Phase 3 Study of Adjunctive Treatment With Seltorexant in Adult and Elderly Participants With Major Depressive Disorder and Insomnia Symptoms

Launched by JANSSEN RESEARCH & DEVELOPMENT, LLC · Aug 15, 2024

Keywords

ClinConnect Summary

This clinical trial is studying a medication called seltorexant to see how well it helps adults and elderly people who have major depressive disorder (MDD) along with insomnia symptoms. The goal is to find out if seltorexant can improve mood and sleep when used alongside a currently prescribed antidepressant that hasn't been fully effective. Participants must be between 18 and 75 years old and should have already tried at least one or two antidepressants without getting enough relief from their depression, meaning they still have some ongoing symptoms.

If you or a loved one qualifies, you can expect to take part in this study, which will involve taking either seltorexant or a placebo (a look-alike pill that doesn’t contain the active medication) for a certain period while continuing the current antidepressant treatment. The study will monitor how well the medication works and if there are any safety concerns. It’s important to note that not everyone will be eligible; for example, those with certain serious medical conditions or those who have had specific health issues like seizures or thyroid problems may not qualify. Overall, this trial aims to find better treatment options for those struggling with depression and sleep issues.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• Participants in part 1 and direct enrollers to part 2:
• • Meet DSM-5 MDD, without psychotic features based upon clinical assessment and confirmed by the structured clinical interview for DSM-5 Axis I disorders-clinical trials version (SCID-CT) diagnosed with first depressive episode prior to age 60
• • Have had an inadequate response to at least 1 but no more than 2 antidepressants, administered at an adequate dose and duration in the current episode of depression. An inadequate response is defined as less than (\<) 50% reduction but with some improvement (that is, improvement greater than \[\>\] 0%) in depressive symptom severity with residual symptoms other than insomnia present, and overall good tolerability, as assessed by the MGH-ATRQ, and this must include the participant's current antidepressant treatment
• • Is receiving and tolerating well any one of the following SSRI or SNRI for depressive symptoms at screening, in any formulation and available in the participating country: citalopram, duloxetine, escitalopram, fluvoxamine, fluoxetine, milnacipran, levomilnacipran, paroxetine, sertraline, venlafaxine, desvenlafaxine, vilazodone, or vortioxetine at a stable dose (at therapeutic dose level) for at least 6 weeks
• • Having a major depressive episode of at least moderate severity, as assessed with 17-item Hamilton Depression Rating Scale, implemented through the Structured Interview Guide (SIGH-D) in a blinded manner at screening and must not demonstrate a clinically significant improvement from the beginning to end of screening.
• Participants entering after completing part 1:
• • Must have completed Part 1 DB treatment phase
• • Can consistently tolerate study drug (at the end of Part 1), and there is no additional safety risk for the participant if they proceed to Part 2
• • Was able to consistently follow the study procedures in Part 1 as judged by the investigator.
• • Must be medically stable based on clinical laboratory tests
• Exclusion Criteria:
• • Has a recent (last 3 months) history of, or current signs and symptoms of, severe renal insufficiency clinically significant or unstable cardiovascular, respiratory, gastrointestinal, neurologic, hematologic, rheumatologic, immunologic or endocrine disorders and uncontrolled Type 1 or Type 2 diabetes mellitus
• • Has a history of narcolepsy and seizures
• • Has current signs/symptoms of hypothyroidism or hyperthyroidism
• • Participants taking thyroid supplementation for antidepressant purposes
• • Has Cushing's disease, Addison's disease, primary amenorrhea, or other evidence of significant medical disorders of the HPA axis