ClinicalTrials.gg
TerminatedNCT02189213Updated Oct 11, 2021Results posted

Treatment of Pediatric Anxiety Disorders by Predicting Treatment Response Through Biocellular Markers and Sleep

An interventional study of Sertraline in Generalized Anxiety Disorder, Separation Anxiety Disorder and Social Phobia, sponsored by New York State Psychiatric Institute. Terminated at 1 site in United States. Open to participants aged 8 Years to 25 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2021-10-11.

Sponsored by New York State Psychiatric Institute · Not applicable, Interventional, and Diagnostic

Why this study was terminated
Insufficient funding
Phase
Not applicable
Study type
Interventional
Enrollment
14
Allocation
Non-randomized
Ages
8 Years to 25 Years
Sex
All
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Study summary

1 out of 8 children, adolescents, and young adults suffer from an anxiety disorder. Studies over the past decade show that selective serotonin-reuptake inhibitors (SSRIs), a class of medication that treats anxiety in adults, also works well in young adults, children, and adolescents with anxiety disorders, but only for about 50%. 50% will have undergone treatment for several months before it will be established that the medication is not working to treat the anxiety. The purpose of this study is to find a test that will predict treatment outcome from the beginning based on behavioral and biological measures.

Read the detailed description

Current evidence based psychiatric treatment for child, adolescent, and young adult anxiety disorders involves a trial and error process. Pediatric psychiatrists start with the first line treatments (i.e. SSRI or psychotherapy), which requires from 4-8 weeks to work. There is a long interval between treatment initiation and response with only 50 to 60% likelihood that the treatment chosen will succeed in reducing anxiety symptoms. The science that will enable us to predict who will respond to medication treatment does not exist. Studies have demonstrated a correlation between cellular markers in white blood cells and psychiatric disorders suggesting that certain genes may also change their expression in peripheral cells in response to treatment of psychiatric disorders. Several studies report a significant decrease in expression of key genes that are involved in the pathophysiology of anxiety and depression in the brain, such as BDNF, CREB and HDAC5 levels in leukocytes of people with mood and anxiety disorders. The levels of BDNF, HDAC5 and CREB in white blood cells then respond to treatment and match that of controls after treatment with SSRIs. The increased accessibility to sequencing technology allows us to survey many more potential biomarkers than what was possible just several years ago. This may enable us to formulate a test that will predict, based on biocellular markers, treatment outcome in anxiety disorders for children, adolescents, and young adults before the onset of treatment. By finding molecular markers that can predict treatment success from the onset, the investigators can improve treatment outcomes considerably compared to current standard treatment practices. This kind of personalized medicine is the future of psychiatry.

02

Conditions studied

  • Generalized Anxiety Disorder
  • Separation Anxiety Disorder
  • Social Phobia

Keywords

  • anxiety
  • SSRI
  • biomarker
  • sleep
  • children
  • adolescents
  • young adults
03

In context

Generalized Anxiety Disorder

517 studies on the registry are indexed under Generalized Anxiety Disorder; 124 are open to participants now.

This study's enrollment of 14 is below the median of 83 across 439 interventional studies indexed under Generalized Anxiety Disorder.

Browse Generalized Anxiety Disorder studies →

Lead sponsor

New York State Psychiatric Institute is the lead sponsor of 435 studies on the registry; 27 are open to participants now.

Of its 51 completed or terminated interventional studies of FDA-regulated products, 45 (88%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
8 Years to 25 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

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

  1. Participants aged 8-25 years inclusive at the time of the consent/assent, either outpatient or inpatient if hospitalization is required for one of the following reasons:

    • It is presently unsafe for subject to stay at home because he/she may run away
    • Subject needs closer monitoring while being started on medications
    • Subject needs a level of care that is greater than once a week outpatient treatment and is willing to participate in the study.
  2. Participant's parent or legally authorized representative (LAR) must provide signature of , and there must be documentation of assent by the participant.
  3. Participant meets Fourth Edition (DSM-IV) or Fifth Edition (DSM-V) criteria for a clinically impairing anxiety disorder based on detailed psychiatric evaluation at screening including completion of the Anxiety Disorders Interview Schedule for DSM-IV or DSM-V Child Version (ADIS-C) and a Children's Global Assessment Scale (CGAS) score less than 65.
  4. Participants who are female of (defined as ≥9 years of age or if \<9 years of age are post-menarchal) must have a negative urine pregnancy test at the Baseline Visit. Females of child-bearing potential must abstain from sexual activity that could result in pregnancy or agree to use acceptable methods of . Condoms should be used with the following acceptable contraceptives:

    • Intrauterine devices,
    • Hormonal contraceptives (oral, depot, patch, injectable, or vaginal ring).
    • Other acceptable contraceptive methods are double barrier methods (e.g., condoms and diaphragms with spermicidal gel or foam).

Exclusion criteria

Exclusion Criteria:

  1. Participant has a current co-morbid psychiatric diagnosis of bipolar disorder, psychosis, a pervasive developmental disorder other than Asperger's Syndrome, an eating disorder, substance abuse disorder, or a sleep disorder of narcolepsy and/or sleep apnea.
  2. Participant has any condition or illness which, in the opinion of the study doctor, represents as an inappropriate risk to the participant and/or could confound the interpretation of the study.
  3. Participant has received any evidence-based psychosocial intervention in the past 6 weeks i.e. Individual Cognitive Behavioral Therapy, Group Cognitive Behavioral Therapy, or Social Effectiveness Training.
  4. Participant is unwilling or unable to provide blood, urine, and/or saliva samples at designated visits.
  5. Participant is female and is pregnant or is currently lactating.
  6. Participant is currently considered at risk for suicide in the opinion of the study doctor, has made a suicide attempt within the past 6 months, or is currently reporting active suicidal ideation. Participants with intermittent passive suicidal ideation are not necessarily excluded based on the assessment of the study doctor. Control participants with any suicidal ideation will not be eligible for the study.
  7. Participant has had a substance use disorder within the past 6 months.
  8. Participant has a abnormality on drug and alcohol screen.
  9. Participant has started or changed the dosage of medication (including herbal supplements) that has anxiolytic, anxiogenic, or central nervous system (CNS) effects within the past 3 months.
  10. Participant has a known or suspected allergy, , or clinically significant intolerance to any components found in the study drug.
  11. Participant has had several failed attempts with SSRI treatment.
  12. Participant has an acute illness and/or is taking short term medication at the time of initiation of the study.
  13. Participant failed screening or was previously enrolled in this study
  14. Participant is unable to read.
Terms in these criteria, in plain language(6)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

DSM diagnostic criteria

The American Psychiatric Association’s manual of mental health diagnoses. DSM-5 (2013, revised as DSM-5-TR in 2022) replaced DSM-IV, and some studies still name the older edition. “Meets DSM criteria for …” means diagnosed by that edition’s diagnostic criteria, usually by a clinician in an interview.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

05

Study design

Phase
Not applicable
Primary purpose
Diagnostic
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
14 participants (actual)

Study arms

  • Active comparator
    Sertraline

    Sertraline will be administered PO to treat anxiety disorders in children and adolescents. he following dosing schedules will be used: Sertraline will be titrated from 25mg once a day orally up to 200mg once a day orally, for 12 weeks. The titration will stop at the dose in which the participant shows a full response to the medication or experiences side effects that will inhibit titration.

    Drug: Sertraline

  • No intervention
    Control

    There will be no intervention in this arm.

Interventions

  • Sertraline will be administered to treat anxiety disorders in children and adolescents.

    Also known as: Zoloft

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What researchers measure

Primary outcomes

  1. Clinical Global Impression-Improvement (CGI-I) Score

    The CGI-I score at the final visit will determine treatment response. The CGI-Improvement scale comprises a one-item measures evaluating the following change from the initiation of treatment on a seven-point scale. The following one query is rated on a seven-point scale: "Compared to the patient's condition at admission to the project \[prior to medication initiation\], this patient's condition is: 1=very much improved since the initiation of treatment; 2=much improved; 3=minimally improved; 4=no change from baseline (the initiation of treatment); 5=minimally worse; 6= much worse; 7=very much worse since the initiation of treatment. CGI-I scale of 1-2 is considered response to treatment. Anything below that is considered non-response to sertraline treatment.

    Time frame: Final visit, at 12 weeks of treatment

07

Results

Posted Oct 11, 2021

Participant flow

Participant flow — Overall Study
MilestoneSertralineHealthy Control
Started131
Completed71
Not completed60

Outcome measures

PrimaryClinical Global Impression-Improvement (CGI-I) Score

The CGI-I score at the final visit will determine treatment response. The CGI-Improvement scale comprises a one-item measures evaluating the following change from the initiation of treatment on a seven-point scale. The following one query is rated on a seven-point scale: "Compared to the patient's condition at admission to the project \[prior to medication initiation\], this patient's condition is: 1=very much improved since the initiation of treatment; 2=much improved; 3=minimally improved; 4=no change from baseline (the initiation of treatment); 5=minimally worse; 6= much worse; 7=very much worse since the initiation of treatment. CGI-I scale of 1-2 is considered response to treatment. Anything below that is considered non-response to sertraline treatment.

Time frame:
Final visit, at 12 weeks of treatment
Reported as:
Mean · units on a scale
Clinical Global Impression-Improvement (CGI-I) Score
units on a scaleSertraline RespondersSertraline Non-Responders
Clinical Global Impression-Improvement (CGI-I) Score1.00 ± 1.403.66 ± 2.12
Statistical analysis
  • Sertraline Responders vs Sertraline Non-Responders · t-test, 2 sided · p = =0.0002

Adverse events

Collected over Adverse event data was collected for 12 weeks during the duration the patients were receiving medications. Only participants who were treated and healthy controls were monitored/assessed for adverse events.. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Sertraline0/8 (0%)0/8 (0%)0/8 (0%)
Healthy Control0/1 (0%)0/1 (0%)0/1 (0%)

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)SertralineControlTotal
<=18 years12012
Between 18 and 65 years112
>=65 years000
Sex: Female, Male
Sex: Female, Male(Participants)SertralineControlTotal
Female819
Male505
Race (NIH/OMB)
Race (NIH/OMB)(Participants)SertralineControlTotal
American Indian or Alaska Native000
Asian000
Native Hawaiian or Other Pacific Islander000
Black or African American213
White11011
More than one race000
Unknown or Not Reported000
Region of Enrollment
Region of Enrollment(participants)SertralineControlTotal
United States13114
08

Study locations

1 site
  • NYSPI
    New York, New York 10032, United States
09

References and documents

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No

10

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Jul 2014 to primary completion in Dec 2019, 65 months.

Results were first posted in Oct 2021, 1 year 10 months after primary completion. A results delay was requested in Feb 2021.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 7, 2014
First posted
Jul 14, 2014
StartActual
Jul 2014
Primary completionActual
Dec 2019
CompletionActual
Dec 2019
Results delay requested
Feb 18, 2021
Results first posted
Oct 11, 2021
Last update
Oct 11, 2021
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Oct 11, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT02189213
Collaborators
Columbia University
Responsible party
Amir A. Levine (Psychiatrist 2/Associate Professor of Clinical Psychiatry, New York State Psychiatric Institute) — Principal investigator
First posted
Jul 14, 2014
Start date
Jul 2014
Primary completion
Dec 2019
Completion
Dec 2019
Results posted
Oct 11, 2021
Last update
Oct 11, 2021

Study contacts

Amir Levine
principal investigator · New York State Psychiatric Institue

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is terminated, as verified in Sep 2021. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Sertraline

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