Anhedonia, Development, and Emotions: Phenotyping and Therapeutics

• Status: Recruiting
• Trial end date: 2025-10-01
• Target enrollment: 0
• Participant gender: All

Summary

The goal of the ADEPT Study is to understand anhedonia in young people and how it changes based on treatments targeting the brain circuit underlying it. Anhedonia is a challenging mental health symptom that involves difficulty with motivation to experience pleasant events. This study could help develop treatments for people whose depression does not improve with traditional treatments.

The ADEPT Study includes two phases. In Phase 1, participants are asked to go through a series of activities to measure anhedonia, including MRI scans, blood draws, behavioral tasks, clinical interviews, questionnaires, and app-based assessments of experiences and behaviors. Phase 2 involves therapeutic activities, such as transcranial magnetic stimulation (TMS), positive affect training, and, for some people, ketamine administration. If the participant qualifies and is interested, they may choose to do Phase 2 activities in addition to Phase 1.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Erika Forbes
• Treatments: Ketamine

Criteria

Inclusion Criteria:

Phase 1 (all participants)

• Current DSM-5 depressive disorder

• Severity ≥ 12 on MADRS

• Moderate-severe anhedonia (75% of sample) or low anhedonia (25% of sample)

Phase 2 (for participants in TBS and ketamine phase, in addition to above)

• ≥ 1 failed antidepressant trial (for qualification for Phase 2 of study and definition of non-response to TMS in order to be eligible for ketamine) = Treatment for at least 6 weeks with an antidepressant medication reaching recommended dosage for adults for at least 3 weeks of the treatment (e.g., 20 mg fluoxetine)

Exclusion Criteria:

Phase 1 (all participants)

• Lifetime psychosis, bipolar disorder, autism spectrum disorder, or developmental disorder

• Serious, unstable neurological disorder (e.g., seizure disorder)

• Brain injury with loss of consciousness

• Daily nicotine use

• Moderate-severe substance use disorder, past 6 mos.

• MRI contraindications (e.g., metal in body)

Phase 2 (for participants in TBS and ketamine phase, in addition to above)

• Serious, unstable respiratory or cardiovascular illness

• Pre-TBS: Alcohol binge in past week or > 3 drinks/day in past 3 days

• Pre-ketamine: use of MAOIs in past 2 weeks

• Medication: SNRIs, bupropion, antipsychotics, or stimulants

• Pregnancy

• High blood pressure

• Current illicit stimulant use

• Lifetime recreational ketamine or PCP use