Prediction of ECT treatment response and reduction of Cognitive Side-effects using EEG and Rivastigmine

2024-518047-37-01 Protocol 202000842 Therapeutic use (Phase IV) Ended

End 3 Jun 2025 · Status Ended · 1 EU/EEA countries · 4 sites · Protocol 202000842

Overview

Sponsor-declared trial summary

Phase Therapeutic use (Phase IV)
Status Ended
Participants planned 100
Countries 1
Sites 4

Depression

The aim of our study is two folded: first, we aim to improve cognition after ECT, improving its acceptability and tolerability and hence increase its application. If ECT would be used for the calculated 26% of patients who have chronic severe depression, morbidity and mortality of this disorder would decrease steeply. …

Key facts

Sponsor
Universitair Medisch Centrum Groningen
Participant type
Patients
Age range
18-64 years
Gender
Male and Female
Therapeutic area
Psychiatry and Psychology [F] - Mental Disorders [F03]
Trial duration
completed 3 Jun 2025
Decision date (initial)
2024-12-16
Transition trial
Yes
Low-intervention
No
Rare-disease indication
No
Vulnerable population
Yes

External identifiers

EU CT number
2024-518047-37-01
EudraCT number
2020-005633-33

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Safety, Therapy, Prophylaxis, Efficacy

The aim of our study is two folded: first, we aim to improve cognition after ECT, improving its acceptability and tolerability and hence increase its application. If ECT would be used for the calculated 26% of patients who have chronic severe depression, morbidity and mortality of this disorder would decrease steeply. Second, we aim to develop a prediction method based on clinical and EEG characteristics, to accurately predict who will respond to ECT. If it is possible to accurately predict ECT response (and non-response), it could be prevented that patients with a low chance of recovery receives ECT without response but with the associated risks.

Secondary objectives 7

  1. To investigate quality of life related measures after rivastigmine addition.
  2. To investigate whether free speech is predictive of the antidepressant effects.
  3. To investigate whether EEG could predict cognitive impairment.
  4. To investigate how network related measures change during an ECT course.
  5. To investigate how blood and DNA methylation change during ECT.
  6. To develop a comprehensive prediction method based on the available parameters.
  7. To investigate subjective measures of (anticipation) of response and side effects.

Conditions and MedDRA coding

Depression

Regulatory references

Plan to share IPD
No
EU CT numberTitleSponsor
2024-518047-37-00 PRECISER; Prediction of ECT treatment response and reduction of Cognitive Side-effects using EEG and Rivastigmine Universitair Medisch Centrum Groningen

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 4

  1. Age over 18 years
  2. Clinical indication for ECT (as indicated by the treating physician/psychiatrist)
  3. Uni- or bipolar depression (as assessed by the treating psychiatrist)
  4. Dutch as first language

Exclusion criteria 7

  1. Currently using rivastigmine, galantamine, donezepil (all cholinesterase inhibitors for mild to moderate Alzheimer’s Disease).
  2. Pregnancy and/or lactation/breast feeding
  3. Suspicion of neurodegenerative disorders (as diagnosed earlier)
  4. Contraindications for ECT (recent myocardinfarct, recent cerebrovasculair accident, recent intracranial surgery, pheochromocytoma and instable angina pectoris)
  5. Contraindications for rivastigmine (bradycardia or atrioventricular (AV) conduction disorders (first degree AV-block excluded))
  6. Patients who have had an allergic reaction to rivastigmine
  7. Cognitive disorder not explained by the depressive episode

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 3

  1. No change in the rivastigmine group on cognitive and memory related measures (compared to an effect in the placebo group): significant interaction term between placebo and rivastigmine AND non-significant comparison on cognition and memory measures in the rivastigmine group between the timepoints (versus significant difference in the placebo group): at p <0.05
  2. Classification algorithm for ECT response: accurate and statistically significant at p<0.05
  3. Classification algorithm for side effects: accurate and statistically significant at p<0.05

Secondary endpoints 7

  1. To investigate quality of life related measures after rivastigmine addition: significant for the different measures at p<0.05
  2. To investigate whether free speech is predictive of the antidepressant effects: classification (significant at p<0.05) AND significant (non)linear modelling at p<0.05
  3. To investigate whether EEG could predict cognitive impairment: accurate and statistically significant at p<0.05
  4. To investigate how network related measures change during an ECT course: statistically significant change between timepoints (p<0.05)
  5. To investigate how blood and DNA methylation change during ECT (or are predictive): p<0.05
  6. To develop a comprehensive prediction method based on the available parameters: statistically significant change between timepoints (p<0.05)
  7. To investigate subjective measures of (anticipation) of response and side effects: p < 0.05

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 2

Rivastigmine

SUB10345MIG · Substance

Active substance
Rivastigmine
Pharmaceutical form
TRANSDERMAL PATCH
Route of administration
TRANSDERMAL USE
Max daily dose
4.6 mg milligram(s)
Max total dose
4.6 mg milligram(s)
Max treatment duration
3 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
Yes
Modification description
Introduction of a new transdermal patch formulation to provide an additional dosing option for patients with moderate to severe dementia.

Rivastigmine

SUB10345MIG · Substance

Active substance
Rivastigmine
Pharmaceutical form
TRANSDERMAL PATCH
Route of administration
TRANSDERMAL USE
Max daily dose
9.5 mg milligram(s)
Max total dose
9.5 mg milligram(s)
Max treatment duration
1 Week(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
Yes
Modification description
Introduction of a new transdermal patch formulation to provide an additional dosing option for patients with moderate to severe dementia.

Placebo 2

Rivastigmin adhesive plaster 9.5 mg placebo containing 0 mg of rivastigmin

N/A · Product

Other product name
N/A
Pharmaceutical form
N/A
ATC code
N/A — N/A
Marketing authorisation
N/A
MA holder
N/A
MA country
Iceland
Paediatric formulation
No

Rivastigmin adhesive plaster 4.6 mg placebo containing 0 mg of rivastigmin

N/A · Product

Other product name
N/A
Pharmaceutical form
N/A
ATC code
N/A — N/A
Marketing authorisation
N/A
MA holder
N/A
MA country
Iceland
Paediatric formulation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Universitair Medisch Centrum Groningen

Sponsor organisation
Universitair Medisch Centrum Groningen
Address
Hanzeplein 1
City
Groningen
Postcode
9713 GZ
Country
Netherlands

Scientific contact point

Organisation
Universitair Medisch Centrum Groningen
Contact name
Jasper Nuninga

Public contact point

Organisation
Universitair Medisch Centrum Groningen
Contact name
Jasper Nuninga

Locations

1 EU/EEA country · 4 investigational sites

By country

CountryMS statusPlanned subjectsSites
Netherlands Ended 100 4
Rest of world 0

Investigational sites

Netherlands

4 sites · Ended
Universitair Medisch Centrum Groningen
BSCS, Hanzeplein 1, 9713 GZ, Groningen
Sint Antonius Ziekenhuis Stichting
Psychiatrie en medische psychologie, Koekoekslaan 1, 3435 CM, Nieuwegein
Universitair Medisch Centrum Utrecht
Psychiatry, Heidelberglaan 100, 3584 CX, Utrecht
Tergooiziekenhuizen
Psychiatrie, Laan Van Tergooi 2, 1212 VG, Hilversum

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 4 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) D1_Protocol 2024-518047-37-01 3.3
Recruitment arrangements (for publication) Blank document 1
Subject information and informed consent form (for publication) L1_SIS and ICF 4.5
Summary of Product Characteristics (SmPC) (for publication) E2_SmPC Rivastigmin 1

Application history

1 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2024-12-02 Netherlands Acceptable
2024-12-16
2024-12-16