Using Drug Augmentation to Treat Obsessive Compulsive Disorder Patients Who Did Not Respond to Previous Treatment (EPMTOC)
Pharmacological Augmentation Strategies for Obsessive Compulsive Disorder Patients Non-respondent to First Line Medication Treatment: a Double Blind Placebo Controlled Study
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Arm 1: SSRI (Fluoxetine 40mg* once a day) + Clomipramine 75mg* once a day.
Arm 2: SSRI (Fluoxetine 40mg* once a day) + Quetiapine 200mg* once a day.
Arm 3: SSRI (Fluoxetine 80mg* once a day) + Placebo once a day.
*or maximum tolerated dose
We hypothesize that quetiapine and clomipramine will be effective augmentation strategies for resistant OCD patients in comparison to placebo.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
SP
-
Sao Paulo, SP, Brazil, 05403-010
- Institute of Psychiatry
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- OCD diagnosis
- YBOCS score ≥ 16 (for patients with both obsessions and compulsions) or ≥ 10 (for patients with only obsessions or compulsions)
- Previously signed informed consent to participate in this clinical trial
Exclusion Criteria:
- Patients with clinical or neurological diseases that may be worsen by the medications included in treatment protocol
- Current substance dependence or abuse
- Current psychotic symptoms
- Current suicide risk
- Current pregnancy or intention to get pregnant before the end of the treatment protocol
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Quetiapine (fluoxetine plus quetiapine)
fluoxetine up to 40mg once a day plus Quetiapine up to 200mg once a day, during 12 weeks
|
Quetiapine at maximum tolerated dosage of 200mg per day plus fluoxetine at maximum dosage of 40mg per day
Other Names:
|
|
Active Comparator: Clomipramine (fluoxetine plus clomipramine)
Fluoxetine up to 40mg once a day plus clomipramine up to 75mg once a day, during 12 weeks
|
Clomipramine at maximum dosage of 75mg per day plus fluoxetine at maximum dosage of 40mg per day
Other Names:
|
|
Placebo Comparator: Placebo (fluoxetine plus placebo)
Fluoxetine up to 80 mg once a day plus placebo 3 pills once a day, during 12 weeks
|
Placebo plus fluoxetine at maximum dosage of 80mg per day
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
YBOCS
Time Frame: 12 weeks
|
Rates of improvement after 12 weeks of treatment based on the difference of initial and final Yale Brown Obsessive Compulsive Scale (YBOCS) scores for obsessions and compulsions
|
12 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
QoL
Time Frame: 12 weeks
|
Improvement of quality of life (QOL) will be assessed through SF-36 administered on weeks 0 and 12.
|
12 weeks
|
|
Social Adaptation
Time Frame: 12 weeks
|
Improvement of social adaptation using the Social Adaptation Scale (SAS) (Weissman & Payket, 1974) administered on weeks 0 and 12
|
12 weeks
|
|
Tolerability
Time Frame: weeks 0,1,2,3,4,8,12
|
Tolerability of the proposed treatments through adverse events follow-up performed each visit (emphasis in serotonergic syndrome)
|
weeks 0,1,2,3,4,8,12
|
|
BDI
Time Frame: 12 weeks
|
Score obtained with Beck depression inventory (BDI)
|
12 weeks
|
|
BAI
Time Frame: 12 weeks
|
Score obtained with Beck´s anxiety inventory (BAI)
|
12 weeks
|
|
CGI
Time Frame: 12 weeks
|
Clinical global impression measure of improvement
|
12 weeks
|
|
Cardiotoxicity
Time Frame: 2 weeks
|
Change from baseline EKG regarding QT interval
|
2 weeks
|
|
Plasma levels
Time Frame: weeks 2 and 12
|
Fluoxetine dosage and Clomipramine plasmatic dosages (when applies)
|
weeks 2 and 12
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Juliana B Diniz, MD, University of Sao Paulo Medical School
Publications and helpful links
General Publications
- Diniz JB, Shavitt RG, Fossaluza V, Koran L, Pereira CA, Miguel EC. A double-blind, randomized, controlled trial of fluoxetine plus quetiapine or clomipramine versus fluoxetine plus placebo for obsessive-compulsive disorder. J Clin Psychopharmacol. 2011 Dec;31(6):763-8. doi: 10.1097/JCP.0b013e3182367aee.
- Fossaluza V, Diniz JB, Pereira Bde B, Miguel EC, Pereira CA. Sequential allocation to balance prognostic factors in a psychiatric clinical trial. Clinics (Sao Paulo). 2009;64(6):511-8. doi: 10.1590/s1807-59322009000600005.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Mental Disorders
- Pathologic Processes
- Personality Disorders
- Anxiety Disorders
- Disease
- Compulsive Personality Disorder
- Obsessive-Compulsive Disorder
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Enzyme Inhibitors
- Antipsychotic Agents
- Tranquilizing Agents
- Psychotropic Drugs
- Serotonin Uptake Inhibitors
- Neurotransmitter Uptake Inhibitors
- Membrane Transport Modulators
- Serotonin Agents
- Antidepressive Agents
- Cytochrome P-450 Enzyme Inhibitors
- Antidepressive Agents, Second-Generation
- Antidepressive Agents, Tricyclic
- Cytochrome P-450 CYP2D6 Inhibitors
- Clomipramine
- Quetiapine Fumarate
- Fluoxetine
Other Study ID Numbers
Other Study ID Numbers
- 05/55628-8
- 2005/55628-08 (Other Grant/Funding Number: FAPESP)
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