RELMED-I: Improving antidepressant choice through computer-based tasks

Summary

We want to understand how antidepressant medications work. Over the past 20 years, research has revealed that antidepressants can change the brain's learning processes. However, it remains unclear if this is how antidepressants treat depression. Computer-based tasks that resemble games are used in research to study learning processes. The different ways people complete these tasks provide insights into how learning occurs in the brain.

Our aim is to find out if two different antidepressants, escitalopram and bupropion, affect learning processes in different ways. To achieve this, participants will complete tasks which allow us to measure learning processes.

We are looking to recruit adults over the age of 18 with low mood or depression, who are under the care of a GP in the UK, are not currently taking an antidepressant and who have no known contraindications to escitalopram and bupropion. We will screen potential participants initially to confirm they are eligible to take part. We are recruiting at five sites in and around London, Oxford, Bristol, Nottingham and Newcastle. People who participate in the study will be randomly allocated to take either escitalopram or bupropion for 6 months (or in some cases a placebo for the first two weeks followed one of the two antidepressants after two weeks) and asked to complete a series of learning tasks on the computer at home. Everyone will complete the same tasks, but people in different groups will take different medications.

We will also ask participants to complete some questionnaires and we will invite participants to take part in two optional brain recording sessions (EEG). We will ask participants to complete the learning tasks and/or the questionnaires again on six occasions in the first six months and one last time after one year. At the end of the study we will compare the learning processes in the different groups. We hope this will help improve the way doctors decide which antidepressant to choose for a particular person.