Condition category
Mental and Behavioural Disorders
Date applied
Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status
No longer recruiting
Publication status

Plain English Summary

Not provided at time of registration

Trial website

Contact information



Primary contact

Prof Ian Anderson


Contact details

Neuroscience and Psychiatry Unit
Room G704 Stopford Building
Stopford Building
Oxford Road
M13 9PT
United Kingdom

Additional identifiers

EudraCT number number

Protocol/serial number


Study information

Scientific title

REmission MEchanisms in Depression



Study hypothesis

We will recruit 48 unmedicated depressed participants aged 18 - 55 years with a Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) major depressive episode and 24 age and sex matched controls. Depressed participants will be scanned using magnetic resonance imaging, before and after administration of 8 weeks treatment with daily citalopram (20 mg, increasing to 40 mg at week 4 if necessary). Half of the controls will be retested after 8 weeks but receive no treatment. Also, prior to oral administration of citalopram, depressed participants will be randomised to receive citalopram or saline infusion in the scanning protocol. Depressed participants will be treated by the clinical research fellow and monitored for treatment response, side effects and suicidal risk by face-to-face appointments at 2, 4, 6 and 8 weeks and by phone interviews at 1, 3 and 5 weeks.

Ethics approval

Stockport LREC approved on the 3rd December 2007

Study design

Randomised interventional treatment trial

Primary study design


Secondary study design

Randomised controlled trial

Trial setting

GP practices

Trial type


Patient information sheet


Topic: Mental Health Research Network, Primary Care Research Network for England; Subtopic: Depression, Not Assigned; Disease: Depression, All Diseases


8 week treatment with citalopram 20 - 40 mg, citalopram pharmacoMRI. Patients are randomised to citalopram infusion (7.5 mg) versus saline during fMRI scanning at baseline in a 3:1 ratio.

Follow up length: 2 months
Study entry: registration only

Intervention type



Not Specified

Drug names


Primary outcome measure

Baseline neuronal responses predicting outcome a 8 weeks

Secondary outcome measures

1. Montgomery Asberg Depression Rating Scale (MADRS), measured at baseline and 8 weeks
2. Neuronal responses to emotional processing tasks using fMRI, measured at baseline and 8 weeks depressed patients versus controls

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


Participant inclusion criteria

Depressed subjects:
1. DSM-IV major depressive episode with a Montgomery Asberg Depression Rating Scale (MADRS) score greater than 20
2. Psychotropic drug-free for greater than 2 weeks (2 months for fluoxetine)

3. Psychiatrically well

4. Good physical health
5. Aged 18 - 55 years, either sex

Participant type


Age group




Target number of participants

Planned Sample Size: 72; UK Sample Size: 72

Participant exclusion criteria

Depressed subjects:
1. Duration of depressive episode greater than 1 year or depression superimposed on dysthymia
2. Failure to respond to 2 antidepressants given for 6 weeks at an adequate dose in current episode
3. Failure to respond to citalopram or escitalopram in current episode
4. Allergy or intolerance to citalopram or escitalopram
5. Contraindications to selective serotonin reuptake inhibitor (SSRI) treatment (e.g., history of peptic ulcer/gasterointestinal [GI] bleeding or taking non-steroidal anti-inflammatory drugs [NSAIDs], in the absence of concurrent ulcer-protective treatment)
6. Other concurrent psychotropic medication except for small stable doses of short acting hypnotics
7. Electroconvulsive therapy (ECT) or lithium in current episode
8. Significant suicidal risk or likely need for other psychiatric intervention during the study period
9. Other current co-morbid Axis I psychiatric disorders except anxiety disorders (excluding OCD) secondary to depression
10. Primary cluster A or B Axis II (personality) disorder
11. History of psychotic, bipolar or organic psychiatric disorder

12. Personal psychiatric history including Axis II (personality) disorder
13. Significant family psychiatric history (eg psychosis, recurrent affective disorder)
14. Psychotropic medication

15. Medical condition that might compromise subject safety or interfere with interpretation of results
16. History of significant head trauma (loss of consciousness greater than 5 minutes)
17. Current medication for a medical condition that would compromise subject safety or interfere with interpretation of results in the judgement of the investigator (e.g., possible exceptions intermittent analgesics, contraceptive pill, occasional inhaler for mild asthma)
18. Subjects whose English is insufficiently good to enable them to validly complete the questionnaires or perform simple computer-based tasks
19. Pregnancy or no effective contraception in women of childbearing age
20. Any illicit drug use in the last 2 months and a lifetime history of a DSM-IV substance or alcohol misuse disorder
21. Current Alcohol use above 14 units/week for women and 21 units/week for men
22. Excessive caffeine use (greater than 6 cups of coffee/day)
23. Smoking greater than 10 cigarettes/day
24. Contraindications to scanning (determined by standard screening instrument)
25. Likely not to be able to complete the full study for any reason

Recruitment start date


Recruitment end date



Countries of recruitment

United Kingdom

Trial participating centre

Neuroscience and Psychiatry Unit
M13 9PT
United Kingdom

Sponsor information


University of Manchester (UK)

Sponsor details

Oxford Road
M13 9PL
United Kingdom

Sponsor type




Funder type

Research council

Funder name

Medical Research Council (MRC) (UK)

Alternative name(s)


Funding Body Type

government organisation

Funding Body Subtype

National government


United Kingdom

Results and Publications

Publication and dissemination plan

PhD thesis:
Arnone D (2011) Imaging structure and function in recovery from depression. Awarded by the University of Manchester for the degree of PhD in the Faculty of Medical and Human Sciences

IPD sharing statement
The datasets generated during and/or analysed during the current study are available upon request from Prof. Emeritus Ian M Anderson ( in an anonymised form and in keeping with MRC data sharing guidance.

Intention to publish date

Participant level data

Available on request

Basic results (scientific)

Publication list

Published conference abstracts:
2009 results in: (added 26/11/2019)
2009 results in: (added 26/11/2019)
2009 results in: Arnone D, Pegg EJ, McKie S, Downey D, Elliott R, Williams SR, Deakin JFW, Anderson IM (2009) Current major depression but not remitted major depression shows increased neural responses to sad facial expressions. Journal of Psychopharmacology Suppl to Vol 23(6), A26 (added 26/11/2019)
2009 results in: Pegg EJ, Arnone D, McKie S, Elliott R, Deakin JFW, Anderson IM (2009) Citalopram treatment increases neural responses to positive words and decreases responses to negative words in depression. Journal of Psychopharmacology Suppl to Vol 23(6), A25 (added 26/11/2019)

Refereed papers:
2012 results in: (added 26/11/2019)
2013 results in: (added 26/11/2019)
2019 results in: (added 26/11/2019)

Publication citations

Additional files

Editorial Notes

26/11/2019: Publication references and IPD sharing statement added. 25/11/2019: No publications found. Verifying results with principal investigator. 14/07/2016: No publications found, verifying study status with principal investigator.