 4, and 6 in CGI-S score) Change in treatment efficacy for depression (change from baseline to day 5-7, week 2, 4, and 6 in CGI-I score) Changes in the concentrations of the following brain metabolites from baseline to week 4 (NAA, Glu, Gln, Glx, Cho, mI, GABA) left dorsolateral prefrontal cortex left anterior cingulate cortex Changes in the gut microbiota from baseline to week 4 (16S rRNA gene amplicon sequencing) All-cause discontinuation Discontinuation due to adverse events Incidence of total adverse events Incidence of serious adverse events Mortality rate Incidences of individual adverse events | — |
Contacts
Public ContactTaro Kishi
Fujita Health University Hospital
Outcome results
None listed