Examining the Effects of Escitalopram and Memantine on Pattern Separation in Major Depressive Disorder
Jeffrey Miller
Summary
This study seeks to examine the effects of treatment with a selective serotonin reuptake inhibitor (SSRI), escitalopram, a first-line treatment for depression, in combination with placebo or with extended-release memantine, on neuropsychological function, regional brain activity assessed by functional magnetic resonance imaging, and depressive symptoms, in participants with Major Depressive Disorder. Escitalopram is administered in an open-label fashion in this study; extended release memantine is administered in a double-blind, randomized, placebo-controlled manner.
Description
Pattern separation is the process of separating overlapping sensory information, contexts, or experiences into distinct neural representations. In humans, deficits in pattern separation are believed to underlie overgeneralization seen in depression and post-traumatic stress disorder (PTSD). Cross-sectional data support the effects of SSRI medications on pattern separation. Specifically, a recent paper demonstrated patients with depression who responded to SSRI medication had improved pattern separation performance (mnemonic discrimination) of emotionally neutral stimuli than SSRI non-responder…
Eligibility
- Age range
- 18–50 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Age 18-50 * Current diagnosis of MDD without psychotic features assessed within three weeks of study enrollment * 17-item Hamilton Depression Rating Scale score ≥17 assessed within 3 weeks of study enrollment * Using an effective form of contraception at study enrollment and agrees to continue throughout study participation for individuals of child-bearing potential * Capacity to provide informed consent * Proficient in English * Willing to provide emergency contact Exclusion Criteria: * Currently taking an antidepressant medication at study enrollment * Pregnant or br…
Interventions
- DrugSSRI (escitalopram or sertraline)
11 weeks of open-label treatment with an SSRI, of which the last 6 weeks are augmented with memantine vs placebo. Primary SSRI for the study is escitalopram. In cases of prior intolerance or non-response to escitalopram, individuals will be treated with sertraline instead of escitalopram.
- DrugExtended-Release Memantine
6 weeks of treatment with extended-release memantine as augmentation to ongoing escitalopram treatment
- DrugPlacebo
6 weeks of treatment with placebo as augmentation to ongoing escitalopram treatment
Location
- New York State Psychiatric Institute (NYSPI)New York, New York