Autism Clinical Trials

Has the Potential Participant been diagnosed by a doctor with any of the following conditions? *
Please select all that apply.

Major depressive disorder (MDD)

Attention deficit hyperactivity disorder (ADHD)

Generalized anxiety disorder (GAD)

Social anxiety disorder (SAD)

Bipolar Disorder (BPD)

Antisocial Personality Disorder

Obsessive Compulsive Disorder (OCD)

Borderline Personality Disorder

Schizophrenia

Schizophreniform disorder

Schizoaffective disorder

Delusional disorder

Eating disorder (anorexia/bulimia/binge eating/etc)

Post-traumatic Stress Disorder (PTSD)

Autism Spectrum Disorder

Rett syndrome

Fragile X syndrome

Type 1 diabetes

Diabetic ketoacidosis

Acute or chronic hepatitis

None of the above

Is the Potential Participant currently experiencing any of the following symptoms of depression? *
Please select all that apply…

Persistent feeling of sadness or emptiness

Loss of interest in things I normally enjoy

Lack of sleep or too much sleep

Lack of energy

Lack of concentration or poor memory

Agitation / outburst / frustration

None of the above

Has the Potential Participant experienced a depressive episode(s) in the past? *
Please note: A depressive episode is a period of two weeks or longer in which a person experiences certain symptoms of major depression: feelings of sadness and hopelessness, fatigue, weight gain or weight loss, changes in sleeping habits, loss of interest in activities, or thoughts of suicide.

Yes - currently experiencing a depressive episode

Yes - but not currently experiencing a depressive episode

No - never experienced a depressive episode

Unsure

Has the Potential Participant tried 2 or more different antidepressant medications? *
Examples include: Prozac® (fluoxetine), Zoloft® (sertraline), Paxil® (paroxetine), Celexa® (citalopram), Lexapro® (escitalopram), Cymbalta® (duloxetine), Effexor XR® (venlafaxine), Pristiq® (desvenlafaxine), Wellbutrin® (bupropion), Remeron® (mirtazapine), Viibryd® (vilazodone), Fetzima® (levomilnacipran), Trintellix® (vortioxetine), etc.

Yes - 2 or more antidepressant medications

No

Is the Potential Participant currently taking antidepressant medication to treat their MDD? *
Examples include: Prozac® (fluoxetine), Zoloft® (sertraline), Paxil® (paroxetine), Celexa® (citalopram), Lexapro® (escitalopram), Cymbalta® (duloxetine), Effexor XR® (venlafaxine), Pristiq® (desvenlafaxine), Wellbutrin® (bupropion), Remeron® (mirtazapine), Viibryd® (vilazodone), Fetzima® (levomilnacipran), Trintellix® (vortioxetine), etc.

Yes - currently taking medication to treat MDD

No

Has the Potential Participant treated their depression symptoms with any of the following? *

Ketamine

Esketamine

Psychedelics (e.g. psilocybin / lisuride)

None of the above

Unsure

Has the Potential Participant ever received treatment with Electroconvulsive Therapy (ECT), vagus nerve stimulation, or transcranial magnetic stimulation (TMS) for their depression in the last 5 years? *

Yes - ECT/VNS/TMS in last 5 years

No

Does the Potential Participant experience irritability symptoms? *
(Examples include mood swings, tantrums, aggressive behavior such as hitting or kicking, sensory sensitivity, communication challenges, or withdrawal/avoidance).

Yes - Experiences irritability symptoms

No

Unsure

Has the Potential Participant been diagnosed (by a doctor) with any other medical conditions? * 
(Note: please include all medical conditions including those that are psychiatric in nature)
Please list here or write 'none'.
Please only include conditions which have been diagnosed by a doctor.

Is the Potential Participant taking any additional medications or treatments for their health conditions? *
Please list them below or type ‘none’.

Has the Potential Participant taken a GLP-1 medication in the last few months? * 
(Example: Ozempic®, Trulicity®, Victoza®, Saxenda®, Rybelsus®, Mounjaro®, Zepbound™) 

Yes - GLP-1 medication

No

Autism Clinical Trials

Study benefits include:

Your child may qualify if they: