Actively Recruiting

Phase 4
Age: 18Years - 65Years
All Genders
ID05913947

Lithium Versus Cariprazine in the Acute Phase Treatment of Bipolar Depression A Pragmatic Head-to-head Open, Randomized Multicenter Study The 9th Study of the Danish University Antidepressant Group (DUAG 9)

Led by Aalborg University Hospital · Updated on 2026-01-21

122

Participants Needed

1

Research Sites

N/A

Total Duration

On this page

Sponsors

A

Aalborg University Hospital

Lead Sponsor

G

Glostrup University Hospital, Copenhagen

Collaborating Sponsor

AI-Summary

What this Trial Is About

Researchers are evaluating the effects of lithium compared to cariprazine in adults with bipolar disorder experiencing a current depressive episode. The main focus is to see the difference in improvement on the Hamilton Depression Scale, 6-item version (HDS-6), from the start of treatment to after 8 weeks. The study also compares these medications on other important factors like mood symptoms, sleep, cognitive function, social functioning, and suicidal thoughts. Participants will be randomly assigned to receive either lithium or cariprazine. Lithium treatment starts at 12 mmol once daily before bedtime and may be adjusted to maintain specific blood levels. Cariprazine begins at 1.5 mg daily with possible adjustment to 3 mg after at least two weeks. The study lasts 8 weeks, during which participants have scheduled visits for interviews, ratings, blood samples, ECGs, and urine samples. Telephone interviews are also conducted six times throughout the study. During the study, participants will attend four visits for interviews and assessments, including blood tests and heart monitoring. They will also participate in six telephone interviews. Researchers will measure changes in depression scores and other clinical outcomes. Safety and treatment adherence will be monitored closely. The trial runs until September 2028, allowing thorough assessment of both treatments over the acute phase of bipolar depression.

CONDITIONS

Brief Title

Lithium Versus Cariprazine in the Acute Phase Treatment of Bipolar Depression (DUAG9)

Who Can Participate

Age: 18Years - 65Years
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Diagnosis of bipolar disorder type 1 or 2 with a current depressive episode according to DSM-5
  • Score of at least 21 on the self-reported Major Depression Inventory (MDI)
  • No start or dose increase of psychotropic medication (except specified sleep aids) within 2 weeks before inclusion
  • No new formal psychotherapy sessions (except psychoeducation) in the 4 weeks before inclusion
  • Age between 18 and 64 years at randomization
  • Current depressive episode duration between 4 and 52 weeks
  • Clinical uncertainty about whether lithium or cariprazine is the better choice
  • Female participants must be sterile, non-fertile, or have a negative pregnancy test and use safe contraception
  • Signed informed consent form
Not Eligible

You will not qualify if you...

  • Prior or ongoing acute treatment of the current depressive episode with lithium or cariprazine for more than 14 days
  • Electroconvulsive therapy (ECT) during the current depressive episode
  • MAS score greater than 6
  • Diagnosis of dementia
  • High risk of non-adherence as assessed by investigator
  • Inability to understand Danish language
  • Psychiatric coercion such as forced admission or forensic psychiatric care
  • Presence of clinically relevant delusions, hallucinations, or other psychotic symptoms
  • Suicidality indicated by positive responses on C-SSRS question 4 or 5 or investigator judgment
  • Medical conditions like cancer, kidney failure, epilepsy, or deep brain stimulation device that interfere with study outcomes or safety
  • Current harmful use or dependency of alcohol or drugs
  • Known allergy to any ingredients in the study medications

AI-Screening

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

1 visit (in-person)

Treatment

Duration - 8 weeks

Participants receive active treatment with either lithium or cariprazine for acute bipolar depression to evaluate effectiveness and safety.

Baseline visit and periodic visits during treatment

Trial Site Locations

Total: 1 location

1

Aalborg University Hospital

Aalborg, Denmark, 9000

Actively Recruiting

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Research Team

S

Sanne V. Hovgesen, MD

S

Simon Johnsen, MsN

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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Published Research Related To This Trial

Lithium versus cariprazine in the acute phase treatment for depressive episodes in patients with bipolar disorder: a protocol for a pragmatic open, randomised multicentre study - the 9th trial of the Danish University Antidepressant Group, DUAG-9.

Sanne Vendelbo Hovgesen, Rasmus W Wentzer Licht, Sune Puggaard Vogt Straszek...

https://pubmed.ncbi.nlm.nih.gov/40866064