Effects of erythropoietin on depressive symptoms and neurocognitive deficits in depression and bipolar disorder.

BACKGROUND: Depression and bipolar disorder are associated with reduced neural plasticity and deficits in memory, attention and executive function. Drug treatments for these affective disorders have insufficient clinical effects in a large group and fail to reverse cognitive deficits. There is thus...

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Main Authors: Miskowiak, K, Vinberg, M, Harmer, C, Ehrenreich, H, Knudsen, G, Macoveanu, J, Hansen, A, Paulson, O, Siebner, H, Kessing, L
Format: Journal article
Language:English
Published: 2010
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author Miskowiak, K
Vinberg, M
Harmer, C
Ehrenreich, H
Knudsen, G
Macoveanu, J
Hansen, A
Paulson, O
Siebner, H
Kessing, L
author_facet Miskowiak, K
Vinberg, M
Harmer, C
Ehrenreich, H
Knudsen, G
Macoveanu, J
Hansen, A
Paulson, O
Siebner, H
Kessing, L
author_sort Miskowiak, K
collection OXFORD
description BACKGROUND: Depression and bipolar disorder are associated with reduced neural plasticity and deficits in memory, attention and executive function. Drug treatments for these affective disorders have insufficient clinical effects in a large group and fail to reverse cognitive deficits. There is thus a need for more effective treatments which aid cognitive function. Erythropoietin (Epo) is involved in neuroplasticity and is a candidate for future treatment of affective disorders. The investigators have demonstrated that a single dose of Epo improves cognitive function and reduces neurocognitive processing of negative emotional information in healthy and depressed individuals similar to effects seen with conventional antidepressants. The current study adds to the previous findings by investigating whether repeated Epo administration has antidepressant effects in patients with treatment resistant depression and reverses cognitive impairments in these patients and in patients with bipolar disorder in remission. METHODS/DESIGN: The trial has a double-blind, placebo-controlled, parallel-group design. 40 patients with treatment-resistant major depression and 40 patients with bipolar disorder in remission are recruited and randomised to receive weekly infusions of Epo (Eprex; 40,000 IU) or saline (NaCl 0.9%) for 8 weeks. Randomisation is stratified for age and gender. The primary outcome parameters for the two studies are: depression severity measured with the Hamilton Depression Rating Scale 17 items (HDRS-17) 1 in study 1 and, in study 2, verbal memory measured with the Rey Auditory Verbal Learning Test (RAVLT) 23. With inclusion of 40 patients in each study we obtain 86% power to detect clinically relevant differences between intervention and placebo groups on these primary outcomes. TRIAL REGISTRATION: The trial is approved by the Local Ethics Committee: H-C-2008-092, Danish Medicines Agency: 2612-4020, EudraCT: 2008-04857-14, Danish Data Agency: 2008-41-2711 and ClinicalTrials.gov: NCT 00916552.
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spelling oxford-uuid:9b5dc407-620c-430e-b0d5-0de2cdda30342022-03-27T00:28:19ZEffects of erythropoietin on depressive symptoms and neurocognitive deficits in depression and bipolar disorder.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:9b5dc407-620c-430e-b0d5-0de2cdda3034EnglishSymplectic Elements at Oxford2010Miskowiak, KVinberg, MHarmer, CEhrenreich, HKnudsen, GMacoveanu, JHansen, APaulson, OSiebner, HKessing, L BACKGROUND: Depression and bipolar disorder are associated with reduced neural plasticity and deficits in memory, attention and executive function. Drug treatments for these affective disorders have insufficient clinical effects in a large group and fail to reverse cognitive deficits. There is thus a need for more effective treatments which aid cognitive function. Erythropoietin (Epo) is involved in neuroplasticity and is a candidate for future treatment of affective disorders. The investigators have demonstrated that a single dose of Epo improves cognitive function and reduces neurocognitive processing of negative emotional information in healthy and depressed individuals similar to effects seen with conventional antidepressants. The current study adds to the previous findings by investigating whether repeated Epo administration has antidepressant effects in patients with treatment resistant depression and reverses cognitive impairments in these patients and in patients with bipolar disorder in remission. METHODS/DESIGN: The trial has a double-blind, placebo-controlled, parallel-group design. 40 patients with treatment-resistant major depression and 40 patients with bipolar disorder in remission are recruited and randomised to receive weekly infusions of Epo (Eprex; 40,000 IU) or saline (NaCl 0.9%) for 8 weeks. Randomisation is stratified for age and gender. The primary outcome parameters for the two studies are: depression severity measured with the Hamilton Depression Rating Scale 17 items (HDRS-17) 1 in study 1 and, in study 2, verbal memory measured with the Rey Auditory Verbal Learning Test (RAVLT) 23. With inclusion of 40 patients in each study we obtain 86% power to detect clinically relevant differences between intervention and placebo groups on these primary outcomes. TRIAL REGISTRATION: The trial is approved by the Local Ethics Committee: H-C-2008-092, Danish Medicines Agency: 2612-4020, EudraCT: 2008-04857-14, Danish Data Agency: 2008-41-2711 and ClinicalTrials.gov: NCT 00916552.
spellingShingle Miskowiak, K
Vinberg, M
Harmer, C
Ehrenreich, H
Knudsen, G
Macoveanu, J
Hansen, A
Paulson, O
Siebner, H
Kessing, L
Effects of erythropoietin on depressive symptoms and neurocognitive deficits in depression and bipolar disorder.
title Effects of erythropoietin on depressive symptoms and neurocognitive deficits in depression and bipolar disorder.
title_full Effects of erythropoietin on depressive symptoms and neurocognitive deficits in depression and bipolar disorder.
title_fullStr Effects of erythropoietin on depressive symptoms and neurocognitive deficits in depression and bipolar disorder.
title_full_unstemmed Effects of erythropoietin on depressive symptoms and neurocognitive deficits in depression and bipolar disorder.
title_short Effects of erythropoietin on depressive symptoms and neurocognitive deficits in depression and bipolar disorder.
title_sort effects of erythropoietin on depressive symptoms and neurocognitive deficits in depression and bipolar disorder
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