A Phase 2 interventional study of Ganaxolone and Placebo in Depressive Disorder, Depression and Depression, Postpartum, sponsored by Marinus Pharmaceuticals. Completed at 33 sites in United States. Open to female participants aged 18 Years to 48 Years. Per ClinicalTrials.gov, last updated 2023-08-18.
Sponsored by Marinus Pharmaceuticals · Phase 2, Interventional, and Treatment
A clinical study to evaluate safety, tolerability and efficacy of oral administration of ganaxolone in women with postpartum depression
Exclusion Criteria:
Oral
Drug: Ganaxolone
Oral
Drug: Placebo
Oral
Oral
Change From Baseline in Hamilton Depression Rating Scale 17-item Version (HAMD17) Through Treatment
The HAMD17 was a 17-item clinician-rated instrument used to assess the range of symptoms that were most frequently observed in participants with major depression. All items were scored on an ordinal scale between 0 and 4 (8 items) or 0 and 2 (9 items) of increasing severity. Each of 17 items was rated by clinician with rating of 0: absent, 1: doubtful to mild, 2: mild to moderate, 3: moderate to severe, and 4: very severe. A total score (0 to 52) was calculated by adding scores of all 17 items, where 0 indicated no depression and 52 indicated severe depression. Higher score represented more severe condition. Baseline was defined as the Day 1 assessment before study drug infusion. Change from Baseline is defined as post dose visit value minus Baseline value.
Time frame: Baseline (Day 1) and through Day 10 for 2 week treatment group and Day 29 for 4 week treatment groups
Change From Baseline in Hamilton Depression Rating Scale 17-item Version Post Treatment
The HAMD17 was a 17-item clinician-rated instrument used to assess the range of symptoms that were most frequently observed in participants with major depression. All items were scored on an ordinal scale between 0 and 4 (8 items) or 0 and 2 (9 items) of increasing severity. Each of 17 items was rated by clinician with rating of 0: absent, 1: doubtful to mild, 2: mild to moderate, 3: moderate to severe, and 4: very severe. A total score (0 to 52) was calculated by adding scores of all 17 items, where 0 indicated no depression and 52 indicated severe depression. Higher score represented more severe condition. Baseline was defined as the Day 1 assessment before study drug infusion. Change from Baseline is defined as post dose visit value minus Baseline value.
Time frame: Baseline (Day 1) and Through Day 38 for 2 week treatment group and Day 71 and 119 for 4 week treatment groups
Number of Participants With Response to Hamilton Depression Rating Scale 17 Item (HAMD17)
HAMD17 Response was defined as ≥50% reduction from Baseline in total score. The HAMD-17 is a 17-item assessment used to assess the severity of depression and its improvement during the course of therapy. Each item was evaluated and scored using either a 5-point scale of 0 (not present/absent) to 4 (very severe) or a 3-point scale of 0 (not present/absent) to 2 (marked). Items rated on the 3-point scale include: insomnia early, middle, late; somatic symptoms gastrointestinal and general; genital symptoms; loss of weight; insight. Items rated on 5-point scale include: depressed mood; feelings of guilt; suicide; work and activities; retardation; agitation; anxiety psychic and somatic; hypochondriasis. The total score was the sum of the scores from HAMD-17 Items 1 through 17 and ranged from 0 (not at all depressed) to 52 (severely depressed). Higher scores indicate greater symptom severity. Number of participants with response to HAMD-17 has been presented.
Time frame: Day 2 (all treatment groups), Day 7 (TID & QHS), Day 8/10 (all treatment groups), Day 15/17 (all treatment groups), Day 22 and 29 (QHS, 1125mg), Day 36/38 (all treatment groups), Day 57/59 (QHS, 1125mg), Day 71 (1125mg), Day 89 (QHS), Day 119 (QHS)
Number of Participants With Hamilton Depression Rating Scale 17-item Remission
Remission was defined as an observed total score of 0 to 7. The HAMD-17 is a 17-item assessment used to assess the severity of depression and its improvement during the course of therapy. Each item was evaluated and scored using either a 5-point scale of 0 (not present/absent) to 4 (very severe) or a 3-point scale of 0 (not present/absent) to 2 (marked). Items rated on the 3-point scale include: insomnia early, middle, late; somatic symptoms gastrointestinal and general; genital symptoms; loss of weight; insight. Items rated on 5-point scale include: depressed mood; feelings of guilt; suicide; work and activities; retardation; agitation; anxiety psychic and somatic; hypochondriasis. The total score was the sum of the scores from HAMD-17 Items 1 through 17 and ranged from 0 (not at all depressed) to 52 (severely depressed). Higher scores indicate greater symptom severity. Number of participants with HAMD-17 remission has been presented.
Time frame: Day 8/10 (all treatment arms), Day 15/17 (all treatment arms), Day 22 and 29 (QHS & 1125mg), Day 36/38 (all treatment arms), Day 57/59 (QHS & 1125mg), Day 71 (1125mg), Day 89 & 119 (QHS)
Change From Baseline in Edinburgh Postnatal Depression Scale (EPDS) Total Score
The EPDS is a validated 10-question depression assessment for postpartum women, which includes anxiety symptoms and excludes constitutional symptoms associated with depression common in the postpartum period, such as changes in sleeping patterns. It consists of 10 multiple choice questions with scores for each question ranging from 0-3. Questions 1, 2, \& 4 are scored 0, 1, 2 or 3 with top box scored as 0 and the bottom box scored as 3. Questions 3 and 5 to 10 are reverse scored, with the top box scored as a 3 and the bottom box scored as 0. Scores are then summed for a total score, which ranges from 0: no depression to 30: severe depression. Higher score indicates severe depression. Baseline was defined as the Day 1 assessment before study drug infusion. Change from Baseline is defined as post dose visit value minus Baseline value.
Time frame: Baseline (Day 1) through Day 119
Change From Baseline in Spielberger State-Trait Anxiety Inventory, 6-item Version
The Spielberger State-Trait Anxiety Inventory was a 6-item questionnaire designed and validated. It is a reliable and sensitive measure of anxiety. The 6-item version has been shown to have acceptable reliability, producing similar scores as the full 20-item inventory for those with normal and raised levels of anxiety. Participants are prompted to respond to indicate "how \[the participant\] feel right now, at this moment", followed by a list of common experiences like "I feel calm, I am tense, I feel upset, I am relaxed I feel content and I am worried." Responses range from Not at all (1) to Very much (4), with overall scores ranging from 20-80, where higher scores reflected higher states of anxiety. Baseline was defined as the Day 1 assessment before study drug infusion. Change from Baseline is defined as post dose visit value minus Baseline value.
Time frame: Baseline (Day 1) through Day 119
Number of Participants With Clinical Global Impression-Improvement
The CGI-I scale is a clinician-rated 7-point scale used to assess how much the participant's illness had improved or worsened relative to a Baseline state at the beginning of the intervention. It was rated as: 1. "very much improved" 2. "much improved" 3. "minimally improved" 4. "no change" 5. "minimally worse" 6. "much worse" 7. "very much worse". Higher scores indicated worse condition. Only those participants with CGI- improvement have been presented.
Time frame: Baseline through Day 119
| Milestone | TID (2-week) | QHS (2-week) | QHS (4-week) | 1125 mg (4-week) |
|---|---|---|---|---|
| Started | 2 | 14 | 25 | 43 |
| Completed | 2 | 9 | 16 | 34 |
| Not completed | 0 | 5 | 9 | 9 |
| Withdrew: Adverse event | 0 | 0 | 0 | 1 |
| Withdrew: Lack of efficacy | 0 | 0 | 0 | 2 |
| Withdrew: Lost to follow-up | 0 | 1 | 2 | 1 |
| Withdrew: Pregnancy | 0 | 0 | 0 | 1 |
| Withdrew: Protocol violation | 0 | 0 | 0 | 1 |
| Withdrew: Withdrawal by subject | 0 | 4 | 7 | 3 |
The HAMD17 was a 17-item clinician-rated instrument used to assess the range of symptoms that were most frequently observed in participants with major depression. All items were scored on an ordinal scale between 0 and 4 (8 items) or 0 and 2 (9 items) of increasing severity. Each of 17 items was rated by clinician with rating of 0: absent, 1: doubtful to mild, 2: mild to moderate, 3: moderate to severe, and 4: very severe. A total score (0 to 52) was calculated by adding scores of all 17 items, where 0 indicated no depression and 52 indicated severe depression. Higher score represented more severe condition. Baseline was defined as the Day 1 assessment before study drug infusion. Change from Baseline is defined as post dose visit value minus Baseline value.
| score on a scale | TID (2-week) | QHS (2-week) | QHS (4-week) | 1125 mg (4-week) |
|---|---|---|---|---|
| Day 2/4 | -8.0 ± 9.90 | -5.7 ± 4.87 | -0.8 ± 3.19 | -2.6 ± 5.46 |
| Day 7 | -15.0 ± 12.73 | -6.7 ± 7.93 | — | — |
| Day 8/10 | -3.0 ± 0 | -10.5 ± 7.21 | -6.8 ± 7.25 | -10.2 ± 7.44 |
| Day 15/17 | -9.5 ± 9.19 | -8.8 ± 7.12 | -9.7 ± 7.36 | -9.4 ± 7.94 |
| Day 22 | — | — | -10.3 ± 5.94 | -12.0 ± 7.98 |
| Day 29 | — | — | -12.2 ± 8.40 | -14.0 ± 7.64 |
The HAMD17 was a 17-item clinician-rated instrument used to assess the range of symptoms that were most frequently observed in participants with major depression. All items were scored on an ordinal scale between 0 and 4 (8 items) or 0 and 2 (9 items) of increasing severity. Each of 17 items was rated by clinician with rating of 0: absent, 1: doubtful to mild, 2: mild to moderate, 3: moderate to severe, and 4: very severe. A total score (0 to 52) was calculated by adding scores of all 17 items, where 0 indicated no depression and 52 indicated severe depression. Higher score represented more severe condition. Baseline was defined as the Day 1 assessment before study drug infusion. Change from Baseline is defined as post dose visit value minus Baseline value.
| score on a scale | TID (2-week) | QHS (2-week) | QHS (4-week) | 1125 mg (4-week) |
|---|---|---|---|---|
| Day 36/38 | -19.0 ± 7.07 | -7.1 ± 8.44 | -14.6 ± 9.63 | -12.4 ± 8.82 |
| Day 57/59 | — | — | -13.2 ± 8.20 | -12.3 ± 9.11 |
| Day 71 | — | — | — | -12.2 ± 8.45 |
| Day 89 | — | — | -14.2 ± 9.98 | — |
| Day 119 | — | — | -20.5 ± 6.59 | — |
HAMD17 Response was defined as ≥50% reduction from Baseline in total score. The HAMD-17 is a 17-item assessment used to assess the severity of depression and its improvement during the course of therapy. Each item was evaluated and scored using either a 5-point scale of 0 (not present/absent) to 4 (very severe) or a 3-point scale of 0 (not present/absent) to 2 (marked). Items rated on the 3-point scale include: insomnia early, middle, late; somatic symptoms gastrointestinal and general; genital symptoms; loss of weight; insight. Items rated on 5-point scale include: depressed mood; feelings of guilt; suicide; work and activities; retardation; agitation; anxiety psychic and somatic; hypochondriasis. The total score was the sum of the scores from HAMD-17 Items 1 through 17 and ranged from 0 (not at all depressed) to 52 (severely depressed). Higher scores indicate greater symptom severity. Number of participants with response to HAMD-17 has been presented.
| Participants | TID (2-week) | QHS (2-week) | QHS (4-week) | 1125 mg (4-week) |
|---|---|---|---|---|
| Day 2/4 - Response | 0 | 2 | 0 | 3 |
| Day 7 - Response | 1 | 4 | — | — |
| Day 8/10 - Response | 0 | 4 | 7 | 12 |
| Day 15/17 - Response | 1 | 4 | 7 | 16 |
| Day 22 - Response | — | — | 8 | 20 |
| Day 29 - Response | — | — | 10 | 22 |
| Day 36/38 - Response | 2 | 3 | 12 | 17 |
| Day 57/59 - Response | — | — | 8 | 18 |
| Day 71 - Response | — | — | — | 13 |
| Day 89 - Response | — | — | 9 | — |
| Day 119 - Response | — | — | 10 | — |
Remission was defined as an observed total score of 0 to 7. The HAMD-17 is a 17-item assessment used to assess the severity of depression and its improvement during the course of therapy. Each item was evaluated and scored using either a 5-point scale of 0 (not present/absent) to 4 (very severe) or a 3-point scale of 0 (not present/absent) to 2 (marked). Items rated on the 3-point scale include: insomnia early, middle, late; somatic symptoms gastrointestinal and general; genital symptoms; loss of weight; insight. Items rated on 5-point scale include: depressed mood; feelings of guilt; suicide; work and activities; retardation; agitation; anxiety psychic and somatic; hypochondriasis. The total score was the sum of the scores from HAMD-17 Items 1 through 17 and ranged from 0 (not at all depressed) to 52 (severely depressed). Higher scores indicate greater symptom severity. Number of participants with HAMD-17 remission has been presented.
| Participants | TID (2-week) | QHS (2-week) | QHS (4-week) | 1125 mg (4-week) |
|---|---|---|---|---|
| Day 8/10 - Remission | 0 | 1 | 1 | 8 |
| Day 15/17 - Remission | 0 | 2 | 4 | 8 |
| Day 22 - Remission | — | — | 3 | 10 |
| Day 29 - Remission | — | — | 7 | 14 |
| Day 36/38 - Remission | 1 | 1 | 9 | 11 |
| Day 57/59 - Remission | — | — | 5 | 12 |
| Day 71 - Remission | — | — | — | 9 |
| Day 89 - Remission | — | — | 7 | — |
| Day 119 - Remission | — | — | 8 | — |
The EPDS is a validated 10-question depression assessment for postpartum women, which includes anxiety symptoms and excludes constitutional symptoms associated with depression common in the postpartum period, such as changes in sleeping patterns. It consists of 10 multiple choice questions with scores for each question ranging from 0-3. Questions 1, 2, \& 4 are scored 0, 1, 2 or 3 with top box scored as 0 and the bottom box scored as 3. Questions 3 and 5 to 10 are reverse scored, with the top box scored as a 3 and the bottom box scored as 0. Scores are then summed for a total score, which ranges from 0: no depression to 30: severe depression. Higher score indicates severe depression. Baseline was defined as the Day 1 assessment before study drug infusion. Change from Baseline is defined as post dose visit value minus Baseline value.
| Score on a scale | TID (2-week) | QHS (2-week) | QHS (4-week) | 1125 mg (4-week) |
|---|---|---|---|---|
| Day 2/4 | -0.5 ± 2.12 | -1.4 ± 2.19 | -0.8 ± 1.18 | -0.6 ± 1.64 |
| Day 7 | -2.0 ± 2.83 | -2.3 ± 2.06 | — | — |
| Day 8/10 | -3.0 ± NA | -1.3 ± 1.57 | -1.5 ± 1.74 | -2.3 ± 2.01 |
| Day 15/17 | -5.0 ± 0.00 | -2.6 ± 1.63 | -1.8 ± 2.17 | -2.2 ± 2.38 |
| Day 22 | — | — | -2.7 ± 2.18 | -3.0 ± 2.62 |
| Day 29 | — | — | -2.9 ± 2.79 | -3.1 ± 2.77 |
| Day 36/38 | -2.0 ± 2.83 | -2.6 ± 1.85 | -3.1 ± 2.77 | -3.7 ± 2.64 |
| Day 57/59 | — | — | -2.5 ± 2.46 | -3.4 ± 2.68 |
| Day 71 | — | — | — | -3.3 ± 2.31 |
| Day 89 | — | — | -2.6 ± 2.41 | — |
| Day 119 | — | — | -3.3 ± 3.20 | — |
The Spielberger State-Trait Anxiety Inventory was a 6-item questionnaire designed and validated. It is a reliable and sensitive measure of anxiety. The 6-item version has been shown to have acceptable reliability, producing similar scores as the full 20-item inventory for those with normal and raised levels of anxiety. Participants are prompted to respond to indicate "how \[the participant\] feel right now, at this moment", followed by a list of common experiences like "I feel calm, I am tense, I feel upset, I am relaxed I feel content and I am worried." Responses range from Not at all (1) to Very much (4), with overall scores ranging from 20-80, where higher scores reflected higher states of anxiety. Baseline was defined as the Day 1 assessment before study drug infusion. Change from Baseline is defined as post dose visit value minus Baseline value.
| Scores on a scale | TID (2-week) | QHS (2-week) | QHS (4-week) | 1125 mg (4-week) |
|---|---|---|---|---|
| Day 2/4 | -11.7 ± 11.81 | -6.4 ± 11.77 | -1.8 ± 11.45 | -9.9 ± 14.84 |
| Day 7 | -11.7 ± 7.00 | -9.0 ± 11.86 | — | — |
| Day 8/10 | -20.0 ± NA | -5.7 ± 11.00 | -11.8 ± 12.40 | -16.8 ± 17.53 |
| Day 15/17 | -33.3 ± 9.48 | -14.8 ± 13.45 | -14.5 ± 17.58 | -15.2 ± 19.97 |
| Day 22 | — | — | -13.0 ± 17.48 | -21.8 ± 19.81 |
| Day 29 | — | — | -17.13 ± 17.94 | -21.4 ± 20.34 |
| Day 36/38 | -31.7 ± 2.33 | -11.3 ± 5.31 | -20.5 ± 17.62 | -23.2 ± 18.96 |
| Day 57/59 | — | — | -16.3 ± 15.52 | -22.8 ± 19.72 |
| Day 71 | — | — | — | -19.2 ± 18.75 |
| Day 89 | — | — | -14.7 ± 18.52 | — |
| Day 119 | — | — | -16.7 ± 17.45 | — |
The CGI-I scale is a clinician-rated 7-point scale used to assess how much the participant's illness had improved or worsened relative to a Baseline state at the beginning of the intervention. It was rated as: 1. "very much improved" 2. "much improved" 3. "minimally improved" 4. "no change" 5. "minimally worse" 6. "much worse" 7. "very much worse". Higher scores indicated worse condition. Only those participants with CGI- improvement have been presented.
| Participants | TID (2-week) | QHS (2-week) | QHS (4-week) | 1125 mg (4-week) |
|---|---|---|---|---|
| Day 2/4 - Much Improved | 0 | 1 | 1 | 4 |
| Day 2/4 - Minimally Improved | 1 | 6 | 4 | 15 |
| Day 7 - Very much Improved | 0 | 1 | — | — |
| Day 7 - Much Improved | 1 | 5 | — | — |
| Day 7 - Minimally Improved | 1 | 2 | — | — |
| Day 8/10 - Very much Improved | 0 | 2 | — | 3 |
| Day 8/10 - Much Improved | 1 | 5 | 7 | 14 |
| Day 8/10 - Minimally Improved | 0 | 2 | 8 | 11 |
| Day 15/17 - Very much Improved | 0 | 2 | 1 | 6 |
| Day 15/17 - Much Improved | 2 | 5 | 9 | 15 |
| Day 15/17 - Minimally Improved | 0 | 3 | 5 | 9 |
| Day 22 - Very much Improved | — | — | 1 | 7 |
| Day 22 - Much Improved | — | — | 9 | 16 |
| Day 22 - Minimally Improved | — | — | 6 | 6 |
| Day 29 - Very much Improved | — | — | 4 | 11 |
| Day 29 - Much Improved | — | — | 7 | 16 |
| Day 29 - Minimally Improved | — | — | 8 | 5 |
| Day 36/38 - Very much Improved | 0 | 1 | 8 | 12 |
| Day 36/38 - Much Improved | 2 | 3 | 4 | 10 |
| Day 36/38 - Minimally Improved | 0 | 1 | 7 | 10 |
| Day 57/59 - Very Much Improved | — | — | 4 | 9 |
| Day 57/59 - Much Improved | — | — | 9 | 14 |
| Day 57/59 - Minimally Improved | — | — | 2 | 7 |
| Day 71 - Very Much Improved | — | — | — | 8 |
| Day 71 - Much Improved | — | — | — | 14 |
| Day 71 - Minimally Improved | — | — | — | 6 |
| Day 89 - Very much Improved | — | — | 6 | — |
| Day 89 - Much Improved | — | — | 4 | — |
| Day 89 - Minimally Improved | — | — | 6 | — |
| Day 119 - Very Much Improved | — | — | 5 | — |
| Day 119 - Much Improved | — | — | 3 | — |
| Day 119 - Minimally Improved | — | — | 3 | — |
Collected over Baseline up through Day 119. Non-serious events are listed at a 1% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| TID (2-week) | 0/2 (0%) | 0/2 (0%) | 2/2 (100%) |
| QHS (2-week) | 0/14 (0%) | 0/14 (0%) | 5/14 (35.7%) |
| QHS (4-week) | 0/25 (0%) | 0/25 (0%) | 16/25 (64%) |
| 1125 mg (4-week) | 0/43 (0%) | 1/43 (2.3%) | 32/43 (74.4%) |
| Event | TID (2-week) | QHS (2-week) | QHS (4-week) | 1125 mg (4-week) |
|---|---|---|---|---|
| Pulmonary EmbolismRespiratory, thoracic and mediastinal disorders | 0/2 | 0/14 | 0/25 | 1/43 |
| Event | TID (2-week) | QHS (2-week) | QHS (4-week) | 1125 mg (4-week) |
|---|---|---|---|---|
| SedationNervous system disorders | 2/2 | 2/14 | 3/25 | 7/43 |
| NauseaGastrointestinal disorders | 1/2 | 0/14 | 2/25 | 5/43 |
| DizzinessNervous system disorders | 1/2 | 1/14 | 2/25 | 7/43 |
| HeadacheNervous system disorders | 1/2 | 1/14 | 4/25 | 11/43 |
| SomnolenceNervous system disorders | 0/2 | 0/14 | 4/25 | 9/43 |
| Dry mouthGastrointestinal disorders | 0/2 | 1/14 | 1/25 | 2/43 |
| Hot flushVascular disorders | 0/2 | 1/14 | 1/25 | 2/43 |
| VertigoEar and labyrinth disorders | 0/2 | 0/14 | 0/25 | 2/43 |
| VomitingGastrointestinal disorders | 0/2 | 0/14 | 0/25 | 2/43 |
| Balance disorderNervous system disorders | 0/2 | 0/14 | 0/25 | 2/43 |
Safety Set
| Age, Continuous(years) | TID (2-week) | QHS (2-week) | QHS (4-week) | 1125 mg (4-week) | Total |
|---|---|---|---|---|---|
| Mean | 23.5 ± 7.78 | 27.5 ± 7.27 | 27.4 ± 5.27 | 28.0 ± 5.72 | 27.7 ± 5.84 |
| Sex: Female, Male(Participants) | TID (2-week) | QHS (2-week) | QHS (4-week) | 1125 mg (4-week) | Total |
|---|---|---|---|---|---|
| Female | 2 | 14 | 25 | 43 | 84 |
| Male | 0 | 0 | 0 | 0 | 0 |
| Ethnicity (NIH/OMB)(Participants) | TID (2-week) | QHS (2-week) | QHS (4-week) | 1125 mg (4-week) | Total |
|---|---|---|---|---|---|
| Hispanic or Latino | 1 | 3 | 11 | 12 | 27 |
| Not Hispanic or Latino | 1 | 11 | 14 | 31 | 57 |
| Unknown or Not Reported | 0 | 0 | 0 | 0 | 0 |
| Race (NIH/OMB)(Participants) | TID (2-week) | QHS (2-week) | QHS (4-week) | 1125 mg (4-week) | Total |
|---|---|---|---|---|---|
| American Indian or Alaska Native | 0 | 1 | 0 | 0 | 1 |
| Asian | 0 | 2 | 2 | 0 | 4 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 | 1 | 1 |
| Black or African American | 1 | 4 | 10 | 16 | 31 |
| White | 1 | 7 | 13 | 25 | 46 |
| More than one race | 0 | 0 | 0 | 0 | 0 |
| Unknown or Not Reported | 0 | 0 | 0 | 1 | 1 |
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Marinus Pharmaceuticals