ClinicalTrials.gg
CompletedNCT01942733Updated Mar 20, 2019Results posted

Study of Brexpiprazole as Adjunctive Treatment of Sleep Disturbances in Patients With Major Depressive Disorder

A Phase 3 interventional study of Brexpiprazole in Sleep Disturbances, sponsored by H. Lundbeck A/S. Completed. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2019-03-20.

Sponsored by H. Lundbeck A/S · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
44
Allocation
Not applicable
Ages
18 Years to 65 Years
Sex
All
01

Study summary

To assess effects of brexpiprazole on sleep patterns of depressed patients with sleep disturbances.

02

Conditions studied

  • Sleep Disturbances

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03

In context

Parasomnias

769 studies on the registry are indexed under Parasomnias; 187 are open to participants now.

This study's enrollment of 44 is below the median of 66 across 579 interventional studies indexed under Parasomnias.

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Lead sponsor

H. Lundbeck A/S is the lead sponsor of 224 studies on the registry; 9 are open to participants now.

Of its 33 completed or terminated interventional studies of FDA-regulated products, 10 (30%) have results posted.

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04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • The patient has a Major Depressive Episode (MDE) associated to Major Depressive Disorder (MDD), diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR™). The current MDE should be confirmed using the Mini International Neuropsychiatric Interview (MINI).
  • The patient has an inadequate response to at least one antidepressant treatment (including the treatment the patient is taking at screening) in the current MDE, as documented by self-report as less than a pre-defined response on the Massachusetts General Hospital Antidepressant Treatment Response Questionnaire (ATRQ).
  • The patient has a pre-defined Montgomery Aasberg Depression Rating Scale (MADRS) total score, and a pre-defined Clinical Global Impression - Severity of Illness (CGI-S) score at screening, and has had the current MDE for ≥10 weeks.
  • The patient is currently treated for the current MDE with an adequate selective serotonin reuptake inhibitor (SSRI) or a serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressant treatment for ≥6 weeks, at the same dosage for ≥2 weeks.
  • The patient has sleep disturbances (difficulty falling asleep and/or difficulty staying asleep and/or problem waking up too early) confirmed by a pre-defined Insomnia Severity Index (ISI) score.
  • The patient agrees to protocol-defined use of effective contraception.

Entry Criteria to Treatment Period (Baseline Visit):

  • The patient still fulfils DSM-IV-TR™ criteria for MDE.
  • The patient received the same SSRI or SNRI antidepressant treatment at adequate dose during the entire lead-in period.
  • The patient has a pre-defined MADRS total score.
  • The patient's improvement in the MADRS total score is a pre-defined percentage compared to screening.
  • The patient has a pre-defined Clinical Global Impression - Global Improvement (CGI-I) score.
  • The patient has sleep disturbances (difficulty falling asleep and/or difficulty staying asleep and/or problem waking up too early) confirmed by a pre-defined ISI score.
  • The patient has sleep disturbances confirmed by pre-defined Latency to Persistent Sleep (LPS) and pre-defined Sleep Efficiency (SE).

Exclusion criteria

Exclusion Criteria:

- The patient is, in the investigator's opinion, unlikely to comply with the protocol or is unsuitable for any reason.

Other inclusion and exclusion criteria may apply.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
44 participants (actual)

Study arms

  • Experimental
    Brexpiprazole

    Brexpiprazole adjunct to open-label treatment with a commercially available antidepressant treatment (ADT)

    Drug: Brexpiprazole

Interventions

  • 2-3 mg/day, once daily, tablets, for oral use. The patients received 1mg/day brexpiprazole during Week 1 and 2mg/day during Week 2 (up-titration) and from Weeks 3 to 6 they received 3mg/day; depending on tolerability the dose could be reduced to 2mg/day based on the investigator's judgment.

06

What researchers measure

Primary outcomes

  1. Changes From Baseline to Week 8 on Sleep Quality as Assessed by Polysomnographic Recorded (PSG) Parameters

    The key PSG parameters assessed were the latency to persistent sleep (PSG LPS), sleep onset latency (PSG SOL), wake-time after sleep onset (PSG WASO), total sleep time (PSG TST), number of awakenings (PSG NAW), and sleep efficiency (PSG SE). The results for PSG LPS, PSG SOL, PSG WASO, and PSG TST are presented separately from the PSG NAW, and from the PSG SE due to the different units of measurement involved. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  2. Changes From Baseline to Week 8 on Sleep Quality as Assessed by Polysomnographic Recorded (PSG) Number of Awakenings (PSG NAW)

    The key PSG parameters assessed were the latency to persistent sleep (PSG LPS), sleep onset latency (PSG SOL), wake-time after sleep onset (PSG WASO), total sleep time (PSG TST), number of awakenings (PSG NAW), and sleep efficiency (PSG SE). The results for PSG LPS, PSG SOL, PSG WASO, and PSG TST are presented separately from the PSG NAW, and from the PSG SE due to the different units of measurement involved. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  3. Changes From Baseline to Week 8 on Sleep Quality as Assessed by Polysomnographic Recorded (PSG) Sleep Efficiency (PSG SE)

    The key PSG parameters assessed were the latency to persistent sleep (PSG LPS), sleep onset latency (PSG SOL), wake-time after sleep onset (PSG WASO), total sleep time (PSG TST), number of awakenings (PSG NAW), and sleep efficiency (PSG SE). The results for PSG LPS, PSG SOL, PSG WASO, and PSG TST are presented separately from the PSG NAW, and from the PSG SE due to the different units of measurement involved. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  4. Changes From Baseline to Week 8 on Sleep Quality as Assessed by the Consensus Sleep Diary for Morning (CSD-M) Sleep Efficiency (SE)

    The key CSD-M parameters assessed were the sleep efficiency (CSD-M SE), total sleep time (CSD-M TST), sleep onset latency (CSD-M SOL), wake-time after sleep onset (CSD-M WASO), and number of awakenings (CSD-M NAW). The results for CSD-M SE are presented separately from CSD-M TST, CSD-M SOL, and CSD-M WASO, and from CSD-M NAW due to the different units of measurement involved. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  5. Changes From Baseline to Week 8 on Sleep Quality as Assessed by the Consensus Sleep Diary for Morning (CSD-M)

    The key CSD-M parameters assessed were the sleep efficiency (CSD-M SE), total sleep time (CSD-M TST), sleep onset latency (CSD-M SOL), wake-time after sleep onset (CSD-M WASO), and number of awakenings (CSD-M NAW). The results for CSD-M SE are presented separately from CSD-M TST, CSD-M SOL, and CSD-M WASO, and from CSD-M NAW due to the different units of measurement involved. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  6. Changes From Baseline to Week 8 on Sleep Quality as Assessed by the Consensus Sleep Diary for Morning (CSD-M) Number of Awakenings (NAW)

    The key CSD-M parameters assessed were the sleep efficiency (CSD-M SE), total sleep time (CSD-M TST), sleep onset latency (CSD-M SOL), wake-time after sleep onset (CSD-M WASO), and number of awakenings (CSD-M NAW). As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  7. Changes From Baseline to Week 8 in Sleep Architecture as Assessed With Polysomnography

    The key sleep architecture parameters assessed with polysomnography were the percentage of time and duration spent in Stages N1 (non-rapid eye movement \[non-REM\]), N2 (non-REM), N3 (non-REM), and REM, respectively, as well as the duration of latency to REM sleep. The results for the percentage of time spent at each stage is presented separately from the duration due to the different units of measurement involved. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  8. Changes From Baseline to Week 8 in Sleep Architecture as Assessed With Polysomnography (Continued)

    The key sleep architecture parameters assessed with polysomnography were the percentage of time and duration spent in Stages N1 (non-rapid eye movement \[non-REM\]), N2 (non-REM), N3 (non-REM), and REM, respectively, as well as the duration of latency to REM sleep. The results for the percentage of time spent at each stage is presented separately from the duration due to the different units of measurement involved. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  9. Change From Baseline to Week 8 in ISI Total Score

    The Insomnia Severity Index (ISI) is a patient-rated scale desgined to measure the patient's perception of his/her insomnia. The ISI comprises 7 items: difficulty falling asleep, difficulty staying asleep, problems waking up early in the morning, satisfaction with current sleep pattern, interference with daily functioning, how much others notice the sleep problem impairs quality of life, and distress caused by the sleep problem. Each of the 7 items is rated on a 5-point scale from 0 (best situation) to 4 (worst situation). The total score of the 7 items ranges from 0 to 28, with higher values indicating worse outcome. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  10. Change From Baseline to Week 8 on ESS Total Score

    The Epworth Sleepiness Scale (ESS) is a is a patient-rated scale designed to measure daytime sleepiness. The ESS consists of 8 items describing different situations/activities and the patients rate the chance of them dozing off or falling asleep when they are in these situations. Each item is rated on a 4-point scale from 0 (would never dose) to 3 (high change of dozing). The total score of the 8 items ranges from 0 to 24, with higher values indicating worse outcome. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  11. Changes From Baseline to Week 8 in Response Speed as Assessed Using a PVT Device

    The psychomotor vigilance task (PVT) measures sustained or vigilant attention by recording response time (milliseconds) to a visual/or auditory stimulus that appears at random inter-stimulus intervals (range: from 2 to 10 seconds). The patient was instructed to monitor a red rectangular box on the computer screen and to press a response button as soon as a yellow stimulus counter appeared on the screen. The parameters assessed using a PVT device were response speed and number of lapses. The results for response speed is presented separately from the number of lapses due to the different units of measurement involved. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  12. Changes From Baseline to Week 8 in Number of Lapses as Assessed Using a PVT Device

    The psychomotor vigilance task (PVT) measures sustained or vigilant attention by recording response time (milliseconds) to a visual/or auditory stimulus that appears at random inter-stimulus intervals (range: from 2 to 10 seconds). The patient was instructed to monitor a red rectangular box on the computer screen and to press a response button as soon as a yellow stimulus counter appeared on the screen. The parameters assessed using a PVT device were response speed and number of lapses. The results for response speed is presented separately from the number of lapses due to the different units of measurement involved. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  13. Change From Baseline to Week 8 on BL-VAS-s (Evening) Score

    The Bond-Lader Visual Analogue Scale - Sedation (BL-VAS-s) is a patient-rated scale designed to assess the current level of sedation. The BL-VAS-s was assessed for the evening (19:00 to 23:59 hours), morning (00:00 to 08:59 hours) and at noon (11:00 to 13:59 hours). The BL-VAS-s is a single item scale rated on a 100mm visual analogue scale. The score is measured from the left to a mark made on the line by the patient and ranges from 0 (alert) to 100 (drowsy). As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  14. Change From Baseline to Week 8 on BL-VAS-s (Morning) Score

    The Bond-Lader Visual Analogue Scale - Sedation (BL-VAS-s) is a patient-rated scale designed to assess the current level of sedation. The BL-VAS-s was assessed for the evening (19:00 to 23:59 hours), morning (00:00 to 08:59 hours) and at noon (11:00 to 13:59 hours). The BL-VAS-s is a single item scale rated on a 100mm visual analogue scale. The score is measured from the left to a mark made on the line by the patient and ranges from 0 (alert) to 100 (drowsy). As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  15. Change From Baseline to Week 8 on BL-VAS-s Scores (Noon)

    The Bond-Lader Visual Analogue Scale - Sedation (BL-VAS-s) is a patient-rated scale designed to assess the current level of sedation. The BL-VAS-s was assessed for the evening (19:00 to 23:59 hours), morning (00:00 to 08:59 hours) and at noon (11:00 to 13:59 hours). The BL-VAS-s is a single item scale rated on a 100mm visual analogue scale. The score is measured from the left to a mark made on the line by the patient and ranges from 0 (alert) to 100 (drowsy). As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  16. Change From Baseline to Week 8 in CPFQ Total Score

    The Cognitive and Physical Functioning Questionnaire (CPFQ) is a patient-rated scale designed to assess cognitive and executive dysfunction including symptoms of fatigue in mood and anxiety disorders. The CPFQ consists of 7 items, each rated on a scale from 1 (greater than normal functioning) to 6 (poorer than normal functioning). The total score of the 7 items ranges from 7 to 42, with higher values indicating worse outcome. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  17. Changes From Baseline to Week 8 in Circadian and Biological Rhythm

    The parameters used to assess circadian and biological rhythm were the time to peak cortisol concentration, time to dim-light melatonin onset (DLMO) and phase angle. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  18. Change From Baseline to Week 8 in MADRS Total Score

    The Montgomery Aasberg Depression Rating Scale (MADRS) is a 10-item rating scale designed to assess the severity of the symptoms in depressive illness and to be sensitive to treatment effects. Items in the scale assess apparent sadness, reported sadness, inner tension, reduced sleep, reduced appetite, concentration difficulties, lassitude, inability to feel, pessimistic thoughts, and suicidal thoughts. Symptoms are rated on a 7-point scale from 0 (no symptoms) to 6 (severe symptoms). Definitions of severity are provided at two-point intervals. The total score of the 10 items ranges from 0 to 60, with higher values indicating worse outcome. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  19. Change From Baseline to Week 8 in CGI-S Score

    The Clinical Global Impression - Severity of Illness (CGI-S) scale assesses the clinician's impression of the patient's current state of mental illness. The clinician uses his or her clinical experience of this patient population to rate the severity of the patient's current mental illness on a 7-point scale ranging from 1 (normal - not at all ill) to 7 (among the most extremely ill patients), with higher values indicating worse outcome. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  20. Percentage of MADRS Responders at Week 8

    The Montgomery Aasberg Depression Rating Scale (MADRS) is a 10-item rating scale designed to assess the severity of the symptoms in depressive illness and to be sensitive to treatment effects. Items in the scale assess apparent sadness, reported sadness, inner tension, reduced sleep, reduced appetite, concentration difficulties, lassitude, inability to feel, pessimistic thoughts, and suicidal thoughts. Symptoms are rated on a 7-point scale from 0 (no symptoms) to 6 (severe symptoms). Definitions of severity are provided at two-point intervals. The total score of the 10 items ranges from 0 to 60, with higher values indicating worse outcome. Response was defined as a ≥50% decrease in MADRS total score from baseline. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Week 8

  21. Percentage of MADRS Remitters at Week 8

    The Montgomery Aasberg Depression Rating Scale (MADRS) is a 10-item rating scale designed to assess the severity of the symptoms in depressive illness and to be sensitive to treatment effects. Items in the scale assess apparent sadness, reported sadness, inner tension, reduced sleep, reduced appetite, concentration difficulties, lassitude, inability to feel, pessimistic thoughts, and suicidal thoughts. Symptoms are rated on a 7-point scale from 0 (no symptoms) to 6 (severe symptoms). Definitions of severity are provided at two-point intervals. The total score of the 10 items ranges from 0 to 60, with higher values indicating worse outcome. Remission was defined as a MADRS total score ≤10 and a ≥50% decrease in MADRS total score from baseline. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Week 8

  22. Changes From Baseline to Week 8 on Sleep Quality as Assessed by Actigraphy (ACT) Parameters

    The key ACT parameters assessed were the total sleep time (ACT TST), wake-time after sleep onset (ACT WASO), sleep onset latency (ACT SOL), sleep efficiency (ACT SE), and the number of awakenings (ACT NAW). The results for ACT TST, ACT WASO, and ACT SOL are presented separately from ACT SE, and from ACT NAW, due to the different units of measurement involved. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  23. Changes From Baseline to Week 8 on Sleep Efficiency (SE) as Assessed by Actigraphy (ACT)

    The key ACT parameters assessed were the total sleep time (ACT TST), sleep efficiency (ACT SE), sleep onset latency (ACT SOL), wake-time after sleep onset (ACT WASO), and the number of awakenings (ACT NAW). The results for ACT TST, ACT SE, ACT WASO, and ACT NAW are presented separately from ACT SOL as the number of patients available for analysis was different. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  24. Changes From Baseline to Week 8 on Number of Awakenings (NAW) as Assessed by Actigraphy (ACT)

    The key ACT parameters assessed were the total sleep time (ACT TST), sleep efficiency (ACT SE), sleep onset latency (ACT SOL), wake-time after sleep onset (ACT WASO), and the number of awakenings (ACT NAW). The results for ACT TST, ACT SE, ACT WASO, and ACT NAW are presented separately from ACT SOL as the number of patients available for analysis was different. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  25. Change From Baseline to Week 8 in BRIAN Total Score

    The Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) is a clinician-rated scale designed to assess biological rhythms. The BRIAN consists of 18 items divided in 4 subscales: sleep (5 items), activity (5 items), social (4 items), and eating pattern (4 items). Each item is rated on a scale from 1 (no difficulties) to 4 (serious difficulties). The total score of the 18 items ranges from 18 to 72, with higher values indicating worse outcome. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

  26. CGI-I Score at Week 8

    The Clinical Global Impression - Global Improvement (CGI-I) assesses the clinician's impression of the patient's improvement (or worsening). The clinician assesses the patient's condition relative to a baseline on a 7-point scale ranging from 1 (very much improved) to 7 (very much worse), with higher values indicating worse outcome. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

    Time frame: Baseline and Week 8

07

Results

Posted Mar 1, 2016

Participant flow

Participant flow — Overall Study
MilestoneBrexpiprazole
Started44
Completed41
Not completed3
Withdrew: Lost to follow-up1
Withdrew: Non-compliance with imp1
Withdrew: Administrative1

Outcome measures

PrimaryChanges From Baseline to Week 8 on Sleep Quality as Assessed by Polysomnographic Recorded (PSG) Parameters

The key PSG parameters assessed were the latency to persistent sleep (PSG LPS), sleep onset latency (PSG SOL), wake-time after sleep onset (PSG WASO), total sleep time (PSG TST), number of awakenings (PSG NAW), and sleep efficiency (PSG SE). The results for PSG LPS, PSG SOL, PSG WASO, and PSG TST are presented separately from the PSG NAW, and from the PSG SE due to the different units of measurement involved. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · minutes (min)
Changes From Baseline to Week 8 on Sleep Quality as Assessed by Polysomnographic Recorded (PSG) Parameters
minutes (min)Brexpiprazole
PSG LPS (n=40)-24.9 ± 4.8
PSG SOL (n=40)-19.7 ± 3.8
PSG WASO (n=40)-26.4 ± 6.1
PSG TST (n=41)49.0 ± 8.2
PrimaryChanges From Baseline to Week 8 on Sleep Quality as Assessed by Polysomnographic Recorded (PSG) Number of Awakenings (PSG NAW)

The key PSG parameters assessed were the latency to persistent sleep (PSG LPS), sleep onset latency (PSG SOL), wake-time after sleep onset (PSG WASO), total sleep time (PSG TST), number of awakenings (PSG NAW), and sleep efficiency (PSG SE). The results for PSG LPS, PSG SOL, PSG WASO, and PSG TST are presented separately from the PSG NAW, and from the PSG SE due to the different units of measurement involved. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · number of events
Changes From Baseline to Week 8 on Sleep Quality as Assessed by Polysomnographic Recorded (PSG) Number of Awakenings (PSG NAW)
number of eventsBrexpiprazole
Changes From Baseline to Week 8 on Sleep Quality as Assessed by Polysomnographic Recorded (PSG) Number of Awakenings (PSG NAW)0.06 ± 0.8
PrimaryChanges From Baseline to Week 8 on Sleep Quality as Assessed by Polysomnographic Recorded (PSG) Sleep Efficiency (PSG SE)

The key PSG parameters assessed were the latency to persistent sleep (PSG LPS), sleep onset latency (PSG SOL), wake-time after sleep onset (PSG WASO), total sleep time (PSG TST), number of awakenings (PSG NAW), and sleep efficiency (PSG SE). The results for PSG LPS, PSG SOL, PSG WASO, and PSG TST are presented separately from the PSG NAW, and from the PSG SE due to the different units of measurement involved. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · percentage (%)
Changes From Baseline to Week 8 on Sleep Quality as Assessed by Polysomnographic Recorded (PSG) Sleep Efficiency (PSG SE)
percentage (%)Brexpiprazole
Changes From Baseline to Week 8 on Sleep Quality as Assessed by Polysomnographic Recorded (PSG) Sleep Efficiency (PSG SE)10.4 ± 1.7
PrimaryChanges From Baseline to Week 8 on Sleep Quality as Assessed by the Consensus Sleep Diary for Morning (CSD-M) Sleep Efficiency (SE)

The key CSD-M parameters assessed were the sleep efficiency (CSD-M SE), total sleep time (CSD-M TST), sleep onset latency (CSD-M SOL), wake-time after sleep onset (CSD-M WASO), and number of awakenings (CSD-M NAW). The results for CSD-M SE are presented separately from CSD-M TST, CSD-M SOL, and CSD-M WASO, and from CSD-M NAW due to the different units of measurement involved. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · percentage of time
Changes From Baseline to Week 8 on Sleep Quality as Assessed by the Consensus Sleep Diary for Morning (CSD-M) Sleep Efficiency (SE)
percentage of timeBrexpiprazole
Changes From Baseline to Week 8 on Sleep Quality as Assessed by the Consensus Sleep Diary for Morning (CSD-M) Sleep Efficiency (SE)13.4 ± 3.2
PrimaryChanges From Baseline to Week 8 on Sleep Quality as Assessed by the Consensus Sleep Diary for Morning (CSD-M)

The key CSD-M parameters assessed were the sleep efficiency (CSD-M SE), total sleep time (CSD-M TST), sleep onset latency (CSD-M SOL), wake-time after sleep onset (CSD-M WASO), and number of awakenings (CSD-M NAW). The results for CSD-M SE are presented separately from CSD-M TST, CSD-M SOL, and CSD-M WASO, and from CSD-M NAW due to the different units of measurement involved. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · minutes (min)
Changes From Baseline to Week 8 on Sleep Quality as Assessed by the Consensus Sleep Diary for Morning (CSD-M)
minutes (min)Brexpiprazole
CSD-M TST (n=21)69.9 ± 14.6
CSD-M SOL (n=21)-37.1 ± 12.3
CSD-M WASO (n=21)-42.9 ± 29.0
PrimaryChanges From Baseline to Week 8 on Sleep Quality as Assessed by the Consensus Sleep Diary for Morning (CSD-M) Number of Awakenings (NAW)

The key CSD-M parameters assessed were the sleep efficiency (CSD-M SE), total sleep time (CSD-M TST), sleep onset latency (CSD-M SOL), wake-time after sleep onset (CSD-M WASO), and number of awakenings (CSD-M NAW). As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · number
Changes From Baseline to Week 8 on Sleep Quality as Assessed by the Consensus Sleep Diary for Morning (CSD-M) Number of Awakenings (NAW)
numberBrexpiprazole
Changes From Baseline to Week 8 on Sleep Quality as Assessed by the Consensus Sleep Diary for Morning (CSD-M) Number of Awakenings (NAW)0.0 ± 0.5
PrimaryChanges From Baseline to Week 8 in Sleep Architecture as Assessed With Polysomnography

The key sleep architecture parameters assessed with polysomnography were the percentage of time and duration spent in Stages N1 (non-rapid eye movement \[non-REM\]), N2 (non-REM), N3 (non-REM), and REM, respectively, as well as the duration of latency to REM sleep. The results for the percentage of time spent at each stage is presented separately from the duration due to the different units of measurement involved. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · percentage of total sleep duration
Changes From Baseline to Week 8 in Sleep Architecture as Assessed With Polysomnography
percentage of total sleep durationBrexpiprazole
Stage N1 (n=40)-0.7 ± 0.7
Stage N2 (n=40)3.5 ± 1.5
Stage N3 (n=40)-2.2 ± 0.8
Stage REM (n=40)-0.6 ± 1.1
PrimaryChanges From Baseline to Week 8 in Sleep Architecture as Assessed With Polysomnography (Continued)

The key sleep architecture parameters assessed with polysomnography were the percentage of time and duration spent in Stages N1 (non-rapid eye movement \[non-REM\]), N2 (non-REM), N3 (non-REM), and REM, respectively, as well as the duration of latency to REM sleep. The results for the percentage of time spent at each stage is presented separately from the duration due to the different units of measurement involved. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · minutes
Changes From Baseline to Week 8 in Sleep Architecture as Assessed With Polysomnography (Continued)
minutesBrexpiprazole
Stage N1 Duration (n=41)4.5 ± 2.5
Stage N2 Duration (n=41)43.1 ± 8.3
Stage N3 Duration (n=41)-3.1 ± 3.0
Stage REM Duration (n=41)4.5 ± 4.4
Latency to REM Sleep Duration (n=38)-16.2 ± 14.4
PrimaryChange From Baseline to Week 8 in ISI Total Score

The Insomnia Severity Index (ISI) is a patient-rated scale desgined to measure the patient's perception of his/her insomnia. The ISI comprises 7 items: difficulty falling asleep, difficulty staying asleep, problems waking up early in the morning, satisfaction with current sleep pattern, interference with daily functioning, how much others notice the sleep problem impairs quality of life, and distress caused by the sleep problem. Each of the 7 items is rated on a 5-point scale from 0 (best situation) to 4 (worst situation). The total score of the 7 items ranges from 0 to 28, with higher values indicating worse outcome. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · units on a scale
Change From Baseline to Week 8 in ISI Total Score
units on a scaleBrexpiprazole
Change From Baseline to Week 8 in ISI Total Score-9.2 ± 1.1
PrimaryChange From Baseline to Week 8 on ESS Total Score

The Epworth Sleepiness Scale (ESS) is a is a patient-rated scale designed to measure daytime sleepiness. The ESS consists of 8 items describing different situations/activities and the patients rate the chance of them dozing off or falling asleep when they are in these situations. Each item is rated on a 4-point scale from 0 (would never dose) to 3 (high change of dozing). The total score of the 8 items ranges from 0 to 24, with higher values indicating worse outcome. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · units on a scale
Change From Baseline to Week 8 on ESS Total Score
units on a scaleBrexpiprazole
Change From Baseline to Week 8 on ESS Total Score-2.6 ± 0.7
PrimaryChanges From Baseline to Week 8 in Response Speed as Assessed Using a PVT Device

The psychomotor vigilance task (PVT) measures sustained or vigilant attention by recording response time (milliseconds) to a visual/or auditory stimulus that appears at random inter-stimulus intervals (range: from 2 to 10 seconds). The patient was instructed to monitor a red rectangular box on the computer screen and to press a response button as soon as a yellow stimulus counter appeared on the screen. The parameters assessed using a PVT device were response speed and number of lapses. The results for response speed is presented separately from the number of lapses due to the different units of measurement involved. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · speed (per second)
Changes From Baseline to Week 8 in Response Speed as Assessed Using a PVT Device
speed (per second)Brexpiprazole
Changes From Baseline to Week 8 in Response Speed as Assessed Using a PVT Device-0.2 ± 0.1
PrimaryChanges From Baseline to Week 8 in Number of Lapses as Assessed Using a PVT Device

The psychomotor vigilance task (PVT) measures sustained or vigilant attention by recording response time (milliseconds) to a visual/or auditory stimulus that appears at random inter-stimulus intervals (range: from 2 to 10 seconds). The patient was instructed to monitor a red rectangular box on the computer screen and to press a response button as soon as a yellow stimulus counter appeared on the screen. The parameters assessed using a PVT device were response speed and number of lapses. The results for response speed is presented separately from the number of lapses due to the different units of measurement involved. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · number
Changes From Baseline to Week 8 in Number of Lapses as Assessed Using a PVT Device
numberBrexpiprazole
Changes From Baseline to Week 8 in Number of Lapses as Assessed Using a PVT Device2.1 ± 2.4
PrimaryChange From Baseline to Week 8 on BL-VAS-s (Evening) Score

The Bond-Lader Visual Analogue Scale - Sedation (BL-VAS-s) is a patient-rated scale designed to assess the current level of sedation. The BL-VAS-s was assessed for the evening (19:00 to 23:59 hours), morning (00:00 to 08:59 hours) and at noon (11:00 to 13:59 hours). The BL-VAS-s is a single item scale rated on a 100mm visual analogue scale. The score is measured from the left to a mark made on the line by the patient and ranges from 0 (alert) to 100 (drowsy). As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · units on a scale
Change From Baseline to Week 8 on BL-VAS-s (Evening) Score
units on a scaleBrexpiprazole
Change From Baseline to Week 8 on BL-VAS-s (Evening) Score1.4 ± 4.2
PrimaryChange From Baseline to Week 8 on BL-VAS-s (Morning) Score

The Bond-Lader Visual Analogue Scale - Sedation (BL-VAS-s) is a patient-rated scale designed to assess the current level of sedation. The BL-VAS-s was assessed for the evening (19:00 to 23:59 hours), morning (00:00 to 08:59 hours) and at noon (11:00 to 13:59 hours). The BL-VAS-s is a single item scale rated on a 100mm visual analogue scale. The score is measured from the left to a mark made on the line by the patient and ranges from 0 (alert) to 100 (drowsy). As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · units on a scale
Change From Baseline to Week 8 on BL-VAS-s (Morning) Score
units on a scaleBrexpiprazole
Change From Baseline to Week 8 on BL-VAS-s (Morning) Score-9.2 ± 4.5
PrimaryChange From Baseline to Week 8 on BL-VAS-s Scores (Noon)

The Bond-Lader Visual Analogue Scale - Sedation (BL-VAS-s) is a patient-rated scale designed to assess the current level of sedation. The BL-VAS-s was assessed for the evening (19:00 to 23:59 hours), morning (00:00 to 08:59 hours) and at noon (11:00 to 13:59 hours). The BL-VAS-s is a single item scale rated on a 100mm visual analogue scale. The score is measured from the left to a mark made on the line by the patient and ranges from 0 (alert) to 100 (drowsy). As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · units on a scale
Change From Baseline to Week 8 on BL-VAS-s Scores (Noon)
units on a scaleBrexpiprazole
Change From Baseline to Week 8 on BL-VAS-s Scores (Noon)-7.4 ± 6.7
PrimaryChange From Baseline to Week 8 in CPFQ Total Score

The Cognitive and Physical Functioning Questionnaire (CPFQ) is a patient-rated scale designed to assess cognitive and executive dysfunction including symptoms of fatigue in mood and anxiety disorders. The CPFQ consists of 7 items, each rated on a scale from 1 (greater than normal functioning) to 6 (poorer than normal functioning). The total score of the 7 items ranges from 7 to 42, with higher values indicating worse outcome. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · units on a scale
Change From Baseline to Week 8 in CPFQ Total Score
units on a scaleBrexpiprazole
Change From Baseline to Week 8 in CPFQ Total Score-8.4 ± 1.1
PrimaryChanges From Baseline to Week 8 in Circadian and Biological Rhythm

The parameters used to assess circadian and biological rhythm were the time to peak cortisol concentration, time to dim-light melatonin onset (DLMO) and phase angle. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · minutes
Changes From Baseline to Week 8 in Circadian and Biological Rhythm
minutesBrexpiprazole
Time to peak cortisol concentration-60 ± 23
Time to DLMO48 ± 49
Phase angle108 ± 61
PrimaryChange From Baseline to Week 8 in MADRS Total Score

The Montgomery Aasberg Depression Rating Scale (MADRS) is a 10-item rating scale designed to assess the severity of the symptoms in depressive illness and to be sensitive to treatment effects. Items in the scale assess apparent sadness, reported sadness, inner tension, reduced sleep, reduced appetite, concentration difficulties, lassitude, inability to feel, pessimistic thoughts, and suicidal thoughts. Symptoms are rated on a 7-point scale from 0 (no symptoms) to 6 (severe symptoms). Definitions of severity are provided at two-point intervals. The total score of the 10 items ranges from 0 to 60, with higher values indicating worse outcome. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · units on a scale
Change From Baseline to Week 8 in MADRS Total Score
units on a scaleBrexpiprazole
Change From Baseline to Week 8 in MADRS Total Score-16.0 ± 1.7
PrimaryChange From Baseline to Week 8 in CGI-S Score

The Clinical Global Impression - Severity of Illness (CGI-S) scale assesses the clinician's impression of the patient's current state of mental illness. The clinician uses his or her clinical experience of this patient population to rate the severity of the patient's current mental illness on a 7-point scale ranging from 1 (normal - not at all ill) to 7 (among the most extremely ill patients), with higher values indicating worse outcome. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · units on a scale
Change From Baseline to Week 8 in CGI-S Score
units on a scaleBrexpiprazole
Change From Baseline to Week 8 in CGI-S Score-1.8 ± 0.2
PrimaryPercentage of MADRS Responders at Week 8

The Montgomery Aasberg Depression Rating Scale (MADRS) is a 10-item rating scale designed to assess the severity of the symptoms in depressive illness and to be sensitive to treatment effects. Items in the scale assess apparent sadness, reported sadness, inner tension, reduced sleep, reduced appetite, concentration difficulties, lassitude, inability to feel, pessimistic thoughts, and suicidal thoughts. Symptoms are rated on a 7-point scale from 0 (no symptoms) to 6 (severe symptoms). Definitions of severity are provided at two-point intervals. The total score of the 10 items ranges from 0 to 60, with higher values indicating worse outcome. Response was defined as a ≥50% decrease in MADRS total score from baseline. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Week 8
Reported as:
Number · percentage of patients
Percentage of MADRS Responders at Week 8
percentage of patientsBrexpiprazole
Percentage of MADRS Responders at Week 856
PrimaryPercentage of MADRS Remitters at Week 8

The Montgomery Aasberg Depression Rating Scale (MADRS) is a 10-item rating scale designed to assess the severity of the symptoms in depressive illness and to be sensitive to treatment effects. Items in the scale assess apparent sadness, reported sadness, inner tension, reduced sleep, reduced appetite, concentration difficulties, lassitude, inability to feel, pessimistic thoughts, and suicidal thoughts. Symptoms are rated on a 7-point scale from 0 (no symptoms) to 6 (severe symptoms). Definitions of severity are provided at two-point intervals. The total score of the 10 items ranges from 0 to 60, with higher values indicating worse outcome. Remission was defined as a MADRS total score ≤10 and a ≥50% decrease in MADRS total score from baseline. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Week 8
Reported as:
Number · percentage of patients
Percentage of MADRS Remitters at Week 8
percentage of patientsBrexpiprazole
Percentage of MADRS Remitters at Week 854
PrimaryChanges From Baseline to Week 8 on Sleep Quality as Assessed by Actigraphy (ACT) Parameters

The key ACT parameters assessed were the total sleep time (ACT TST), wake-time after sleep onset (ACT WASO), sleep onset latency (ACT SOL), sleep efficiency (ACT SE), and the number of awakenings (ACT NAW). The results for ACT TST, ACT WASO, and ACT SOL are presented separately from ACT SE, and from ACT NAW, due to the different units of measurement involved. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · minutes
Changes From Baseline to Week 8 on Sleep Quality as Assessed by Actigraphy (ACT) Parameters
minutesBrexpiprazole
ACT TST (n=33)-9.0 ± 15.7
ACT WASO (n=33)-6.1 ± 6.5
ACT SOL (n=32)-5.5 ± 3.6
PrimaryChanges From Baseline to Week 8 on Sleep Efficiency (SE) as Assessed by Actigraphy (ACT)

The key ACT parameters assessed were the total sleep time (ACT TST), sleep efficiency (ACT SE), sleep onset latency (ACT SOL), wake-time after sleep onset (ACT WASO), and the number of awakenings (ACT NAW). The results for ACT TST, ACT SE, ACT WASO, and ACT NAW are presented separately from ACT SOL as the number of patients available for analysis was different. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · percentage of time
Changes From Baseline to Week 8 on Sleep Efficiency (SE) as Assessed by Actigraphy (ACT)
percentage of timeBrexpiprazole
Changes From Baseline to Week 8 on Sleep Efficiency (SE) as Assessed by Actigraphy (ACT)-1.3 ± 3.7
PrimaryChanges From Baseline to Week 8 on Number of Awakenings (NAW) as Assessed by Actigraphy (ACT)

The key ACT parameters assessed were the total sleep time (ACT TST), sleep efficiency (ACT SE), sleep onset latency (ACT SOL), wake-time after sleep onset (ACT WASO), and the number of awakenings (ACT NAW). The results for ACT TST, ACT SE, ACT WASO, and ACT NAW are presented separately from ACT SOL as the number of patients available for analysis was different. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · number of events
Changes From Baseline to Week 8 on Number of Awakenings (NAW) as Assessed by Actigraphy (ACT)
number of eventsBrexpiprazole
Changes From Baseline to Week 8 on Number of Awakenings (NAW) as Assessed by Actigraphy (ACT)-2.0 ± 1.1
PrimaryChange From Baseline to Week 8 in BRIAN Total Score

The Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) is a clinician-rated scale designed to assess biological rhythms. The BRIAN consists of 18 items divided in 4 subscales: sleep (5 items), activity (5 items), social (4 items), and eating pattern (4 items). Each item is rated on a scale from 1 (no difficulties) to 4 (serious difficulties). The total score of the 18 items ranges from 18 to 72, with higher values indicating worse outcome. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · units on a scale
Change From Baseline to Week 8 in BRIAN Total Score
units on a scaleBrexpiprazole
Change From Baseline to Week 8 in BRIAN Total Score-17.4 ± 1.9
PrimaryCGI-I Score at Week 8

The Clinical Global Impression - Global Improvement (CGI-I) assesses the clinician's impression of the patient's improvement (or worsening). The clinician assesses the patient's condition relative to a baseline on a 7-point scale ranging from 1 (very much improved) to 7 (very much worse), with higher values indicating worse outcome. As this was an open-label exploratory study, all outcomes should be considered as exploratory outcomes.

Time frame:
Baseline and Week 8
Reported as:
Mean · units on a scale
CGI-I Score at Week 8
units on a scaleBrexpiprazole
CGI-I Score at Week 82.2 ± 1.1

Adverse events

Collected over Baseline to end of treatment (Week 8). Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Brexpiprazole—0/44 (0%)22/44 (50%)
Most frequent other events
Most frequent other events
EventBrexpiprazole
NauseaGastrointestinal disorders6/44
SedationNervous system disorders6/44
HeadacheNervous system disorders5/44
Upper respiratory tract infectionInfections and infestations4/44
Weight increasedInvestigations4/44
SomnolenceNervous system disorders4/44
FatigueGeneral disorders3/44

Baseline characteristics

The all-patients-treated set (APTS) comprises all patients who took at least one dose of brexpiprazole.

Age, Continuous
Age, Continuous(years)Brexpiprazole
Mean44.4 ± 11.5
Sex: Female, Male
Sex: Female, Male(Participants)Brexpiprazole
Female14
Male30
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Brexpiprazole
American Indian or Alaska Native0
Asian3
Native Hawaiian or Other Pacific Islander0
Black or African American16
White24
More than one race0
Unknown or Not Reported1
MADRS total score
MADRS total score(units on a scale)Brexpiprazole
Mean28.3 ± 3.8
CGI-S score
CGI-S score(units on a scale)Brexpiprazole
Mean4.3 ± 0.8
ESS total score
ESS total score(units on a scale)Brexpiprazole
Mean9.1 ± 4.7
ISI total score
ISI total score(units on a scale)Brexpiprazole
Mean19.4 ± 3.9
CPFQ total score
CPFQ total score(units on a scale)Brexpiprazole
Mean27.1 ± 5.3

1 further baseline measures are reported on the registry.

08

Study locations

No study locations are listed for this record.

09

References and documents

Publications

  • Krystal AD, Mittoux A, Lindsten A, Baker RA. Chronobiologic parameter changes in patients with major depressive disorder and sleep disturbance treated with adjunctive brexpiprazole: An open-label, flexible-dose, exploratory substudy. J Affect Disord. 2021 Jan 1;278:288-295. doi: 10.1016/j.jad.2020.09.026. Epub 2020 Sep 11. PubMed 32979560 ↗
  • Krystal AD, Mittoux A, Meisels P, Baker RA. Effects of Adjunctive Brexpiprazole on Sleep Disturbances in Patients With Major Depressive Disorder: An Open-Label, Flexible-Dose, Exploratory Study. Prim Care Companion CNS Disord. 2016 Sep 8;18(5). doi: 10.4088/PCC.15m01914. PubMed 27835722 ↗
10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Mar 20, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT01942733
Lead sponsor
H. Lundbeck A/S
Responsible party
Sponsor
First posted
Sep 16, 2013
Start date
Sep 2013
Primary completion
Aug 2014
Completion
Aug 2014
Results posted
Mar 1, 2016
Last update
Mar 20, 2019

Study contacts

Email contact via H. Lundbeck A/S
study director · LundbeckClinicalTrials@lundbeck.com

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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