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Trial registered on ANZCTR
Registration number
ACTRN12611000719932
Ethics application status
Approved
Date submitted
11/07/2011
Date registered
11/07/2011
Date last updated
8/10/2012
Type of registration
Prospectively registered
Titles & IDs
Public title
The impact of antidepressants and genetic polymorphisms on emotion.
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Scientific title
Impact of Escitalopram and Serotonin Transporter Polymorphisms on Emotion Processing and Regulation In Healthy Participants: A Randomised Controlled Trial
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Secondary ID [1]
262602
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None
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Universal Trial Number (UTN)
U1111-1122-8682
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Trial acronym
None
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Depression
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Anxiety
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Condition category
Condition code
Mental Health
268426
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0
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Depression
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Mental Health
268427
268427
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0
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Anxiety
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Mental Health
268428
268428
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0
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Studies of normal psychology, cognitive function and behaviour
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Escitalopram (single oral dose, 20mg)
crossed over with Placebo (saccharin, single oral dose) with a washout period of 7 days.
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Intervention code [1]
266944
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Treatment: Drugs
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Comparator / control treatment
Placebo (saccharin, single oral dose)
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Functional magnetic resonance imaging (fMRI) blood-oxygen level dependent (BOLD) responses during viewing of emotional images.
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Assessment method [1]
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Timepoint [1]
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At peak drug blood concentration (3-4 hours after administration).
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Primary outcome [2]
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Electroencephalogram (EEG) alpha asymmetry and heart rate variability (HRV) during rest and a stress test.
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Assessment method [2]
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Timepoint [2]
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At peak drug blood concentration (3-4 hours after administration).
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Secondary outcome [1]
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No expected differences or changes overtime on Depression, Anxiety and Stress Scales; Patient Health Questionnaire; GAD7 anxiety questionnaire; Early life stress; Ratings of emotional images for escitalopram or placebo conditions.
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Assessment method [1]
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Timepoint [1]
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Before administration of treatment and at peak drug blood concentration (3-4 hours after administration)
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Eligibility
Key inclusion criteria
Female
Aged 18-50
Caucasian (if recruitment is slow, we will remove this criterion)
Fluent in English
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Minimum age
18
Years
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Maximum age
50
Years
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Sex
Females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Not on any medication (minimum 1 month drug-free; with the exception of the contraceptive pill) or illicit drugs.
Pregnancy (which will be tested at each visit)
Breastfeeding
Drug or alcohol addiction
A history of brain injury, loss of consciousness, stroke, psychiatric, neurological disorder or other serious medical conditions (e.g., cardiovascular disease and diabetes).
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Subjects will contact the investigators after viewing an advertisement on a University's recruitment website, a poster, or a social media advertisement.
Allocation was conducted by an independent statistician and concealed using opaque envelopes.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
An independent statistician generated a computerised spreadsheet which randomly allocated (using block randomisation) for 25 subjects to have the escitalopram on the first visit and 25 subjects having the placebo first. This spreadsheet was then sent to the pharmacy who then manufactured identical capsules which are then provided to and administered by the investigators. Only the pharmacist will know what each participant received.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
19/07/2011
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
50
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
4231
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2065
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Recruitment postcode(s) [2]
4232
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2008
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Australian Research Council
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Address [1]
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1st Floor, 8 Briadabella Circuit
Briadabella Business Park
Canberra Airport ACT 2609
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Country [1]
267414
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Australia
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Primary sponsor type
University
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Name
The University of Sydney
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Address
The University of Sydney NSW 2006
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
266468
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Other collaborator category [1]
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Hospital
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Name [1]
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Royal North Shore Hospital
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Address [1]
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Royal North Shore Hospital
St Leonards NSW 2065
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Northern Sydney Central Coast NSW Health Human Research Ethics Committee
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Ethics committee address [1]
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Research Office Level 2, Building 51 Royal North Shore Hospital St Leonards NSW 2065
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
269382
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Approval date [1]
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17/05/2011
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Ethics approval number [1]
269382
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1101-027M
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Summary
Brief summary
Selective serotonin reuptake inhibitors (SSRIs) are a type of medication and are a first line treatment for major depression and anxiety. While recent studies have shown that neuroimaging and genetics may be used to predict response to SSRI treatment, (see Kemp, Gordon, Rush, & Willams, 2008 for review) basic experimental research is needed to determine exactly how the effects of SSRIs improve symptoms of depression and anxiety. Acute administration of SSRIs may increase processing of positive emotional information, providing a foundation for subsequent changes in thoughts and behaviour (see Harmer, 2008). In order to examine this further, a number of critical issues remain to be addressed. One such issue is the serotonin transporter (5HTT) gene. The different forms of this gene (5HTT polymorphisms; l/l, l/s, or s/s alleles) have been reported to moderate the impact of SSRIs on emotion perception (Hinkelmann et al., 2010). However, researchers are yet to examine the interacting roles of SSRIs and the 5HTT polymorphisms on emotional processing in realtime. A second issue is that researchers are yet to account for the different types of emotional processing and emotion regulation strategies under different conditions. Aims: The aims of this study are to examine the impact of acute administration of an SSRI (escitalopram oxalate) and 5HTT polymorphisms on covert and overt emotion processing and strategies to regulate this processing. Participants: 50 students will be recruited from first year Psychology students, genotyped and scanned under placebo and escitalopram conditions using a randomised controlled design. Given 5HTT polymorphisms frequencies of 30% (l/l), 50% (l/s), and 20% (s/s) it is expected that a minimum of 15 participants homozygous for the L allele and 35 participants with at least one copy of the S allele will be recruited. Treatment: Administration of escitalopram oxalate (20mg) or placebo (saccharin, an artificial sweetener). Participants will complete experimental tasks once peak absorption has been reached. One week later (for compete elimination of drug), participants will be administered the alternate treatment and complete the experimental tasks once again. Tasks: Data will be collected using functional magnetic resonance imaging (fMRI) during rest, covert and overt emotion processing of different images from the International Affective Picture System. Participants will be asked to either passively view or reappraise emotions evoked by the presented stimuli. Questionnaires: Depression, Anxiety and Stress Scales; Patient Health Questionnaire; GAD7 anxiety questionnaire; Early life stress; Ratings of emotional images Experimental Design: 2 Group (5HTT sallele, lallele) X 2 (escitalopram oxalate, placebo) within-subject design.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Tim Outhred
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Address
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CADE Clinic
Level 5, Building 36 Royal North Shore Hospital
St Leonards NSW 2065
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Country
16105
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Australia
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Phone
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+61 2 99267746
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Fax
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+61 2 99267730
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Email
16105
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[email protected]
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Contact person for scientific queries
Name
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Tim Outhred
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Address
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CADE Clinic
Level 5, Building 36 Royal North Shore Hospital
St Leonards NSW 2065
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Country
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Australia
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Phone
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+61 2 99267746
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Fax
7033
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+61 2 99267730
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Email
7033
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Dimensions AI
Impact of acute administration of escitalopram on the processing of emotional and neutral images: a randomized crossover fMRI study of healthy women
2014
https://doi.org/10.1503/jpn.130118
Dimensions AI
The impact of 5-HTTLPR on acute serotonin transporter blockade by escitalopram on emotion processing: Preliminary findings from a randomised, crossover fMRI study
2014
https://doi.org/10.1177/0004867414533837
Embase
Facilitation of emotion regulation with a single dose of escitalopram: A randomized fMRI study.
2015
https://dx.doi.org/10.1016/j.pscychresns.2015.07.018
Embase
Impact of 5-HTTLPR on SSRI serotonin transporter blockade during emotion regulation: A preliminary fMRI study.
2016
https://dx.doi.org/10.1016/j.jad.2016.02.019
N.B. These documents automatically identified may not have been verified by the study sponsor.
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