16-week Comparative Effectiveness Trial of Lamotrigine vs. Fluoxetine for Bipolar Depression
Stopped early · Phase 4
Conditions studied: Bipolar Disorder
In brief
The FLAME Study is a 16-week clinical trial to study treatment with lamotrigine or fluoxetine in bipolar I, II and bipolar schizoaffective depressed adults. The purpose of the trial is to have a better understanding of whether individuals with a particular gene type and other inherited biological markers will have a good response to fluoxetine or lamotrigine, or alternatively, would be more likely to have side effects to this medication.
Key facts
- Study ID
- NCT02389712
- Run by
- Mayo Clinic
- People needed
- 2
- Starts
- 2015-03-01
- Expected to finish
- 2018-05-23
- Last updated by the study team
- 2019-06-19
Who can join
Age: 18 and older, up to 65. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- Adult participants, age 18-65.
- Outpatients or inpatients with a diagnosis of bipolar I, II or schizoaffective bipolar disorder, depressed phase, non-psychotic, (DSM-5 criteria, Structured Clinical Interview for the Diagnostic and Statistical Manual for Mental Disorders Module D confirmed)
- At least mild symptom severity of depression as defined by the Clinical Global Impression for Bipolar Disorder (CGI-BP, Spearing et al. 1997) >2.
- Bipolar I participants must be on conventional mood stabilizing treatment [lithium, divalproex or valproate, or an atypical antipsychotic]. Participants with a bipolar II disorder may pursue the FLAME Study as monotherapy.
- Negative urine pregnancy test.
- Participants not planning pregnancy in the near future (6 months).
- Negative urine toxicology screen (except cannabis).
- No evidence of clinically significant laboratory screening tests (complete blood count (CBC); electrolytes; thyroid stimulating hormone (TSH); creatinine/blood urea nitrogen, Aspartate Aminotransferase (AST)/ALT). Clinical laboratory evaluation within the last three months is acceptable.
You may not qualify if…
- Inability or unwilling to provide informed consent.
- Inability to understand English.
- Actively suicidal participants at screening or enrollment visit as defined by a response of 3 or 4 on question 4 of the Bipolar Inventory of Symptoms Scale (BISS).
- Active delusions or hallucinations defined as a score of 3 or 4 on the BISS question 40 (persecutory ideas) or 41 (delusions or hallucinations).
- Impaired insight as defined as a score of 3 or 4 on BISS question 42 (insight).
- Hypomania defined by a BISS manic subscore of ≥15.
- Axis I or II comorbidity that by referring mental health professional and/or study psychiatrist is primary need of treatment. (This will be assessed by the site principal investigator, who has >10 years clinical experience with this population. Hospital discharge summaries and outpatient medical records may be reviewed (i.e., adequate trials of mood stabilizing treatments with minimal to no response, prominent self-injurious behavior in the absence of significant mood symptomatology, or atypical cycle patterns) to make this decision.
- Pregnant participants
- Unwilling or unable to taper any current antidepressant therapy
- Participants currently breastfeeding
- Female not practicing a reliable form of birth control (condom, intrauterine device (IUD), Depo-Provera injection)
- Due to lamotrigine pharmacokinetics, female subjects wishing to commence oral contraceptive therapy (OCT) within 3 months of enrollment date or anticipate discontinuing OCT during study (stable oral contraceptive therapy exception).
- History of active substance abuse disorder within the last 3 months (other than caffeine or cannabis)
- Participants with medical contraindications that preclude lamotrigine or fluoxetine treatment
- History of severe adverse reaction to lamotrigine and/or fluoxetine
- Current carbamazepine or oxcarbazepine treatment
- Unstable active medical illness
Where it is running
- Mayo Clinic — Rochester, Minnesota, United States
Full record on ClinicalTrials.gov
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