How does Adderall XR treat anxiety

Psychostimulatory Augmentation of Repetitive TMS for the Treatment of Major Depressive Disorder

detailed description

This study aims to recruit 30 subjects between the ages of 18 and 65 who meet the diagnosis and Statistical Manual of Mental Disorders (DSM-V) criteria for a recent episode of major depressive disorder. Participants will be recruited from the population of patients seeking rTMS from the Transcranial Magnetic Stimulation of the University of California at Los Angeles (UCLA) Clinic. All patients considered for participation in the study have a diagnosis of major depression as determined by the referring psychiatrist, and this is confirmed based on an interview with the Mini International Neuropsychiatric Interview (MINI). In addition, they meet criteria for treatment-resistance, which are defined by lack of response to two previous antidepressant studies at appropriate dosage and duration. able, informed consent, participants are enrolled in the study. Participants will then receive full baseline assessments including the Antidepressant Treatment Progress Form (ATHF) and the 30-point Inventory of Self-Report of Depressive Symptoms (IDS-SR30), as well as the Physician-Rated 17-Point Hamilton Depression Rating Scale (HAM-D17).

Once a diagnosis of treatment-resistant major depression has been made, the primary outcome measure will be the IDS-SR30 score, which is our standard method of monitoring treatment outcome in the TMS clinic. Participants are randomly assigned to one of two treatment conditions: Adderall XR (n = 15) versus placebo (n = 15). Participants and all research results Team members are blinded to the assigned treatment condition.The study protocol uses the "study time," which means that while patients continue to take the drug on weekends, only days of the week (Mon-Fri) count for progress through the protocol evaluate. For example, a patient who started study day 1 on a Thursday would reach day 5 Wednesday the following week. Adderall XR or placebo will be initiated at least 10 days in advance of starting rTMS treatment to assess side effects and establish a stable mood. To study how Adderall XR affects response to rTMS, regardless of direct antidepressant effects, patients must be in a stable mood prior to initiating treatment. RTMS.IDS-SR30 and HAM-D17 are repeated on study days 5 and 10 with the drug To determine if patients have stable mood (see study plan table below) It is assumed that they are stable and will qualify to start treatment if the IDS-SR30 score reaches changes between Ratings on the 5th and 10th study day by less than 10%.

The researchers predict that some patients could have an improvement in IDS scores by day 5. However, if they show significant additional improvement between days 5 and 10, they begin rTMS and will be delayed until depression levels stabilize. In particular, if the mood score changes by more than 10%, the subject waits an additional 5 days, or multiples of 5 days up to 15 days as needed, until the weekly change in mood score meets this criterion.The researchers predict that few of these treatment-resistant, Depressed patients will experience more than a few weeks of continuous improvement, but if they do they may be better suited by continuing stimulant treatment with their primary provider rather than undergoing TMS. Study participants who no longer complain of depression and no longer meet the criteria for Major Depressive Disorder (MDD) after starting treatment (Adderall XR vs. Placebo) will be removed from the study as rTMS is no longer indicated. For such patients, the blind will will be broken and they would have the option of continuing study medication at the discretion of their primary prescribing physician.

In addition to IDS-SR30 ratings and drug side effects, participants are screened for rTMS as soon as they have a stable depressed mood. Participants in Both Treatments Groups begin with an FDA-approved standard rTMS treatment protocol that comes with a Magstim or Magventure device. Participants will be screened for side effects with each rTMS treatment. Participants will complete the IDS-SR30, the HAM-D17, and a Visual Analog Scale (VAS) for overall tolerance after 5 and 10 rTMS treatment sessions. Upon completion of the 10th treatment session and the final series of assessments, all study-related activities will be completed and the blind will be broken.

Based on our most recent observational study, researchers predict that the Adderall The XR effect of the rTMS result will be most noticeable at the beginning of the course of treatment. In addition, in our standard treatment algorithm, rTMS treatment parameters are generally kept consistent throughout the first 10 treatments and then begin to diverge based on treatment response. Examination of the results after treatment 10 yields the best-controlled data set for demonstrating a significant effect of the study drug. Patients can choose additional rTMS treatments at the discretion of the treating physician and may choose to continue taking the study drug at the discretion of their prescribing psychiatrist. Therefore, patients who show significant improvement in depression while taking Adderall XR would have the option to continue beyond the first 10 treatments. Otherwise, patients will discontinue study medication at this point and, given the low dose and short duration of treatment, this is not expected. Patients will have to discontinue study medication. .