Depression Clinical Trial
Official title:
Antidepressant Treatment to Reduce HIV Risk Among IDUs
This study will evaluate the effectiveness of combining cognitive behavioral therapy (CBT) and antidepressants in reducing HIV risk behavior and drug relapse rates in depressed intravenous drug users.
Depression is common among injection drug users (IDUs); it is estimated that up to 50% of
IDUs meet the diagnostic criteria for major depressive disorder, a severe form of
depression. The combination of drug abuse and depression increases the likelihood of
engaging in HIV high-risk behaviors such as unprotected sex and the use of unhygienic
needles to inject drugs. Research has shown that IDUs who receive treatment for depression
have lower rates of drug relapse and are less likely to engage in high-risk sexual behavior
compared to IDUs who have not received treatment for depression. Combination treatment,
which includes cognitive behavioral therapy (CBT) and antidepressant medication, has been
shown to be the most effective treatment for depression. This study will evaluate the
effectiveness of combination treatment in reducing HIV risk behaviors and drug relapse rates
in cocaine or opiate addicted IDUs with a diagnosis of depression.
In this 9-month study, participants will be randomly assigned to either a combination
treatment group or an assessment only group that will receive no treatment. Participants
assigned to combination treatment will receive the antidepressant Celexa, and will attend 8
CBT sessions and 7 psychopharmacology sessions. Each CBT session will last about 60 minutes
and each psychopharmacology session will last about 15 minutes. If a participant does not
respond well to Celexa, Wellbutrin or Effexor may be taken instead. Participants in both
groups will attend 4 study visits during which they will complete standardized psychological
questionnaires and interviews to assess depression levels, drug use, and high-risk sexual
behaviors. Blood will be drawn at baseline and Month 9 for HIV testing.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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