Terminé

The Central Nervous System Effects of Pharmacologically Induced Hypogonadotropic Hypogonadism With and Without Estrogen and Progesterone Replacement

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Ce qui est testé

Leuprolide Acetate 3.75

+ Leuprolide Acetate 3.75

+ Estradiol

Médicament
Qui peut participer

De 18 à 50 ans
Voir tous les critères d'éligibilité
Comment se déroule l'étude

Recherche fondamentale

Phase 1 & 2
Interventionnel
Date de début : juin 1994
Voir le détail du protocole

Résumé

Sponsor principalNational Institute of Mental Health (NIMH)
Dernière mise à jour : 22 mars 2022
Issu d'une base de données validée par les autorités. Revendiquer en tant que partenaire

Date de début de l'étude : 9 juin 1994

Date à laquelle le premier participant a commencé l'étude.

Evidence suggests that the gonadal steroids may exert clinically significant effects on central nervous system function. For example, the menstrual cycle may influence the occurrence of seizures in some female epileptics and the performance on certain cognitive tests. Central nervous system effects of gonadal steroids have been inferred largely from changes in behavior occurring in association with presumed changes in gonadal steroids during the normal menstrual cycle, during the administration of ovarian hormones, or in a gender-specific context. These inferences are, by definition, indirect and associational in nature and further are incapable of disentangling the effects of hormones which are simultaneously present in women of reproductive age. This study is designed to address those problems by comparing measures during Lupron-induced hypogonadism with those during replacement with estrogen or progesterone. On the basis of prior findings from our group and from others, we will be asking the following questions: 1) Is the decreased r-CBF that we observed in the prefrontal cortex during the hypogonadal state confirmed in individual women using new imaging techniques; 2) Will variation in genotype (e.g., COMT val/met, BDNF val/met) confer differential sensitivity to ovarian steroids in brain circuitry and 3) Are the menstrual cycle phase-related changes in reward systems that we previously observed related to estradiol or progesterone actions within the brain (1). Additionally, this protocol will serve as a control study for protocol # 90-M-0088.

NCT00001322
Sponsor principalNational Institute of Mental Health (NIMH)
Dernière mise à jour : 22 mars 2022
Issu d'une base de données validée par les autorités. Revendiquer en tant que partenaire

Protocole

Cette section fournit des détails sur le plan de l'étude, y compris la manière dont l'étude est conçue et ce qu'elle évalue.
Détails du design

100 participants à inclure

Nombre total de participants que l'essai clinique vise à recruter.

Recherche fondamentale

Cette étude cherche à mieux comprendre les mécanismes biologiques à l'origine d'une maladie ou d'un problème de santé, sans viser directement un traitement.


Éligibilité

Les chercheurs recherchent des patients correspondant à une certaine description appelée critères d'éligibilité : état de santé général ou traitements antérieurs du patient.
Critères

Femme

Le sexe biologique des participants éligibles à s'inscrire.

De 18 à 50 ans

Tranche d'âge des participants éligibles à participer.

Volontaires sains autorisés

Indique si les individus en bonne santé et ne présentant pas la condition étudiée peuvent participer.

Critères

INCLUSION CRITERIA: Volunteers participating in this study will be women meeting the following criteria: Between the ages of 18 and 50 years, Not pregnant, In good medical health, Medication free, No history of menstrual-related mood or behavioral disturbances. Additionally, we will recruit a subsample of 20 asymptomatic women who will meet all inclusion and exclusion criteria in this protocol except they will have a history of a past major depressive episode. Finally, a third sample of 10 women who meet all the inclusion and exclusion criteria listed above for this protocol will be recruited to establish the dose range of transdermal estrogen gel for this and related protocols (i.e., 90-M-0088 and 05-M-0059). EXCLUSION CRITERIA: The following conditions will constitute contraindications to treatment with hormonal therapy and will preclude a subject's participation in this protocol: Current Axis I psychiatric diagnosis (with the exception of this women with a past major depression who will be studied on this protocol); History consistent with endometriosis; Diagnosis of ill-defined, obscure pelvic lesions, particularly undiagnosed ovarian enlargement; Hepatic disease as manifested by abnormal liver function tests; History of mammary carcinoma; History of pulmonary embolism or phlebothrombosis; Undiagnosed vaginal bleeding; Porphyria; Diabetes mellitus; History of malignant melanoma; Cholecystitis or pancreatitis; Cardiovascular or renal disease; Pregnancy; Any woman meeting the Stages of Reproductive Aging Workshop Criteria (STRAW) for the perimenopause (129). Specifically, we will exclude any woman with an elevated plasma follicle stimulating hormone (FSH) level (greater than or equal to 14 IU/L) and with menstrual cycle variability of > 7 days different from their normal cycle length. National Institute of Mental Health (NIMH) employees/staff and their immediate family members will be excluded from the study per NIMH policy. Subjects taking birth control pills will be excluded from the study. Subjects taking diuretics, prostaglandin inhibitors, or pyridoxine (putative treatments for MRMD) will similarly be excluded from the study, as will patients taking psychotropic agents (e.g., lithium carbonate, tricyclic antidepressants). All subjects will be required to use non-hormonal forms of birth control (e.g., barrier methods) to avoid pregnancy during this study. Participants who have an active condition that places them at an increased risk for osteoporosis will be excluded from this protocol.

Plan de l'étude

Découvrez tous les traitements administrés dans cette étude, leur description détaillée et ce qu'ils impliquent.
Groupes de traitement
Objectifs de l'étude

3 groupes d'intervention sont désignés dans cette étude

Cette étude ne comporte pas de groupe placebo. 

Groupes de traitement

Groupe I

Expérimental
Eight to 12 weeks of GnRH agonist treatment 3.75 mg given intramuscularly monthly.

Groupe II

Expérimental
12 weeks of GnRH agonist treatment 3.75 mg given intramuscularly monthly. Additionally, 4 weeks of transdermal Estradiol (100mcg/day by skin patch) and placebo suppositories. Week 5 involves 100mcg/day transdermal Estradiol and active Progesterone suppositories (200mg vaginally twice/day). Followed by 1-2 weeks (weeks 6-7) washout period. Then crossover to 5 weeks (week 8-12) of Progesterone suppositories (200mg vaginally twice/day) and placebo patches.

Groupe III

Expérimental
12 weeks of GnRH agonist treatment 3.75 mg given intramuscularly monthly. Additionally, 5 weeks of Progesterone suppositories (200mg vaginally twice/day) and placebo patches. Followed by 1-2 weeks (weeks 6-7) washout period. Then crossover to 4 weeks (weeks 8-11) of transdermal Estradiol (100mcg/day by skin patch) and placebo suppositories. Week 12 involves 100mcg/day transdermal Estradiol and active Progesterone suppositories (200mg vaginally twice/day).

Objectifs de l'étude

Objectifs principaux

Centres d'étude

Ce sont les hôpitaux, cliniques ou centres de recherche où l'essai est conduit. Vous pouvez trouver le site le plus proche de vous ainsi que son statut.

Cette étude comporte 1 site

National Institutes of Health Clinical Center, 9000 Rockville Pike

Bethesda, United StatesOuvrir National Institutes of Health Clinical Center, 9000 Rockville Pike dans Google Maps
Terminé1 Centres d'Étude