ISRCTN ISRCTN28988273
DOI https://doi.org/10.1186/ISRCTN28988273
Clinical Trials Information System (CTIS) 2008-000281-23
Protocol serial number N/A
Sponsor University of Oxford (UK)
Funder National Institute for Health Research, Research for Innovation, Speculation and Creativity (RISC) programme (UK)
Submission date
09/04/2008
Registration date
16/05/2008
Last edited
21/04/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Acute mania or a milder form called hypomania are ways in which bipolar disorder (manic depression) presents. Patients often require hospitalisation and usually require drug treatment with anti-psychotic drugs and mood stabilisers as well as valium-like tranquilisers. The main symptoms include over-activity, racing thoughts, grandiose beliefs and sleep loss. Melatonin is a naturally occurring hormone in the human body which is produced in darkness and suppressed by light. In animal studies it has been shown to inform body tissues about seasonal and light/dark information. In previous studies it caused an improvement in manic symptoms. A further small study of five people showed no effect but was too small a study to answer whether melatonin helps for mania/hypomania. In view of the above it is proposed that melatonin could help as a treatment for acute episodes of mania.

Who can participate?
Manic or hypomanic individuals aged from 18 to 65.

What does the study involve?
Participants will be randomly allocated to take either a melatonin (circadin) tablet or a placebo (dummy) tablet every night 1 hour 30 minutes before sleep for 21 days. Mood and sleep rating scales would be used to assess the progress of the patients on the treatments as well as a special watch which picks up levels of activity and sleep, called an Actiwatch. We will also test if melatonin can improve sleep in this group and reduce overactivity.

What are the possible benefits and risks of participating?
We would expect to see early sleep improvements as well as improvement in other symptoms on a more gradual basis in the group taking melatonin. If successful, it is hoped that early use of melatonin might enable some people to stay out of hospital for their period of relapse and get well sooner.

Where is the study run from?
University of Oxford (UK)

When is the study starting and how long is it expected to run for?
July 2008 to December 2009

Who is funding the study?
National Institute for Health Research (UK)

Who is the main contact?
Dr Digby Quested
digby.quested@psych.ox.ac.uk

Contact information

Dr Digby Quested
Scientific

Warneford Hospital
Headington
Oxford
OX37JX
United Kingdom

Phone +44 (0)1865 223703
Email digby.quested@psych.ox.ac.uk

Study information

Primary study designInterventional
Study designDouble-blind randomised controlled phase 2 trial
Secondary study designRandomised controlled trial
Study type Participant information sheet
Scientific titleMelatonin In Acute Mania Investigation (MIAMI-uk): a randomised controlled phase 2 trial
Study acronymMIAMI-uk
Study objectivesMelatonin as a possible treatment for mania.
Ethics approval(s)Ethics Committee Oxford REC A, 04/09/2009, ref: 09/H0604/63
Health condition(s) or problem(s) studiedBipolar disorder
InterventionMelatonin (circadin) 2 mg tablet orally at night 1 hour 30 min before sleep, or placebo for 21 days.
Intervention typeDrug
PhasePhase II
Drug / device / biological / vaccine name(s)Melatonin
Primary outcome measure(s)

Young Mania Rating Scale at baseline, days 4, 7, 14 and 21.

Key secondary outcome measure(s)

1. Activity on the Actiwatch to continue for 21 days
2. Quick Inventory of depressive symptoms C16 (Clinician) at baseline, days 4, 7, 14 and 21
3. Quick Inventory of depressive symptoms SR16 (self report) at baseline, days 4, 7, 14 and 21
4. Altman mania rating scale at baseline, days 4, 7, 14 and 21
5. Adverse events. Duration of follow-up: 21 days
6. Leeds Sleep Evaluation Questionnaire (LSEQ), carried out at baseline, day 4, day 7, day 14 and day 21

Completion date29/06/2012

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
Upper age limit65 Years
SexAll
Target sample size at registration90
Total final enrolment41
Key inclusion criteria1. Age limit from 18 to 65, both genders
2. Young Mania Rating Scale >=20
3. In or out-patients meeting the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM4) criteria for bipolar disorder
4. Currently experiencing manic symptoms
5. Capacity to give informed consent
Key exclusion criteria1. Clinically significant substance abuse
2. Comorbid Axis 1 disorders (DSM4)
Date of first enrolment01/07/2008
Date of final enrolment31/12/2009

Locations

Countries of recruitment

  • United Kingdom
  • England

Study participating centre

Warneford Hospital
Oxford
OX37JX
United Kingdom

Results and Publications

Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Basic results 21/04/2020 No No
HRA research summary 28/06/2023 No No
Participant information sheet Participant information sheet 11/11/2025 11/11/2025 No Yes

Editorial Notes

21/04/2020: The following changes were made to the trial record:
1. Added clinicaltrialsregister.eu link to basic results (scientific).
2. The total final enrollment was added.
30/04/2018: Conference proceedings were added to the publication and dissemination plan.
04/03/2016: the overall trial end date was changed from 31/12/2009 to 29/06/2012.