Major Depressive Disorder
Conditions
Brief summary
The investigators will be looking at MAO-A density before and after seven weeks of treatment with an antidepressant and dietary supplement. MAO-A is an enzyme that breaks down brain chemicals that regulate mood. MAO-A density is elevated in patients with major depressive episodes (MDE) secondary to major depressive disorder (MDD). Many remain treatment resistant with common antidepressant treatments and we think it may be due to poor targeting of brain pathologies. We want to test if adding a dietary supplement may normalize MAO-A.
Detailed description
All subjects are getting the combined treatment of a selective serotonin reuptake inhibitor and the dietary supplement. There are two possible selective serotonin reuptake inhibitor treatments but the dietary supplement remains the same. No subjects are receiving the selective serotonin reuptake inhibitor alone and no subjects are receiving the dietary supplement alone. The dietary supplement is called n-acetylcysteine.
Interventions
DRUGSertraline
selective serotonin reuptake inhibitor
DRUGCitalopram
selective serotonin reuptake inhibitor
DRUGN-acetylcysteine (NAC)
natural health product
DRUGExisting depression medication treatment
Continuation of depression medication treatment already taken prior to study enrollment except for drugs with affinity for MAO-A or potentially influencing MAO-A levels, including phenelzine, tranylcypromine, moclobemide, cytomel and lithium
Sponsors
Centre for Addiction and Mental Health
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 49 Years
Healthy volunteers
No
Inclusion criteria
* DSM-IV diagnosis of current major depressive episode and major depressive disorder * Hamilton Depression Rating Scale score of at least 20
Exclusion criteria
* Comorbid axis I or II disorders * Antidepressant use in past 6 months * Current use of herbal remedies * Cigarette smoking * Drug or medication use within past 8 weeks * History of substance abuse/neurotoxin use * History of psychotic symptoms * History of CNS medical illness * Current substance use * Test positive on pregnancy test (women)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| MAO-A distribution volume with positron emission tomography | before and after treatment, 7 weeks on average between measures | Treatment take 1 week for titration and 6 weeks at full dose=7weeks average |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hamilton Depression Rating Scale Score | before and after treatment, 7 weeks on average between measures | Treatment takes 1 week for titration and 6 weeks at full dose=7 weeks average |
| Magnetic Resonance Spectroscopy (n-acetylaspartate and glutathione levels) | before and after treatment, 7 weeks on average between measures | Treatment takes 1 week for titration and 6 weeks at full dose=7 weeks average |
| Blood markers of monoamine oxidase-A fragment level and glutathione level | before and after treatment, 7 weeks on average between measures | Treatment takes 1 week for titration and 6 weeks at full dose=7 weeks average |
Countries
Canada
Outcome results
None listed