Study of Inflammation and Brain Chemistry in Teens with Depression to Predict Treatment Response and Long-Term Outcomes

What this Trial Is About

Researchers are investigating depression in adolescents, focusing on why up to 40% do not respond to first-line antidepressants called SSRIs. The study aims to understand how acute stress affects inflammation and glutamate levels in brain areas linked to depression, and how these factors relate to treatment non-response TNR and the clinical course over 18 months. This observational study involves 160 unmedicated depressed adolescents aged 14 to 21. Participants undergo a modified Trier Social Stress Test TSST, which includes a 5-minute arithmetic task and a 5-minute speech task, to measure stress responses. At two time points, before and after a 12-week open-label SSRI treatment with fluoxetine or escitalopram, researchers assess inflammation and glutamate in brain circuits using advanced neuroimaging. Follow-up assessments continue every three months for 15 months to track depression symptoms and social stressors. Participants will attend several visits for mood ratings, blood tests, and brain scans. Researchers use questionnaires and behavioral assessments during stress testing to evaluate changes in mood and biological markers. The main outcomes include depression rating scales and clinical interviews at baseline and after 12 weeks. The long-term follow-up monitors depression trajectories and treatment response predictors to better understand sustained threat mechanisms in adolescent depression.

Inflammatory and Glutamatergic Mechanisms of Sustained Threat in Adolescents With Depression