Developing EVIdence for AntidepreSsant ChoicE to Treat Depression in Huntington’s Disease (DEVISE-HD)
Background
Huntington’s Disease (HD) causes problems with movement and thinking, both worsening over time. People with HD also get depression and other mental health problems. Depression is very common in HD and has effects on quality of life and people’s ability to do things. We know that the inability to do everyday things is the main reason HD has high healthcare costs. We think that by properly treating depression, we can improve the quality of life for people with HD and their families and that this will reduce their need to use expensive healthcare services.
Our data shows that depression in HD is different from depression in people without HD. As such, anti-depressant medicines might work differently in people with HD. We do not know how well anti-depressants work in HD or what is the best way of measuring depression in HD.
Aims and Objectives
We want to know how well anti-depressants do or don’t work to improve depression in HD. The first step in answering this question is to test how well a Randomised Controlled Trial (RCT) of anti-depressants may work.
Design and Methods
Forty people with HD who report mild or moderate symptoms of depression to their doctor will be participants in this study. Half of the participants will be treated with a standard antidepressant (Sertraline), and the other half will be given a dummy pill (placebo) for six months. We will measure depression and other HD symptoms at the beginning of the study and again after six months.
We will also collect blood and the fluid surrounding the brain to see if anti-depressant treatment changes substances the body normally produces in response to damaged cells (inflammation). We will use the data to see if people with HD are willing to join the study if they stay in the study and what the best way of measuring depression is.
Public and Patient Involvement (PPI)
We have worked with people with HD and family members to develop this research question, and they have provided input to this application. In addition to our PPI co-applicant, we will involve people with lived experience in the delivery of the study. The PPI research partners will lead the discussion on communicating with study participants and sharing study results with the broader public.
Potential Impact
The results of this study will be used to design a full RCT to answer our question about what, if any, antidepressants are best for treating depression in HD. We will share our results with the study participants and the broader HD community via HD Buzz and patient-focused organisations. The results will be presented to other doctors and researchers at scientific conferences and journals.