Cost-Effectiveness of Adding Web-Based Cognitive-Behavioral Therapy (CBT) to Luvox CR for Obsessive Compulsive Disorder (OCD)
Recruitment status was Not yet recruiting
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Purpose
This study will test the hypotheses that: 1. 12 weeks of Luvox-CR plus web-based Cognitive-Behavioral Therapy (CBT) [CT-STEPS] will produce greater symptom relief of OCD than treatment with Luvox-CR alone; and, 2. subjects receiving 12 weeks of CT-STEPS added to Luvox-CR treatment after 12-weeks of Luvox-CR monotherapy will experience greater OCD symptom relief (from weeks 12-24) than those continuing Luvox-CR treatment and having access to CT-STEPS from week one. 3. subjects who begin CT-STEPS at week 12 will be more likely to complete it than those who begin CT-STEPS at baseline.
| Condition | Intervention | Phase |
|---|---|---|
|
Obsessive Compulsive Disorder |
Drug: Luvox CR Behavioral: Behavioral Therapy |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Factorial Assignment Masking: Single Blind (Subject) Primary Purpose: Treatment |
| Official Title: | Cost-Effectiveness of Adding Web-Based CBT to Luvox CR for OCD |
- The primary outcome measure (Y-BOCS score) will be obtained by clinician rating [ Time Frame: screening, baseline, and end of weeks 4, 8, 12, 16, 20 and 24. ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 50 |
| Study Start Date: | September 2008 |
| Estimated Study Completion Date: | December 2009 |
| Estimated Primary Completion Date: | August 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
A
Effectiveness of Luvox CR plus Web-based CBT for OCD
|
Drug: Luvox CR
In light of the Luvox-CR dosing procedure of Hollander et al (2003) (50 mg increments weekly) and the available dose capsules of Luvox-CR (100 mg and 150 mg), the Luvox-CR dose will be increased over the first 6 weeks of treatment as tolerated in 50 mg to 100-mg increments every week, as tolerated and clinically indicated, to a bedtime dose between 100 and 300 mg/day. The dose will then be held constant for the duration of the study
Behavioral: Behavioral Therapy
The web-based CBT (CT STEPS) includes an introductory session explaining the treatment, with videotapes of OCD patients who used an earlier version, along with 9 subsequent treatment modules. The CBT will include weekly email feedback from a psychologist in response to questions asked about the CBT by the subjects assigned to this treatment arm.
|
Detailed Description:
Primary Endpoint(s): Change in Y-BOCS score from baseline to endpoint at weeks 12 and 24; and, number (and percent) "responders" at weeks 12 and 24, defined as subjects with a 35% decrease in Y-BOCS score at endpoint and a Clinical Global Impressions score of 1 or 2 (very much or much improved).
Secondary Endpoint(s):
- change in scores on the Work and Social Adjustment Scale, a quality of life measure
change in scores on the Work Productivity and Activity Impairment
Questionnaire:
Specific Health Problem scale; in particular, we will analyze change in work hours/week lost because of OCD, and change in effect of OCD on work productivity (0-10 scale).
- dollar cost per responder
- dollar cost per total number of patients needed to produce one additional responder in the Luvox-CR plus web-based CBT group over the number produced by Luvox-CR alone, i.e., dollar cost per number needed to treat
- dollar cost per 5% decrease in Y-BOCS score at weeks 12 and 24 in the two treatment groups.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Men and women aged 18 years, with OCD of at least 1 year's duration, meeting DSM-IV diagnostic criteria, and having a baseline Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score of 18.
Exclusion Criteria:
- Pregnant or nursing women or women of childbearing age not using an effective contraceptive method
- Organic mental disorder
- Bipolar disorder
- Psychotic disorder
- History of substance abuse or dependence within 3 years of evaluation for study
- Major depression with suicidal risk
- Major depression dominating the clinical picture
- Panic disorder
- Personality disorder severe enough to interfere with cooperation with study procedures
- Need for antipsychotic medication
- Depot neuroleptic drug within 6 months
- Fluoxetine within 5 weeks
- An MAOI within 2 weeks, any nightly sedative, or taking a medication that may interact with fluvoxamine
- Serious or unstable medical condition (hematological, endocrine, cardiovascular, renal or gastrointestinal), a history of malignancy (other than excised basal cell carcinoma), history of brain disease, including more than one childhood febrile convulsion and all forms of epilepsy; or, are receiving behavior therapy for OCD.
- Subjects who qualify for the study while taking an SSRI must have been taking their current dose or a higher dose for at least 12 weeks prior to study baseline.
- Subjects who qualify for the study while taking fluvoxamine must be taking no more than 150 mg/day and never had a trial at a higher dose, must be believed by the investigator to be able to tolerate an increase to 250 mg/day starting at baseline, and must have been taking their pre-study dose or a higher dose (up to 150 mg/day) for at least 12 weeks prior to study baseline.
Contacts and Locations| Contact: Amy Perkins, BA | 414-328-3702 | aperkins@rogershospital.org |
| United States, Wisconsin | |
| The Rogers Center for Research & Training, Inc. | Not yet recruiting |
| Milwaukee, Wisconsin, United States, 53227-1133 | |
| Contact: Amy Perkins, BA 414-328-3702 aperkins@rogershospital.org | |
| Contact: Alex Bruss, BS 414-328-3710 abruss@rogershospital.org | |
| Principal Investigator: John H Greist, MD | |
| Principal Investigator: | John H Greist, MD | The Rogers Center for Research & Training, Inc. |
More Information
No publications provided
| Responsible Party: | John H Greist, MD, Rogers Center for Research & Training, Inc. |
| ClinicalTrials.gov Identifier: | NCT00743834 History of Changes |
| Other Study ID Numbers: | JIIT-07-LCR001a |
| Study First Received: | August 28, 2008 |
| Last Updated: | September 3, 2008 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Obsessive-Compulsive Disorder Compulsive Personality Disorder Anxiety Disorders Mental Disorders Personality Disorders Fluvoxamine Serotonin Uptake Inhibitors Neurotransmitter Uptake Inhibitors Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Pharmacologic Actions |
Serotonin Agents Physiological Effects of Drugs Antidepressive Agents, Second-Generation Antidepressive Agents Psychotropic Drugs Central Nervous System Agents Therapeutic Uses Anti-Anxiety Agents Tranquilizing Agents Central Nervous System Depressants |
ClinicalTrials.gov processed this record on June 18, 2013