E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Diagnosis of a major depressive episode; inpatient at screening visit; suicidal
ideation/behaviour present defined by a clinical rating of ≥ 8 on the Sheehan
Suicidality Tracking Scale (S-STS) at screening and a rating of ≥20 on the Montgomery
Asberg Depression Scale (MADRS) at both screening and baseline visits; both
gender, age ≥18 years. |
|
E.1.1.1 | Medical condition in easily understood language |
patients who are severely depressive and have suicidal ideation or behaviour |
|
E.1.1.2 | Therapeutic area | Psychiatry and Psychology [F] - Mental Disorders [F03] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10012397 |
E.1.2 | Term | Depression suicidal |
E.1.2 | System Organ Class | 10037175 - Psychiatric disorders |
|
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary hypothesis of this confirmatory study is that lithium therapy will
acutely decrease suicidal ideation and/or suicidal behaviour in inpatients with a
major depressive episode (MDE, unipolar and bipolar disorder according to DSM
IV criteria). The specific aim is to test the hypothesis that lithium plus treatment
as usual (TAU), compared to placebo plus TAU, results in a significantly greater
decrease in suicidal ideation and/or behaviour over 5 weeks in inpatients with
MDE. |
|
E.2.2 | Secondary objectives of the trial |
The secondary aim is to observe the influence of the early lithium therapy on other psychometric scales and scores |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Diagnosis of a major depressive episode; inpatient at screening visit; suicidal
ideation/behaviour present defined by a clinical rating of ≥ 8 on the Sheehan
Suicidality Tracking Scale (S-STS) at screening visit and a rating of ≥20 on the Montgomery
Asberg Depression Scale (MADRS) at both screening and baseline visits; both
gender, age ≥ 18 years. |
|
E.4 | Principal exclusion criteria |
Contraindication for and history of lithium treatment within the past 6 months;
patient unable to tolerate lithium treatment in the past; comorbid
borderline/antisocial personality disorder, currently active substance
dependency; patients with acute or unstable severe medical conditions, patients
unable to understand the informed consent or involuntary inpatients, drug dependence (according to ICD10 or DSMIV and positive Diagnose in MINI), pregnancy and lactation |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Change in the clinician administered (S-STS) total score between initial and final
visit |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
day 35 after baseline (first intake) |
|
E.5.2 | Secondary end point(s) |
Change in the Columbia Suicide Severity Rating Scale (C-SSRS) total score between initial and final visit; MADRS response
rate (percent with ≥ 50% decrease from initial to final visit); remission rate
(MADRS of 12 or less) at final visit; change in MADRS, Hamilton Anxiety Scale (HAM-A),
Clinical Global Impression (CGI) and Barratt Impulsivity Scale (BIS) total score
between initial and final visit; weekly change in percent days with 0 score on SSTS
compared to initial visit; weekly change in C-SSRS, MADRS, HAM-A score, YMRS compared to initial visit; association between weekly change in MADRS; HAMA-A
total score and weekly change in SIS; comparison of the initial SIS, MADRS
and HAM-A total scores at the six sites; number and dose of concomitant
psychotropic medication; hours of psychotherapy patients receive. |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
|
E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 6 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
|
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 4 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |