RecruitingPhase 2NCT06408246

ACE-D Aim 3 Clinical Cognitive Trial to Enhance Translation in Depression

Accelerating Cognition-guided Signatures to Enhance Translation in Depression Aim 3: Clinical Cognitive Trial


Sponsor

Stanford University

Enrollment

162 participants

Start Date

Mar 3, 2026

Study Type

INTERVENTIONAL

Conditions

Summary

The purpose of this study is to understand how a psychotropic medication called guanfacine affects brain network functioning in humans, and how this function interacts with cognitive impairments in people experiencing depressive symptoms.


Eligibility

Min Age: 18 YearsMax Age: 60 Years

Inclusion Criteria10

  • In order to be eligible to participate in this study, an individual must meet all of the following criteria:
  • Provision of signed and dated informed consent form
  • Stated willingness to comply with all study procedures and lifestyle considerations (see Section 5.3) and availability for the duration of the study
  • Male or female
  • Age 18-60 years
  • Fluent and literate in English
  • Meets DSM-5-TR diagnostic criteria for MDE (major depressive episode), and criteria for current or recurrent nonpsychotic MDD using the Mini International Neuropsychiatric Interview (MINI Plus)79
  • A total score of 10 or higher on the PHQ-8 at initial screening, including:
  • a. Endorsement of anhedonia, as indexed by a response of "more than half the days" or "nearly every day" to Item 1 ("Little interest or pleasure in doing things") or endorsement of persistent negative mood, as indexed by a response of "more than half the days" or "nearly every day" to Item 2 ("Feeling down, depressed, or hopeless")
  • Meets criteria for cognitive dysfunction (C+ subgroup) or absence of cognitive dysfunction (C- subgroup) based on results from computerized behavioral testing of cognitive control performance (WebNeuro) and from fMRI scanning using the Go/No-Go task.

Exclusion Criteria35

  • An individual who meets any of the following criteria will be excluded from participation in this study:
  • Presence of one or more of the following conditions established via the participant's medical record and confirmed using the MINI Plus:
  • bipolar disorder (I, II, not otherwise specified, current or lifetime)
  • psychosis (current or lifetime)
  • moderate to severe alcohol or substance use disorders (current)
  • post-traumatic stress disorder (PTSD; current)
  • obsessive compulsive disorder (OCD; current or lifetime)
  • attention deficit hyperactivity disorder (ADHD; current or lifetime)
  • eating disorders (ED; current)
  • Suicidality with active plan
  • Severe impediment to vision, hearing, and/or hand movement
  • Current or lifetime history of medical illness or brain injury that may interfere with assessments
  • Pregnant, breastfeeding, or unwilling or unable to use adequate birth control throughout the study (females of child-bearing potential only)
  • T MRI scanner contraindications (e.g., metal in the body, claustrophobia)
  • Concurrent participation in other intervention studies
  • Current use of psychotropic medications contraindicated by guanfacine or sertraline
  • General medical condition or disorder that is deemed by study physicians to be unsafe for GIR as reported by patient or found on medical screening. This may include:
  • Cardiac-related exclusions:
  • Resting heart rate (HR) \< 55 beats per minute (bradycardia)
  • Systolic blood pressure (SBP) \< 90 mmHg or diastolic blood pressure (DBP) \< 60 mmHg (hypotension)
  • Current symptoms suggestive of cardiac dysfunction based on clinician assessment (e.g., persistent chest pain, palpitations, dizziness, fainting)
  • Renal-related exclusions:
  • eGFR \< 60 mL/min/1.73 m²
  • Current symptoms suggestive of kidney dysfunction based on clinician assessment
  • Hepatic-related exclusions:
  • ALT \> 2× ULN
  • AST \> 2× ULN
  • Current symptoms suggestive of liver dysfunction based on clinician assessment
  • Thyroid-related exclusions:
  • TSH outside normal laboratory reference range
  • Current symptoms suggestive of thyroid dysfunction based on clinician assessment
  • Use of substance deemed by the study physician to be unsafe for use with guanfacine
  • Current use of a strong CYP3A4 inhibitor (e.g., ketoconazole) or inducer (e.g., carbamazepine) that, in the judgment of the study clinician, may alter guanfacine plasma concentrations and cannot be safely discontinued for the duration of the study.
  • Unwillingness to verify biotype classification via fMRI
  • Unwillingness or inability to use a computer or access a computer for assessments.

Interventions

DRUGGuanfacine

Guanfacine immediate release is an established and safe FDA-approved treatment that acts directly by stimulating α2A adrenoceptors.

DRUGSertraline

Sertraline is a well-tolerated FDA-approved antidepressant that is among the most widely prescribed medications for depression.


Locations(2)

Stanford Psychiatry and Behavioral Sciences Department

Palo Alto, California, United States

University of Illinois at Chicago

Chicago, Illinois, United States

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NCT06408246


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