Search Clinical Trials
Before medications are approved by the U.S. Food and Drug Administration (FDA) or before certain therapy methods are widely accepted as effective, they are tested on people who volunteer to participate in a clinical trial.
Organizations across the country are looking for people like you to take part in their research studies. The list of studies below have been selected from ClinicalTrials.gov based on their inclusion of one or more of the following terms: anxiety disorders, depression, OCD, PTSD, and bipolar disorder.
The Anxiety and Depression Association of America (ADAA) is supportive of research that is conducted through clinical trials. Participating in research can potentially help change the mental health outcomes for you and others who suffer anxiety, depression, and related disorders. You may learn about new interventions/treatments that are being considered.
Read this ADAA blog about things to know and questions to ask before committing to a clinical trial.
This website page is brought to you in partnership with ResearchMatch.
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A Phase 2 Study of NTX-1472 in Social Anxiety Disorder
Newleos Therapeutics, Inc.
Social Anxiety Disorder (SAD)
The primary goal of this Phase 2 clinical trial is to determine the effects of a novel
V1a receptor antagonist (NTX-1472) in adults with Social Anxiety Disorder (SAD). The main
questions this trial aims to answer are:
- Is NTX-1472 safe and well tolerated in adults with SAD?
- How effective1 expand
The primary goal of this Phase 2 clinical trial is to determine the effects of a novel V1a receptor antagonist (NTX-1472) in adults with Social Anxiety Disorder (SAD). The main questions this trial aims to answer are: - Is NTX-1472 safe and well tolerated in adults with SAD? - How effectively does NTX-1472 treat adults with SAD? Researchers will compare the effects of NTX-1472 with matching placebo (a look-alike capsule that contains no drug). Participants will: - Take NTX-1472 or matching placebo every day for 8 weeks - Visit the clinic 6 times over the course of 14 weeks for checkups and tests Type: Interventional Start Date: Dec 2025 |
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Modulating Anxious Coping
Medical University of South Carolina
Anxiety Disorders
This is a study to find out if a device that temporarily alters brain activity
(repetitive transcranial magnetic stimulation, rTMS) might be used to change how people
with anxiety or related concerns cope with feared or anxiety-producing situations. The
study is recruiting people who recently start1 expand
This is a study to find out if a device that temporarily alters brain activity (repetitive transcranial magnetic stimulation, rTMS) might be used to change how people with anxiety or related concerns cope with feared or anxiety-producing situations. The study is recruiting people who recently started treatment for anxiety or a related concern. The study involves 3 visits to the Medical University of South Carolina. At the first visit, participants do interviews and surveys asking about anxiety and related concerns, and they also do tasks where they see and react to emotional pictures while their brain activation is measured. At the next two visits, participants receive rTMS, which works by rapidly turning a focused magnetic field on and off repeatedly over the head in a way that passes directly through the hair, scalp, and skull and onto the brain and can temporarily increase brain activity under the magnetic field. After rTMS, participants do two tasks where they see and react to emotional situations while wearing sensors on their hand, arms, face, and head. Each visit in this study is expected to last between 2 - 4 hours. This is not a treatment study, but the study is being conducted with the hope that it will help improve treatment in the future. Type: Interventional Start Date: Jun 2021 |
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Determining the Potential for Efficacy of OTX-601 in Reducing PTSD Symptoms
Oui Therapeutics, Inc.
PTSD
Post Traumatic Stress Disorder
This study is exploring the efficacy of a digital therapeutic app in reducing symptoms of
posttraumatic stress disorder (PTSD) in adults. expand
This study is exploring the efficacy of a digital therapeutic app in reducing symptoms of posttraumatic stress disorder (PTSD) in adults. Type: Interventional Start Date: Dec 2025 |
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Transcranial Alternating Current Stimulation (tACS) for the Treatment of Anxiety in Veterans: An Op1
Birmingham VA Health Care System
Anxiety
Transcranial alternating current stimulation (tACS) in a wearable brain stimulation
device that delivers a low intensity, pulsed, alternating current via scalp electrodes.
Prior sham-controlled clinical trials have shown the therapeutic effects and safety of
tACS for the treatment of anxiety and de1 expand
Transcranial alternating current stimulation (tACS) in a wearable brain stimulation device that delivers a low intensity, pulsed, alternating current via scalp electrodes. Prior sham-controlled clinical trials have shown the therapeutic effects and safety of tACS for the treatment of anxiety and depression. In addition, tACS is rapid acting and well tolerated. After the device is issued to the patient during an in-office orientation and training session, the tACS device can be safely used by the patient at the convenience of their own home. Up to 40 Veterans under that age of 70 who have clinically significant anxiety will be enrolled in an 8-week open-label trial of Model FW-200 tACS to evaluate feasibility, acceptability, adherence and impact on anxiety, depression, post-traumatic stress disorder (PTSD), sleep and neurocognitive measures. Participants may have a concurrent diagnosis of major depressive disorder (MDD) and/or PTSD. Type: Interventional Start Date: Dec 2025 |
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A Study of Brenipatide in Adult Participants With Bipolar Disorder (RENEW-Bipolar-1)
Eli Lilly and Company
Bipolar Disorder
The purpose of this study is to assess the efficacy and safety of brenipatide when
administered with standard of care (SoC), compared with placebo plus SoC in delaying the
worsening of bipolar disorder symptoms.
The trial is divided into three periods as follows: Screening period that will last
ap1 expand
The purpose of this study is to assess the efficacy and safety of brenipatide when administered with standard of care (SoC), compared with placebo plus SoC in delaying the worsening of bipolar disorder symptoms. The trial is divided into three periods as follows: Screening period that will last approximately 1 month, treatment period that will last a minimum of 6 months, and the follow up period that will last approximately 2 months. The duration of study participation may vary and may be shortened if bipolar symptoms worsen or if withdrawal from the study occurs for any reason. Type: Interventional Start Date: Nov 2025 |
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A Randomized Study of Azetukalner Versus Placebo in Depressive Episodes Associated With Bipolar I o1
Xenon Pharmaceuticals Inc.
Bipolar Disorder
Bipolar Depression
Bipolar I Disorder
Bipolar II Disorder
X-CEED is a Phase 3, multicenter, randomized, double-blind, placebo-controlled study to
evaluate the efficacy and safety of azetukalner in adult participants diagnosed with
bipolar I or II disorder who are currently in a depressive episode (bipolar depression). expand
X-CEED is a Phase 3, multicenter, randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of azetukalner in adult participants diagnosed with bipolar I or II disorder who are currently in a depressive episode (bipolar depression). Type: Interventional Start Date: Aug 2025 |
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Neurofeedback to Treat Depression - 2
University of Pennsylvania
Major Depressive Disorder (MDD)
This study tests the efficacy of a new psychotherapeutic strategy for reducing negative
attention bias (and therefore depression severity) in participants with MDD. This
real-time fMRI neurofeedback therapy uses cloud-based pattern classification to decode a
patient's attentional state and dynamica1 expand
This study tests the efficacy of a new psychotherapeutic strategy for reducing negative attention bias (and therefore depression severity) in participants with MDD. This real-time fMRI neurofeedback therapy uses cloud-based pattern classification to decode a patient's attentional state and dynamically modulate task stimuli (in a closed loop) based on this state. Type: Interventional Start Date: Nov 2025 |
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Change in Social Media Use and Well-being Among College Students Receiving a Two-week Exercise or M1
Johns Hopkins Bloomberg School of Public Health
Social Media Addiction
Anxiety
Depression Disorder
Wellbeing
The investigators will be randomizing 300 college student participants with high levels
of social media use into either a 1) control condition (no intervention), a 2)
mindfulness meditation cognitive intervention, or 3) a social media reduction + exercise
replacement intervention. Participants comp1 expand
The investigators will be randomizing 300 college student participants with high levels of social media use into either a 1) control condition (no intervention), a 2) mindfulness meditation cognitive intervention, or 3) a social media reduction + exercise replacement intervention. Participants complete intervention activities daily for two weeks. The investigators will collect self-report and behavioral measures of social media use and related psychological constructs at three time points: baseline, immediately after the intervention period, and one-week after the intervention period (three weeks from baseline). Type: Interventional Start Date: Aug 2025 |
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A Study to Evaluate the Efficacy and Safety of SPT-300 (GlyphAllo) in Participants With Major Depre1
Seaport Therapeutics
Major Depressive Disorder (MDD)
Major Depressive Disorder With Anxious Distress
This is a randomized, parallel-group, double-blind, placebo-controlled, monotherapy study
to evaluate the efficacy, safety, and tolerability of SPT-300 (GlyphAllo) in adults with
major depressive disorder (MDD), with or without anxious distress. expand
This is a randomized, parallel-group, double-blind, placebo-controlled, monotherapy study to evaluate the efficacy, safety, and tolerability of SPT-300 (GlyphAllo) in adults with major depressive disorder (MDD), with or without anxious distress. Type: Interventional Start Date: Jun 2025 |
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A Study to Assess the Long-term Safety of KarXT for the Treatment of Manic Episodes in Bipolar-I Di1
Bristol-Myers Squibb
Bipolar Disorder Type I With Mania
This is a phase 3, open-label extension study to assess the long-term safety of KarXT for
the treatment of mania or mania with mixed features in Bipolar-I disorder (BP-I)
The primary objective of the study is to evaluate the long-term safety and tolerability
of KarXT in the treatment of participan1 expand
This is a phase 3, open-label extension study to assess the long-term safety of KarXT for the treatment of mania or mania with mixed features in Bipolar-I disorder (BP-I) The primary objective of the study is to evaluate the long-term safety and tolerability of KarXT in the treatment of participants with mania or mania with mixed features associated with BP-I. Type: Interventional Start Date: Jul 2025 |
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The Exhale Study: Treating Maternal Depression in an Urban Pediatric Asthma Clinic
Children's National Research Institute
Asthma in Children
Depression
The goal of this clinical trial is to test the effectiveness and implementation of
delivering Enhanced Brief Interpersonal Psychotherapy (IPT-B), an evidence-based maternal
depression treatment, to mothers of children under the age of 18 in an urban pediatric
asthma clinic. Researchers will compare1 expand
The goal of this clinical trial is to test the effectiveness and implementation of delivering Enhanced Brief Interpersonal Psychotherapy (IPT-B), an evidence-based maternal depression treatment, to mothers of children under the age of 18 in an urban pediatric asthma clinic. Researchers will compare Enhanced IPT-B and supplemented usual care (brief care coordination). The main questions the trial aims to answer are: 1. Does Enhanced IPT-B decrease maternal depressive symptoms? 2. Does Enhanced IPT-B improve child asthma management and health outcomes (exacerbations, symptoms, control)? 3. What are the preliminary implementation outcomes of delivering Enhanced IPT-B in an urban pediatric asthma clinic? Type: Interventional Start Date: Oct 2024 |
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Adaptive Coping Skills Training to Improve Psychological Distress Among Cardiorespiratory Failure S1
Duke University
Depression
Anxiety
Post-traumatic Stress Disorder
Stress
Worries; Pain or Disability
Conditions treated in intensive care units (ICUs) such as the acute respiratory distress
syndrome (ARDS), congestive heart failure, COVID pneumonia, and sepsis are common. These
can lead to high rates of depression, anxiety, and PTSD that worsen quality of life. Yet
there are few effective strategi1 expand
Conditions treated in intensive care units (ICUs) such as the acute respiratory distress syndrome (ARDS), congestive heart failure, COVID pneumonia, and sepsis are common. These can lead to high rates of depression, anxiety, and PTSD that worsen quality of life. Yet there are few effective strategies able to overcome barriers of limited access to mental health care. Even less is known about the experiences of patients from racially and ethnically minoritized populations because of they haven't been included well in past research. To address this problem, the investigators developed Blueprint, a mobile app that coaches people to use adaptive coping skills to self-manage their symptoms. The investigators found that it reduced depression symptoms and improved quality of life compared to placebo. To confirm these promising findings, the investigators are doing a formal test of Blueprint. The investigators will enroll 400 people who received ICU care from 4 hospitals (Duke, UCLA, Colorado, and Oregon). These patients will be randomized to receive either the Blueprint mobile app or a special Education Program mobile app the investigators developed. -both delivered through similar mobile app platforms. Our specific aims are to see which program improves symptoms better across 6 months of follow up. This project addresses national research priorities and could advance the field with a personalizable yet population-focused therapy that could be scaled broadly and efficiently to enhance mental health equity. Type: Interventional Start Date: Oct 2024 |
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Very Brief Exposure: Development of a Novel Exposure Modality for Social Anxiety Disorder in Transi1
Children's Hospital Los Angeles
Social Anxiety Disorder
The goal of this clinical trial is to identify the circuit activations by very brief
exposure (VBE) among youth with social anxiety disorder (SAD) in order to develop a novel
intervention for those with SAD. The secondary objectives of this study are to measure
the effect of VBE on subjective fear1 expand
The goal of this clinical trial is to identify the circuit activations by very brief exposure (VBE) among youth with social anxiety disorder (SAD) in order to develop a novel intervention for those with SAD. The secondary objectives of this study are to measure the effect of VBE on subjective fear ratings, and participants' awareness and tolerance of the exposure stimuli. - The primary outcome of this study is the mean activation of frontostriatal and prefrontal brain regions to facial stimuli, as measured by Blood Oxygen Level Dependent (BOLD) response, in 4 regions of interest during the magnetic resonance imaging (MRI). - Another primary outcome of the study is to identify networks of regions subserving emotion regulation and attention, as measured by BOLD response of corresponding brain regions. Secondary Outcomes -The secondary outcome of this study is the fear induced by exposure to facial expression stimuli as measured by a 4-point fear scale during the functional magnetic resonance imaging (fMRI) after each block of 10 facial expression stimuli trials. Participants will participate in an interview where they will answer questions both inside and outside of the MRI scan. Participants will be asked to rate on a scale the imagines they see while undergoing MRI scan. Type: Interventional Start Date: Aug 2024 |
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Ketamine-assisted Integrative Treatment for Veterans With Chronic Low Back Pain and Comorbid Depres1
VA Office of Research and Development
Chronic Low Back Pain
Depression
This is a pilot study to evaluate the feasibility, acceptability, and safety of ketamine
infusions followed by a brief behavioral intervention in Veterans with chronic low back
pain and depression. expand
This is a pilot study to evaluate the feasibility, acceptability, and safety of ketamine infusions followed by a brief behavioral intervention in Veterans with chronic low back pain and depression. Type: Interventional Start Date: Dec 2025 |
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A Study to Assess Change in Disease Activity and Adverse Events (AEs) With Cariprazine in the Treat1
AbbVie
Depression
Bipolar I Disorder
Bipolar disorder is a severe chronic mood disorder that affects up to 4% of the adult
population and 1.8% of the pediatric population in the United States. The treatment of
the depressive episodes of bipolar disorder in the pediatric population has not been as
widely studied as the treatment of dep1 expand
Bipolar disorder is a severe chronic mood disorder that affects up to 4% of the adult population and 1.8% of the pediatric population in the United States. The treatment of the depressive episodes of bipolar disorder in the pediatric population has not been as widely studied as the treatment of depressive episodes in bipolar disorder in adults, therefore pharmacotherapeutic options are limited. Given the change in disease state and safety demonstrated in adults with depressive episodes associated with bipolar I disorder, the purpose of this study is to evaluate the change in disease state and safety of cariprazine in the treatment of depressive episodes associated with bipolar I disorder in the pediatric population. Cariprazine is an approved drug for the treatment of depressive episodes in adult participants with bipolar I disorder. Study doctors put participants in 1 of 2 groups, called treatment arms. There is a 1 in 2 chance that a participant will be assigned to placebo. Around 380 Participants ages 10-17 years with bipolar I disorder will be enrolled in approximately 60 sites worldwide. Participants receiving the study drug will receive Dose A or B of Cariprazine based on age and weight. At Week 3, participants with insufficient response will have their dose increased to Dose B or Dose C, while participants with sufficient response will continue receiving the Dose A or B for the remainder of the treatment period. The treatment period will be followed by a safety follow-up (SFU) period for 4 weeks. There may be higher treatment burden for participants in this trial compared to their standard of care. Participants will attend regular weekly visits during the study at a hospital or clinic. The effect of the treatment will be checked by medical assessments, blood tests, checking for side effects and completing questionnaires. Type: Interventional Start Date: Apr 2021 |
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Optimizing Brain Excitability in Depression
Stanford University
Major Depressive Disorder
The goal of this study is to improve depression treatment by establishing reliable
prefrontal excitability markers through Targeting with Automated Real-time Guidance for
Enhancing TEPs (TARGET). expand
The goal of this study is to improve depression treatment by establishing reliable prefrontal excitability markers through Targeting with Automated Real-time Guidance for Enhancing TEPs (TARGET). Type: Interventional Start Date: Oct 2025 |
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Accelerated TMS for MDD
Neuronetics
Major Depressive Disorder
An open-label, multi-center, prospective study to evaluate feasibility and efficacy of
accelerated TMS for patients with Major Depressive Disorder (MDD). expand
An open-label, multi-center, prospective study to evaluate feasibility and efficacy of accelerated TMS for patients with Major Depressive Disorder (MDD). Type: Interventional Start Date: Aug 2025 |
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GATE-251 or Placebo for the Reduction of Symptoms of Major Depressive Disorder With Comorbid Anxiet1
Syndeio Biosciences, Inc
Major Depressive Disorder
The goal of this clinical trial is to learn if GATE-251 works to treat depression in
adults. It will also learn about the safety of GATE-251. The main questions it aims to
answer are:
Does GATE-251 reduce depression scores in participants compared to participants who take
a placebo (a look-alike t1 expand
The goal of this clinical trial is to learn if GATE-251 works to treat depression in adults. It will also learn about the safety of GATE-251. The main questions it aims to answer are: Does GATE-251 reduce depression scores in participants compared to participants who take a placebo (a look-alike tablet that contains no GATE-251)? What medical problems are observed in participants who take GATE-251? Participants will take one tablet of GATE-251 or placebo every week for 6 weeks. Participants will visit the clinic every week of the 6 week period to have the severity of their depression evaluated. Type: Interventional Start Date: Dec 2025 |
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Visual Perception in Schizophrenia
University of Rochester
Schizophrenia Disorders
Bipolar Disorder
Schizo Affective Disorder
This study aims to identify novel markers of psychosis using electroencephalography
(EEG). expand
This study aims to identify novel markers of psychosis using electroencephalography (EEG). Type: Interventional Start Date: Nov 2025 |
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Ketamine for Pain, Opioid Use, and Mental Health in Orthopedic Trauma Patients
Texas Tech University Health Sciences Center
Orthopedic Trauma Surgery Patients
Postoperative Pain
Opioid Use
Depression
Post-traumatic Stress Disorder (PTSD)
The goal of this clinical trial is to learn if ketamine, given during surgery, can help
improve recovery for adults with serious orthopedic trauma. The study will test whether
ketamine reduces pain, lowers the need for opioids, and improves mental health outcomes
like depression and post-traumatic1 expand
The goal of this clinical trial is to learn if ketamine, given during surgery, can help improve recovery for adults with serious orthopedic trauma. The study will test whether ketamine reduces pain, lowers the need for opioids, and improves mental health outcomes like depression and post-traumatic stress disorder (PTSD). The main questions it aims to answer are: Does ketamine reduce pain after surgery compared to standard anesthesia? Does ketamine reduce the amount of opioids patients need for pain control? Does ketamine improve symptoms of depression and PTSD after orthopedic trauma? Researchers will compare patients who receive ketamine during surgery with those who receive standard anesthesia without ketamine to see if ketamine helps improve both physical and psychological recovery. Participants will: Be randomly assigned to receive either a single dose of ketamine or standard anesthesia during surgery. Report their pain using a simple pain scale (Visual Analog Scale, VAS). Complete short surveys about mood and mental health (PHQ-9 for depression and PCL-5 for PTSD) at several time points after surgery. Allow the research team to review their electronic medical records to measure opioid prescriptions during recovery. Attend follow-up visits in clinic or by secure telehealth (e.g., Zoom) at 1-7 days, 2-3 weeks, 6 weeks, 3 months, and 6 months after surgery Type: Interventional Start Date: Nov 2025 |
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Integrated Treatment for Opioid Use Disorder and PTSD
Medical University of South Carolina
Opioid Use Disorder
Posttraumatic Stress Disorder (PTSD)
This study will test a therapy intervention, HOPE, for individuals with opioid use
disorder and posttraumatic stress disorder. Interested individuals will need to be taking
medications for opioid use disorder (e.g., suboxone, naltrexone, methadone). Interested
participants will complete a 10-12 wee1 expand
This study will test a therapy intervention, HOPE, for individuals with opioid use disorder and posttraumatic stress disorder. Interested individuals will need to be taking medications for opioid use disorder (e.g., suboxone, naltrexone, methadone). Interested participants will complete a 10-12 week therapy, and be asked to complete surveys. Type: Interventional Start Date: Mar 2025 |
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Treating Major Depression With Yoga Mono-therapy
University of California, San Francisco
Depression Mild
Depression Moderate
The goal of this single-center, single-blind, randomized, controlled, parallel group,
interventional trial is to evaluate antidepressant efficacy of yoga monotherapy of
12-weeks duration in 180 adults meeting diagnostic criteria for mild-to-moderate major
depression at the Zuckerberg San Francisco1 expand
The goal of this single-center, single-blind, randomized, controlled, parallel group, interventional trial is to evaluate antidepressant efficacy of yoga monotherapy of 12-weeks duration in 180 adults meeting diagnostic criteria for mild-to-moderate major depression at the Zuckerberg San Francisco General Hospital. Researchers will compare the yoga interventions to an education control intervention on holistic healthcare. Type: Interventional Start Date: Oct 2024 |
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Mood and Thought Process Study
Butler Hospital
Depression in Remission
Depressive Symptoms
Depression
The primary objective for this project is to test whether affective executive functioning
is a mechanism of action of mindfulness-based cognitive therapy and Wellness for
Wellbeing. The main questions it aims to answer are:
1. Test the effect of MBCT vs. Wellness for Wellbeing on affective inhib1 expand
The primary objective for this project is to test whether affective executive functioning is a mechanism of action of mindfulness-based cognitive therapy and Wellness for Wellbeing. The main questions it aims to answer are: 1. Test the effect of MBCT vs. Wellness for Wellbeing on affective inhibition (i.e., emotionally valenced inhibition as measured via the affective Go/No Go task) using an RCT. 2. Test the effect of MBCT vs. Wellness for Wellbeing on (a) affective updating and (b) affective shifting. Outcomes will be measured with the affective n-Back and the affective Internal Switching Task, respectively. 3a) The investigators will examine whether depression symptom severity co-varies with change in affective executive functioning (i.e., affecting inhibition, shifting, and updating) over time. 3b) The investigators will examine whether compliance with treatment protocol (e.g., number of classes attended, amount of home practice) predicts endpoint executive functioning. Participants will complete surveys, interviews, and computer tasks, and will be randomized to either Mindfulness-Based Cognitive Therapy or Wellness for Wellbeing. Type: Interventional Start Date: Apr 2023 |
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Cortical Inhibition as a Biomarker of Response in a Comparison of Bilateral Versus Unilateral Accel1
University of California, San Diego
Suicidal Ideation
Treatment-resistant Depression
This is a prospective clinical trial to confirm the effectiveness of bilateral
accelerated theta burst stimulation (aTBS) on suicidal ideation (SI), while exploring
cortical inhibition measures in this treatment paradigm. In this proposed study, the
investigators will evaluate the anti-suicidal eff1 expand
This is a prospective clinical trial to confirm the effectiveness of bilateral accelerated theta burst stimulation (aTBS) on suicidal ideation (SI), while exploring cortical inhibition measures in this treatment paradigm. In this proposed study, the investigators will evaluate the anti-suicidal effects of bilateral aTBS over the DLPFC compared to accelerated intermittent theta burst stimulation (aiTBS) over the left DLPFC in participants with TRD and SI. Additionally, the investigators aim to identify neurophysiological targets through which bilateral aTBS induces remission of SI in TRD differentially from aiTBS. Type: Interventional Start Date: Sep 2022 |
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Combination of Novel Therapies for CKD Comorbid Depression
Stony Brook University
Chronic Kidney Diseases
Major Depressive Disorder
End Stage Kidney Disease (ESRD)
The overall goal of the study is to determine if treatment of a Major Depressive Disorder
(MDD) improves the outcomes of patients with chronic kidney disease (CKD). We showed that
MDD is present in 25% of CKD patients and independently associated with progression to
End-Stage Kidney Disease, hospit1 expand
The overall goal of the study is to determine if treatment of a Major Depressive Disorder (MDD) improves the outcomes of patients with chronic kidney disease (CKD). We showed that MDD is present in 25% of CKD patients and independently associated with progression to End-Stage Kidney Disease, hospitalization, and death. Depression is also associated with lower quality of life (QOL), fatigue, poor sleep, and non-adherence to diet and medications. However, evidence for efficacy and tolerability of commonly-used antidepressant medications or nonpharmacologic treatments are limited in CKD patients. Our group was the first to conduct a double-blind randomized controlled trial for MDD treatment in 201 patients with non-dialysis CKD, and showed that sertraline, a commonly used selective serotonin reuptake inhibitor (SSRI), was no more efficacious than placebo for improving depressive symptoms. It becomes imperative to test novel strategies to treat MDD in CKD. We propose to compare with a control group, the efficacy and tolerability of two novel treatment strategies - (1) Behavioral Activation Teletherapy (BAT) for 16 weeks, with the addition of bupropion, a non-SSRI antidepressant, at 8 weeks for patients whose depression has not remitted (non-remitters); and (2) bupropion for 16 weeks, with the addition of BAT at 8 weeks for non-remitters. In Aim 1, we will investigate the efficacy and tolerability of these 2 strategies vs. control for improvement in a primary endpoint of depressive symptoms in 201 patients (67 per group) with CKD stages 3b-5 and MDD at 2 sites, randomized 1:1:1 to either strategy or a control group of Clinical Management plus placebo. We hypothesize that either approach vs. control will result in a minimal clinically important difference of 2 points improvement in depressive symptoms, as ascertained blindly by the Quick Inventory of Depressive Symptomatology. In Aim 2 we will investigate the efficacy and tolerability of 8 weeks of (1) single-blind BAT plus placebo or (2) double-blind bupropion plus Clinical Management vs. control for improvement in depressive symptoms. In Aim 3, we will compare the efficacy of these 2 treatments strategies vs. control for improvement in CKD patient-centered outcomes including a. adherence to medications and healthcare visits; b. fatigue; c. sleep; and d. overall functioning. A clinical trial is urgently needed to address the evidence gap that exists for MDD treatment in CKD patients. Type: Interventional Start Date: Sep 2020 |