Unipolar Depression
Conditions
Keywords
repetitive Transcranial Magnetic Stimulation (rTMS), Major depressive disorders, Depression, Venlafaxine
Brief summary
The purpose of this study is to assess the efficacy of add-on therapy with repetitive Transcranial Magnetic Stimulation (rTMS) and venlafaxine in the treatment of major depressive disorders compared to venlafaxine only (the optimal medication) and to rTMS only.
Detailed description
rTMS parameters : Intensity of 120% of individually determined motor threshold; frequency : 1 Hz; 360 impulsions; on period : 1 min; off period : 30 s.
Interventions
active venlafaxine LP 75 mg : 1 capsule per day for 3 days, then 2 per day for 2 to 4 weeks, if necessary 3 per day the next 2 weeks. active rTMS : 5 sessions per week for 2 to 6 weeks
active rTMS : 5 sessions per week for 2 to 6 weeks sham venlafaxine LP 75 mg : 1 capsule per day for 3 days, then 2 per day for 2 to 4 weeks, if necessary 3 per day the next 2 weeks.
sham rTMS : 5 sessions per week for 2 to 6 weeks active venlafaxine LP 75 mg : 1 capsule per day for 3 days, then 2 per day for 2 to 4 weeks, if necessary 3 per day the next 2 weeks.
Sponsors
Study design
Eligibility
Inclusion criteria
* Adults * Clinical diagnosis of major depressive disorder (DSM-IV) * HDRS-17 items \> 20 * Failure of one antidepressant treatment (efficacious doses for 6 weeks at least)
Exclusion criteria
* I or II bipolar disorder * Psychotic features * Failure of one previous venlafaxine treatment * Addiction comorbidity or schizophrenia comorbidity * Involuntary hospitalization * Seizures history * Pregnancy or breastfeeding * Somatic comorbidity able to impact on cognitive functions
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome measure is remission. It will be evaluated using the Hamilton Depression Rating Scale (HDRS-17 < 8)and Montgomery Asberg Depression Rating Scale (MADRS) | 2 to 6 weeks |
Secondary
| Measure | Time frame |
|---|---|
| Onset of action for remission and response (HDRS-17 diminution > 50%) | 2 to 6 weeks |
| Anxiety will be assessed using the Covi Anxiety Scale. | 2 to 6 weeks |
| Side effects will be assessed using the UKU Scale. | 2 to 6 weeks |
| Evaluation of depression using 2 other scales : the Montgomery Asberg Depression Rating Scale (MADRS) and the Beck Depression Inventory scale (BDI-13) | 2 to 6 weeks |
| Onset of action using the Clinical Global Impressions scale (CGI) | 2 to 6 weeks |
Countries
France, Monaco