- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00074802
Adding Cognitive Behavioral Therapy to Drug Treatment for Social Anxiety Disorder
CBT Augmentation of Paroxetine for Social Anxiety
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Social anxiety disorder is a prevalent and disabling condition for which effective long-term treatments need to be identified. Paroxetine is effective in treating the acute symptoms of social anxiety, but many patients achieve less than optimal response. CBT has also been effective in treating social anxiety disorder; thus,it may also be effective in augmenting paroxetine response. This study will examine the effects of paroxetine treatment alone and in combination with CBT among patients who achieve less than optimal response after an open trial with paroxetine.
Participants in this study will receive paroxetine for 12 weeks (Phase 1). After 12 weeks, participants who have completed this open trial but have achieved some but less than optimal response will move forward to Phase 2. To be eligible to move forward to Phase 2, patients must have achieved at least a 10% improvement in their open-trial Liebowitz Social Anxiety Scale Scores (LSAS) but still have an LSAS score of 30 or greater. Patients meeting these criteria will be randomly assigned to either add weekly sessions of CBT to their treatment or to continue taking paroxetine alone for another 16 weeks. Social anxiety symptoms, rates of response and remission, fear of negative evaluation, disability and quality of life will be assessed.
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
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New York
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New York, New York, United States, 10032
- New York State Psychiatric Institute Anxiety Disorders Clinic
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19122-6085
- Adult Anxiety Clinic of Temple University
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Diagnostic and Statistical Manual of Mental Disorders, Fourth edition (DSM-IV) criteria for generalized social phobia
- Willing and able to give written informed consent
- English-speaking
Exclusion Criteria:
- Prior or current diagnosis of schizophrenia, schizoaffective disorder, organic mental disorder, bipolar disorder, or antisocial, schizotypal, and schizoid personality disorders
- Suicidal thoughts
- History of failed paroxetine treatment of at least 6 weeks' duration at adequate doses or a history of failed outcome of a previous adequate trial of CBT
- Clinically significant and/or unstable medical disease
- Pregnancy or breast-feeding. Women of childbearing potential will be required to sign a statement indicating their intention to avoid pregnancy during the study through the use of an effective method of contraception.
- Alcohol or substance abuse or dependence within the past 3 months. Patients with a positive drug screen but no substance abuse disorder will be eligible for the study, provided they have not met criteria for abuse/dependence within the last 6 months and provide two clean urine samples 2 weeks apart.
- Current or past history of seizure disorder (except febrile seizure in childhood)
- Conditions that contraindicate the use of paroxetine
- Inability to tolerate or unwillingness to accept a drug-free period of 4 weeks for monoamine oxidase inhibitors (MAOIs) or fluoxetine and 2 weeks for other selective serotonin reuptake inhibitors (SSRIs), neuroleptics, antidepressants, benzodiazepines, mood stabilizers, buspirone, beta-adrenergic blockers, or other psychotropic drugs prior to beginning the study
- Currently receiving psychotherapy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: Paroxetine Continuation
Participants who showed only partial response to paroxetine in Phase 1 will receive continued treatment with paroxetine for 16 additional weeks.
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Treatment with paroxetine will consist of an immediate release, flexible dosage of 20 to 50 mg per day.
Other Names:
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Experimental: Paroxetine with CBT Augmentation
Participants who showed only partial response to paroxetine in Phase 1 will receive continued treatment with paroxetine plus cognitive behavioral therapy (CBT) for 16 additional weeks.
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Treatment with paroxetine will consist of an immediate release, flexible dosage of 20 to 50 mg per day.
Other Names:
CBT will consist of 16 weekly treatment sessions.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Liebowitz Social Anxiety Scale (LSAS)
Time Frame: Change measured from Week 12 to Week 28
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The LSAS is a 24-item clinician-administered measure, which provides 0-3 ratings for anxiety and avoidance of social and performance situations.
Anxiety and avoidance ratings are summed across items, yielding a range of scores from 0-144, with higher scores representing greater severity of social anxiety symptoms.
We examined amount of change from week 12 to week 28 as the primary outcome.
Change was calculated as Week 12 score minus Week 28 score, so a positive score equals greater positive change.
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Change measured from Week 12 to Week 28
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Clinical Global Impression Improvement Scale (CGI-I)
Time Frame: Responder and remitter status measured at Week 28
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The CGI-I is a 7-point clinician-administered scale measuring improvement in symptoms over time.
Lower numbers represent greater improvement.
We examined responder status (i.e., percent of patients receiving an endpoint, Week 28, rating of 1 or 2) as well as remission status (i.e., percent of patients receiving an endpoint, Week 28, rating of 1) as secondary outcomes.
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Responder and remitter status measured at Week 28
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Social Interaction Anxiety Scale (SIAS)
Time Frame: Change measured from Week 12 to Week 28
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The SIAS is a 20-item self-report measure of anxiety experienced while interacting in dyads or groups.
Items are rated on a 0-4 scale, yielding a range of scores from 0-80, with higher scores representing greater anxiety.
We examined amount of change at from week 12 to week 28 as a secondary outcome.
Change was calculated as Week 12 score minus Week 28 score, so a positive score equals greater positive change.
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Change measured from Week 12 to Week 28
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Social Phobia Scale (SPS)
Time Frame: Change measured from Week 12 to Week 28
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The SPS is a 20-item self-report measure of anxiety experienced when being observed by others.
Items are rated on a 0-4 scale, yielding a range of scores from 0-80, with higher scores representing greater anxiety.
We examined amount of change at from week 12 to week 28 as a secondary outcome.
Change was calculated as Week 12 score minus Week 28 score, so a positive score equals greater positive change.
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Change measured from Week 12 to Week 28
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Brief Fear of Negative Evaluation Scale (BFNE)
Time Frame: Change measured from Week 12 to Week 28
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The BFNE is a 12-item self-report measure of concern about negative evaluation by others.
Items are rated on a 1-5 scale, yielding scores ranging from 12-60, with higher scores indicating greater fear of negative evaluation.
We examined amount of change at from week 12 to week 28 as a secondary outcome.
Change was calculated as Week 12 score minus Week 28 score, so a positive score equals greater positive change.
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Change measured from Week 12 to Week 28
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Liebowitz Self-Report Disability Scale (LSRDS)
Time Frame: Change measured from Week 12 to Week 28
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The LSRDS is an 11-item self-report measure of the degree to which one's emotional problems limit one's ability to function in a variety of domains.
Items are rated on a 0-3 scale of severity, and 10 of the 11 items (choosing either school or work as one area and omitting the other) are summed to produce a total score, ranging from 0-30.
Higher scores represent greater disability.
We examined amount of change at from week 12 to week 28 as a secondary outcome.
Change was calculated as Week 12 score minus Week 28 score, so a positive score equals greater positive change.
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Change measured from Week 12 to Week 28
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Quality of Life Inventory (QOLI)
Time Frame: Change measured from Week 12 to Week 28
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The QOLI is a 16-item self-report measure of life satisfaction.
Each item is rated for importance (0-2) and satisfaction (-3 to +3), and these ratings are multiplied, summed, and divided by the number of non-zero entries to yield an average item score, which can range from -6 to +6.
We examined amount of change at from week 12 to week 28 as a secondary outcome.
Change was calculated as Week 12 score minus Week 28 score, so a positive score equals greater positive change.
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Change measured from Week 12 to Week 28
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Richard Heimberg, PhD, Adult Anxiety Clinic of Temple University
- Principal Investigator: Michael Liebowitz, MD, New York State Psychiatric Institute Anxiety Disorders Clinic
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Mental Disorders
- Phobic Disorders
- Anxiety Disorders
- Phobia, Social
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Psychotropic Drugs
- Serotonin Uptake Inhibitors
- Neurotransmitter Uptake Inhibitors
- Membrane Transport Modulators
- Serotonin Agents
- Antidepressive Agents
- Cytochrome P-450 Enzyme Inhibitors
- Antidepressive Agents, Second-Generation
- Cytochrome P-450 CYP2D6 Inhibitors
- Paroxetine
Other Study ID Numbers
- R01MH064481 (U.S. NIH Grant/Contract)
- DSIR 83-ATAS (NIMH Program Class Code)
- R01MH064726 (U.S. NIH Grant/Contract)
- GSK ID: 101618 (Other Identifier: GlaxoSmithKline)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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