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Sponsored by: |
National Institute of Mental Health (NIMH) |
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Information provided by: | National Institute of Mental Health (NIMH) |
ClinicalTrials.gov Identifier: | NCT00612313 |
This study will compare the effectiveness of fluoxetine alone with the effectiveness of fluoxetine with cognitive behavioral therapy in increasing recovery and preventing relapse in youth with major depressive disorder.
Condition | Intervention |
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Depression |
Drug: Fluoxetine Behavioral: Relapse prevention cognitive behavioral therapy (CBT) |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Single Blind (Outcomes Assessor), Active Control, Parallel Assignment, Efficacy Study |
Official Title: | Pediatric MDD: Sequential Treatment With Fluoxetine and Relapse Prevention |
Estimated Enrollment: | 200 |
Study Start Date: | February 2008 |
Estimated Study Completion Date: | January 2013 |
Estimated Primary Completion Date: | January 2013 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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1: Active Comparator
Participants will receive antidepressant treatment with fluoxetine for 30 weeks
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Drug: Fluoxetine
Participants will take 10 to 40 mg per day of fluoxetine for 30 weeks.
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2: Experimental
Participants will receive antidepressant treatment with fluoxetine for 30 weeks plus relapse prevention cognitive behavioral therapy for the last 24 weeks of treatment
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Drug: Fluoxetine
Participants will take 10 to 40 mg per day of fluoxetine for 30 weeks.
Behavioral: Relapse prevention cognitive behavioral therapy (CBT)
After the first 6 weeks of treatment with fluoxetine, some participants will be assigned to additionally receive relapse prevention CBT for the remaining 24 weeks of treatment. These participants will attend 10 to 12 CBT sessions, during which they will learn specific skills to reduce and prevent the occurrence of residual depressive symptoms.
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Major depressive disorder (MDD) is a serious psychiatric disorder that affects approximately 1 out of every 12 to 15 children and adolescents. Depression can cause problems with school, family, and friends, and if left untreated, these difficulties can persist into adulthood. Treatments using antidepressants and forms of psychotherapy have been shown to be effective in reducing symptoms of depression. However, many youth experience a return of depressive symptoms within 1 to 2 years of remission. Recent studies have shown that adding cognitive behavioral therapy (CBT), a form of psychotherapy that focuses on behavioral modification, to initial antidepressant treatment may increase remission and reduce relapse rates. This study will compare the effectiveness of fluoxetine alone versus fluoxetine plus added CBT in increasing recovery and preventing relapse in youth with MDD.
Participation in this study will last 78 weeks. Potential participants will undergo initial screening, which will include interviews and questionnaires about mood, behavior, and medical history; vital sign measurements; blood draws; urine drug and pregnancy tests; a learning assessment; and a meeting with a psychiatrist. All eligible participants will then begin 6 weeks of treatment with fluoxetine. During this 6-week period, participants will attend weekly study visits, which will include vital sign measurements, questionnaires on symptoms and mood, and medication dosage adjustments. At Week 6, participants will be evaluated by an independent evaluator who will determine whether their depression has improved. Participants who have not improved with fluoxetine will end their study participation and will be provided with recommendations for other treatment options.
All participants who have shown improvement will continue to receive fluoxetine for another 24 weeks, for a total of 30 weeks of treatment. Half of these participants will be randomly assigned to additionally receive CBT for the remaining 24 weeks. All participants will attend study visits that will occur every other week for 3 months and then monthly for 3 months. These visits will last 20 to 30 minutes and will include vital sign measurements and questions about mood and behavior. Participants receiving CBT will also attend 10 to 12 CBT sessions, which will last 50 minutes each and will occur weekly for the first 4 weeks, every other week for 1.5 months, and monthly for the last 3 months. The CBT sessions will involve both individual child and parent-child sessions, which will focus on modifying depressive thoughts, feelings, and behaviors. Participants will undergo repeat evaluations with the independent evaluator at Weeks 12, 18, 24, 30, 52, and 78.
Ages Eligible for Study: | 8 Years to 17 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contact: Jaime Murphy, BA | 214-456-8918 | jaime.murphy@utsouthwestern.edu |
United States, Texas | |
Children's Medical Center of Dallas, Outpatient Psychiatry Clinic | Recruiting |
Dallas, Texas, United States, 75235 | |
Principal Investigator: Graham J. Emslie, MD | |
Principal Investigator: Beth D. Kennard, PsyD | |
Sub-Investigator: Rongrong Tao, MD, PhD |
Principal Investigator: | Graham J. Emslie, MD | University of Texas Southwestern Medical Center at Dallas |
Principal Investigator: | Beth D. Kennard, PsyD | University of Texas Southwestern Medical Center at Dallas |
Responsible Party: | University of Texas Southwestern Medical Center ( Graham Emslie, MD ) |
Study ID Numbers: | 2-R01 MH039188-14A2, DSIR 84-CTS |
Study First Received: | February 7, 2008 |
Last Updated: | February 27, 2008 |
ClinicalTrials.gov Identifier: | NCT00612313 |
Health Authority: | United States: Federal Government |
Major Depressive Disorder MDD Children |
Adolescents Antidepressant CBT |
Fluoxetine Depression Mental Disorders Mood Disorders |
Depressive Disorder, Major Depressive Disorder Serotonin Behavioral Symptoms |
Neurotransmitter Agents Neurotransmitter Uptake Inhibitors Serotonin Agents Molecular Mechanisms of Pharmacological Action Therapeutic Uses Physiological Effects of Drugs |
Psychotropic Drugs Antidepressive Agents, Second-Generation Central Nervous System Agents Serotonin Uptake Inhibitors Antidepressive Agents Pharmacologic Actions |