Inflammatory and Glutamatergic Mechanisms of Sustained Threat in Adolescents With Depression
NCT05329441
Summary
Despite the prevalence and significant public health concern over depression among adolescents, up to 40% of depressed adolescents do not respond to first-line antidepressants (herein termed treatment non-response, TNR). The goal of this project is to recruit and assess 160 treatment-seeking depressed adolescents and test whether acute stress impacts peripheral levels of inflammation and downstream levels of glutamate in corticolimbic regions previously associated with depression, whether these stress-related biomarkers predict TNR to a 12-week trial of either fluoxetine or escitalopram, and whether these stress-related biomarkers predict 18-month clinical course.
Eligibility
Inclusion Criteria: * DSM-V criteria for a depressive disorder * All sexes and genders * All ethnicities * Ages 14-21 * Postpubertal (Tanner stage \> 3) * No medications that will interfere with the study (including antidepressants, mood stabilizers, hormone supplements, steroids, etc.) for at least 2-6 weeks (depending on exact medication) * Currently being seen by a clinician who will treat the participant with fluoxetine or escitalopram * The ability to provide assent, understand, and complete all study procedures * Caregiver consent (if applicable) Exclusion Criteria: * Primary mental health diagnosis other than a depressive disorder according to DSM-V * Any contraindications to MRI scanning, phlebotomy, or SSRI treatment * Stimulant usage * A concussion within the last 6 weeks or any lifetime concussion with loss of consciousness for at least 10 minutes * Any inflammatory conditions or use of anti-inflammatory medications that may influence study findings * Any major neurological or developmental disorders which could impact the participant's ability to comply with study procedure * Meeting for current or lifetime criteria of mania or psychosis, diagnosis of bipolar disorder, or any substance use disorders * First-degree relative with current, past, or suspected mania or psychosis
Conditions2
Locations1 site
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NCT05329441