Evidence map›Paper›PMID 30097056›Full record

ArticleTrials2018

Using acute tryptophan depletion to investigate predictors of treatment response in adolescents with major depressive disorder: study protocol for a randomised controlled trial.

Richard M Stewart, Sean D Hood, Pradeep Rao, Julia K Moore, Kevin C Runions, Susannah E Murphy, Janice W Y Wong, Florian D Zepf

Open access · goldAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Trial
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

Richard M StewartCentre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Divisions of Paediatrics and Psychiatry, UWA Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, 35 Stirling Highway (M561), Crawley WA, Perth, 6009, Australia.
Sean D HoodDivision of Psychiatry, UWA Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia.
Pradeep RaoCentre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Divisions of Paediatrics and Psychiatry, UWA Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, 35 Stirling Highway (M561), Crawley WA, Perth, 6009, Australia.
Julia K MooreCentre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Divisions of Paediatrics and Psychiatry, UWA Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, 35 Stirling Highway (M561), Crawley WA, Perth, 6009, Australia.
Kevin C RunionsCentre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Divisions of Paediatrics and Psychiatry, UWA Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, 35 Stirling Highway (M561), Crawley WA, Perth, 6009, Australia.
Susannah E MurphyDepartment of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK.
Janice W Y WongCentre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Divisions of Paediatrics and Psychiatry, UWA Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, 35 Stirling Highway (M561), Crawley WA, Perth, 6009, Australia.ORCID http://orcid.org/0000-0003-1994-3001
Florian D ZepfCentre & Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Divisions of Paediatrics and Psychiatry, UWA Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, 35 Stirling Highway (M561), Crawley WA, Perth, 6009, Australia. florian.zepf@uwa.edu.au.
The University of Western Australia · AUThe Kids Research Institute Australia · AUWarneford Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSelective serotonin reuptake inhibitors (SSRIs) are amongst the most prescribed antidepressants for adolescents with depressive symptoms and major depressive disorder. However, SSRIs have significant shortcomings as a first-line treatment considering that not all patients respond to these antidepressants. Amongst paediatric populations, meta-analyses indicate that up to approximately 40% of patients do not respond, and for those who do show benefit, there is substantial heterogeneity in response onset. The neurotransmitter serotonin (5-HT) plays a role in the clinical effectiveness and mechanisms of action of SSRIs. However, the exact and complete mechanism of action and reasons for the low response rate to SSRIs in some adolescent populations remains unknown.

methodsTo examine SSRI response and the role of 5-HT, this study will employ a randomised double-blind within subject, repeated measures design, recruiting adolescent patients with major depressive disorder. Participants will be subjected to acute tryptophan depletion (ATD) and the balanced control condition on two separate study days within a first study phase (Phase A), and the order in which these conditions (ATD/balanced control condition) occur will be random. This phase will be followed by Phase B, where participants will receive open label pharmacological treatment as usual with the SSRI fluoxetine and followed-up over a 12-week period. DISCUSSION: ATD is a neurodietary method typically used to investigate the impact of lowered brain 5-HT synthesis on mood and behaviour. The major hypothesis of this study is that ATD will be negatively associated with mood and cognitive functioning, therefore reflecting individual serotonergic sensitivity and related depressive symptoms. Additionally, we expect the aforementioned effects of ATD administration on mood to predict clinical improvement with regard to overall depressive symptomatology 12 weeks into SSRI treatment.

trial registrationAustralian and New Zealand Clinical Trials Registry (ANZCTR) ACTRN12616001561471 . Registered on 11 November 2016.

Indexed as

Dietary SupplementsAdolescentAdolescent BehaviorAffectAge FactorsAmino AcidsAntidepressive Agents, Second-GenerationBrainChildChild BehaviorCombined Modality TherapyDouble-Blind MethodFemaleFluoxetineHumansMajor Depressive DisorderAmino AcidsAntidepressive Agents, Second-GenerationFluoxetineSelective Serotonin Reuptake InhibitorsSerotoninTryptophanAdolescentsChildrenDepressionMood disordersNeurosciencePharmacologySerotoninTryptophan depletion

Identifiers

PMID30097056
PMCPMC6086023
OpenAlexW2886356555

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.