Depression and Health Outcomes in Refractory Epilepsy
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Purpose
To define the benefits of antidepressant treatment or cognitive behavior therapy on mood, function, and quality of life in persons with depression and refractory epilepsy.
| Condition | Intervention | Phase |
|---|---|---|
|
Depression Epilepsy |
Drug: sertraline Behavioral: cognitive behavior therapy |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Depression and Health Outcomes in Refractory Epilepsy |
- Depression as measured by the CES-D [ Time Frame: completed every 2 weeks during the 16 week intervention period and at 6 month and 1 year follow ups ] [ Designated as safety issue: No ]
- MINI [ Time Frame: completed at screen and 16 weeks ] [ Designated as safety issue: No ]
- Health Related Quality of life as measured by the QOILIE-89 [ Time Frame: completed every 4 weeks during the 16 week intervention period and at 6 month and 1 year follow ups ] [ Designated as safety issue: No ]
- antiepileptic medication compliance [ Time Frame: assessed at 16 weeks ] [ Designated as safety issue: No ]
- antiepileptic medication toxicity as measured by the AEP [ Time Frame: assessed every 2 weeks during the 16 week intervention period ] [ Designated as safety issue: No ]
- seizure frequency and seizure severity [ Time Frame: assessed every 2 weeks during the 16 week intervention period ] [ Designated as safety issue: No ]
| Enrollment: | 140 |
| Study Start Date: | August 2001 |
| Study Completion Date: | June 2008 |
| Primary Completion Date: | June 2007 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: Sertraline |
Drug: sertraline
Sertraline: 25-200mg PO (orally); Subjects begin at 25mg for week 1 and increase to 50mg at the beginning of week 2. Sertraline is increased in 50mg increments when subjects score in the depressed range on the CES-D, a questionnaire that is administered every 2 weeks over the 16 week intervention period. Subjects may reduce dosage if toxicity occurs.
|
| Active Comparator: CBT |
Behavioral: cognitive behavior therapy
CBT (Cognitive Behavior Therapy) - CBT is a psychotherapy based on modifying cognitions, assumptions, beliefs and behaviors, with the aim of influencing disturbed emotions. Subjects will meet with a trained CBT therapist for 1 hour each week over the 16 week intervention period and will be given assignments to work on each week.
Other Name: CBT
|
Detailed Description:
This randomized clinical trial will be conducted to compare the drug sertraline to cognitive behavioral therapy on symptoms of depression, antiepileptic medication compliance, seizure frequency, and quality of life outcomes in persons with depression and a seizure disorder or epilepsy. Approximately 140 persons will be enrolled in this study over a period of five years. Individual participation will last approximately 16 weeks. Study participants will be chosen randomly to receive either the study medication (sertraline) or cognitive behavior therapy for 16 weeks. Sertraline is approved by the Food and Drug Administration (FDA). Subjects who receive cognitive behavior therapy will be provided with a one-hour individual session with a licensed clinical psychologist each week for 15 weeks. All study participants will attend scheduled clinic visits every 4 weeks for 16 weeks.
Eligibility| Ages Eligible for Study: | 21 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
INCLUSION:
- Must have a seizure disorder.
- Must meet the DSM-IV criteria for major depression.
- Must be willing to provide written informed consent.
- Must be age 21 to 75 years old.
- Must be compliant, cooperative, reliable, and able to follow instructions, and to visit the clinic on schedule.
EXCLUSION:
- Have active suicidal or homicidal ideation.
- Have current alcohol or other substance abuse disorders or a history of bipolar depression or any psychotic disorder.
- Are pregnant or lactating.
- Are known to be hypersensitive to sertraline.
- Have a progressive central nervous system disorder (such as a tumor or multiple sclerosis), or severe hepatic or renal disease (serum creatinine >3 mg/dl).
- Currently taking an antidepressant medication or seeing a therapist regularly.
Contacts and Locations| United States, Missouri | |
| Washington University School of Medicine | |
| St. Louis, Missouri, United States | |
| United States, New York | |
| Columbia University Medical Center | |
| New York, New York, United States | |
| Principal Investigator: | Frank Gilliam, M.D. | Dept. of Neurology, Columbia University, New York |
More Information
No publications provided
| Responsible Party: | Columbia University |
| ClinicalTrials.gov Identifier: | NCT00026637 History of Changes |
| Other Study ID Numbers: | AAAB1084, R01NS4080 |
| Study First Received: | November 14, 2001 |
| Last Updated: | January 12, 2012 |
| Health Authority: | United States: Federal Government |
Keywords provided by Columbia University:
|
depression epilepsy seizures |
Additional relevant MeSH terms:
|
Depression Depressive Disorder Epilepsy Behavioral Symptoms Mood Disorders Mental Disorders Brain Diseases Central Nervous System Diseases Nervous System Diseases Sertraline Antidepressive Agents |
Psychotropic Drugs Central Nervous System Agents Therapeutic Uses Pharmacologic Actions Serotonin Uptake Inhibitors Neurotransmitter Uptake Inhibitors Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Serotonin Agents Physiological Effects of Drugs |
ClinicalTrials.gov processed this record on May 16, 2013