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Trial registered on ANZCTR
Registration number
ACTRN12623001158651
Ethics application status
Approved
Date submitted
17/10/2023
Date registered
8/11/2023
Date last updated
21/07/2024
Date data sharing statement initially provided
8/11/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
The influence of amitriptyline on human thermoregulation in young healthy adults
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Scientific title
The influence of amitriptyline on critical thermal limits in young healthy adults
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Secondary ID [1]
310803
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
AHT
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Heat related thermal strain
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Heat related cardiovascular strain
331788
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Heat related changes in thermal perceptions (i.e., comfort and sensation)
331789
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Condition category
Condition code
Injuries and Accidents
328525
328525
0
0
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Other injuries and accidents
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Public Health
328526
328526
0
0
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Other public health
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Cardiovascular
328527
328527
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0
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Normal development and function of the cardiovascular system
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Neurological
328627
328627
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0
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Studies of the normal brain and nervous system
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants will be asked to complete a humidity ramp heat stress test 7 hours after oral ingestion of a single dose of 75 mg amitriptyline hydrochloride or placebo. All participants will complete two trials, one with amitriptyline hydrochloride and one with placebo in a cross-over design with a wash-out period between treatments of at least 7 days. Ingestion of the drug/placebo will occur onsite and will be monitored by research staff.
The heat stress test involves participants being asked to remain seated while exposed to 43°C, 20% relative humidity (RH) for 30 minutes before a stepwise increase in relative humidity occurs (4% every 8 min until 64% RH). The heating protocol is a standard methodological approach within the field of human thermoregulation. The total duration of the heat stress test is 118min. The heat stress test is carried out in a climate-controlled chamber at the research clinic and monitored by research staff.
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Intervention code [1]
327214
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Prevention
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Intervention code [2]
327215
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Early detection / Screening
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Intervention code [3]
327216
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Treatment: Drugs
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Comparator / control treatment
Participants will be asked to complete a humidity ramp heat stress test 7 hours after oral ingestion of a single dose of identical placebo containing non-active microcrystalline cellulose. The heat stress test involves participants being exposed to 43°C, 20% relative humidity (RH) for 30 minutes before a stepwise increase in relative humidity occurs (4% every 8 min until 64% RH). The heating protocol is a standard methodological approach within the field of human thermoregulation.
The study is a crossover trial with all participants carrying out an amitriptyline and a placebo control trial.
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Control group
Placebo
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Outcomes
Primary outcome [1]
336347
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Critical relative humidity at which an inflection in rectal temperature is observed
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Assessment method [1]
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Measured environmental conditions in the climate-controlled chamber and a thin, flexible temperature probe self-inserted 10-12 cm into the participants' rectum for rectal temperature.
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Timepoint [1]
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The "critical" relative humidity is when an inflection in rectal temperature is observed during the ramp.
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Secondary outcome [1]
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Critical relative humidity at which an inflection in heart rate is observed
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Assessment method [1]
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Measured environmental conditions in the climate-controlled chamber and a chest strap monitor for heart rare
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Timepoint [1]
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The "critical" relative humidity is when an inflection in heart rate is observed during the ramp.
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Secondary outcome [2]
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Change in rectal temperature
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Assessment method [2]
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A thin, flexible temperature probe self-inserted 10-12 cm into the participants' rectum.
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Timepoint [2]
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Change from minimum to maximum rectal temperature recorded during the heat stress test
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Secondary outcome [3]
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Change in heart rate
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Assessment method [3]
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Absolute heart rate (beats per minute) will be continuously recorded via chest strap monitor.
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Timepoint [3]
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Change from minimum to maximum heart rate recorded during the heat stress test
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Secondary outcome [4]
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Perceptual rating of whole-body thermal sensation
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Assessment method [4]
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Using a 100 mm visual analogue scale participants will rate their whole body thermal sensation from neutral (0 mm) to very hot (100 mm) providing inside into their perception of their thermal environment as well as the influence of the intervention on this perception.
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Timepoint [4]
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At the end of baseline (30min) and every 16 min points, 38 to 118 min during the heat stress test.
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Secondary outcome [5]
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Perceptual rating of whole-body thermal discomfort
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Assessment method [5]
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Thermal discomfort will be monitored via a four-point visual analogue scale which ranges from not uncomfortable (1) to very uncomfortable (4). This outcome will indicate the thermal acceptability of the environment/ intervention combination.
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Timepoint [5]
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At the end of baseline (30min) and every 16 min points, 38 to 118 min during the heat stress test.
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Secondary outcome [6]
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Thirst perception
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Assessment method [6]
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Participants will be asked to rate their thirst, mouth dryness and how pleasant a drink of water would be on three separate visual analogue scales. These scales are each 100 mm long and the participant may mark anywhere on the line, with a score between 0-100 being determined for each. These three scores will be taken as an indication of the participants level of thirst throughout the exposure.
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Timepoint [6]
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At the end of baseline (30min) and every 16 min points, 38 to 118 min during the heat stress test.
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Secondary outcome [7]
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Whole body sweat rate/ loss
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Assessment method [7]
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Nude body mass will be measured on a platform scale to calculate sweating output (g/h).
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Timepoint [7]
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Body mass measurements will take place at the beginning and end of each heat stress test.
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Secondary outcome [8]
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Activated sweat gland density
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Assessment method [8]
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Iodine soaked cotton paper (9 cm^2) will be applied to the skin surface at the upper back for a period of 3-5 seconds intermittently throughout the exposure. This will reveal each individual sweat gland that is active in the area of application allowing the subsequent estimation of active sweat glands (glands/cm^2).
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Timepoint [8]
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Sweat gland density will be measured at 94min and 118min during the heat stress test
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Secondary outcome [9]
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Rectal Temperature
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Assessment method [9]
427952
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A thin, flexible temperature probe self-inserted 10-12 cm into the participants' rectum.
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Timepoint [9]
427952
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At end of baseline (30min) and every 16 min points, 38 to 118 min during the heat stress test
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Secondary outcome [10]
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Heart Rate (absolute)
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Assessment method [10]
427953
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Absolute heart rate (beats per minute) will be continuously recorded via chest strap monitor.
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Timepoint [10]
427953
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At end of baseline (30min) and every 16 min points, 38 to 118 min during the heat stress test
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Secondary outcome [11]
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Rate pressure product
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Assessment method [11]
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The product of systolic blood pressure (measured via an automated blood pressure cuff) and heart rate (measured via a chest strap monitor) will be calculated and taken as an index of myocardial oxygen consumption, and hence cardiovascular strain (mmHg/bpm).
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Timepoint [11]
427954
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At end of baseline (30min) and every 16 min points, 38 to 118 min during the heat stress test
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Secondary outcome [12]
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Skin blood flow
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Assessment method [12]
427955
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A laser doppler flowmetry (LDF) unit will be secured to the chest and the forearm of the participant and used to monitor cutaneous blood flow.
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Timepoint [12]
427955
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At end of baseline (30min) and every 16 min points, 38 to 118 min during the heat stress test
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Secondary outcome [13]
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Local sweat rate
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Assessment method [13]
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Local sweat rate will be measured continuously during the study visits using a plastic capsule attached to the skin surface and ventilated with dry air on the chest and the forearm
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Timepoint [13]
427956
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At end of baseline (30min) and every 16 min points, 38 to 118 min during the heat stress test
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Eligibility
Key inclusion criteria
1. Between the ages of 18-40 years
2. Able to understand the demands of the protocol, has had any questions answered and has voluntarily signed the participant consent form prior to any study procedures
3. In good health, a non-smoker, with no history of respiratory, metabolic, cardiovascular, blood pressure disease or diabetes and not currently taking any medication
4. Cleared for participation from licenced medical professional
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Minimum age
18
Years
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Maximum age
40
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
1. Determined at risk of bipolar disorder by the study physician, where screening includes detailed psychiatric history, family history of suicide, bipolar disorder and depression
2. Contraindications to rectal temperature including haemorrhoids, heterotopic ossification rectal bleeding or bleeding disorder, fissures or active infections, participants on anticoagulant therapy, and colitis
3. Current smoker
4. Pregnancy
5. History of seizures
6. Glaucoma
7. Cardiovascular disorder(s)
8. Endocrine disorder(s)
9. Hepatic/renal impairment(s)
10. Scheduled elective surgery (within the next 3 months)
11. Taking any regular medication(s), within five days of heat stress test.
12. Known hypersensitivity to amitriptyline
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation via a computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software (i.e. computerised sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Crossover
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Other design features
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Phase
Phase 4
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Type of endpoint/s
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Statistical methods / analysis
The relative humidity at which an inflection is observed and the change during the heat stress test, for both rectal temperature and heart rate, during PLA and AT administration will be performed using paired t-tests, as will HASGD at two time points (94 min and 138 min), and WBSL.
Differences in physiological responses (Trec, Tsk, BP, SkBF/CVC, and LSR) and perceptual measures (WBTS, WBTC, PTS) during PLA and AT administration throughout the heat stress test will be analysed using two-way repeated measures analysis of variance utilising the independent variables of treatment (2 levels: PLA, AT) and time (7 levels, end of baseline (30 min) every 16 min (38-118).
All values will be reported as the mean (±SD), and a the level for all statistical analyses will be set at 0.05.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
13/11/2023
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Actual
13/11/2023
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
18
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Accrual to date
12
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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The University of Sydney (Discretionary Research Account held by Dr. Ollie Jay)
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Address [1]
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The University of Sydney Camperdown NSW 2006
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Country [1]
315040
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Australia
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Primary sponsor type
University
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Name
The University of Sydney
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Address
The University of Sydney Camperdown NSW 2006
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
317068
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Country [1]
317068
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
314001
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The University of Sydney Human Research Ethics Committee
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Ethics committee address [1]
314001
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Research Integrity & Ethics Administration Research Portfolio Level 3, F23 Administration Building The University of Sydney, NSW, 2006
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Ethics committee country [1]
314001
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Australia
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Date submitted for ethics approval [1]
314001
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Approval date [1]
314001
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25/07/2023
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Ethics approval number [1]
314001
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2022/449
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Summary
Brief summary
The influence of amitriptyline on critical thermal limits. Primary objective is to assess whether oral ingestion of amitriptyline influences critical thermal limits and thermal and cardiovascular strain during an acute heat stress. With a secondary outcome to assess whether oral ingestion of amitriptyline influences heat and thirst perception during an acute heat stress. Participants will be asked to complete a humidity ramp heat stress test 7 hours after oral ingestion of either i) 75 mg placebo (PLA) or, ii) 75 mg amitriptyline hydrochloride (AT). The heat stress test involves participants being exposed to 43°C, 20% relative humidity (RH) for 30 minutes before a stepwise increase in relative humidity occurs (4% every 8 min until 64% RH). The heating protocol is a standard methodological approach within the field of human thermoregulation. We anticipate that amitriptyline, an anticholinergic, may decrease sweat output, and as a result exacerbate the rectal temperature and heart rate response to a given heat stress.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Ollie Jay
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Address
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Susan Wakil Health Building, The University of Sydney, Western Ave, Camperdown NSW 2050
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Country
130082
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Australia
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Phone
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+61 449116760
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Fax
130082
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Email
130082
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[email protected]
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Contact person for public queries
Name
130083
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Ollie Jay
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Address
130083
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Susan Wakil Health Building, The University of Sydney, Western Ave, Camperdown NSW 2050
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Country
130083
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Australia
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Phone
130083
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+61 449116760
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Fax
130083
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Email
130083
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[email protected]
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Contact person for scientific queries
Name
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Ollie Jay
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Address
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Susan Wakil Health Building, The University of Sydney, Western Ave, Camperdown NSW 2050
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Country
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Australia
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Phone
130084
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+61 449116760
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Fax
130084
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Email
130084
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
De-identified individual participant data underlying published results only.
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When will data be available (start and end dates)?
Immediately following publication, no end date.
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Available to whom?
Case-by-case basis at the discretion of the primary investigator.
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Available for what types of analyses?
Meta-analysis.
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How or where can data be obtained?
Access subject to approvals by the primary investigator with a requirement to sign a data access agreement. Email:
[email protected]
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
20677
Study protocol
[email protected]
20678
Informed consent form
[email protected]
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF