Bereavement Clinical Trial
Official title:
Optimizing Treatment for Complicated Grief (Healing Emotions After Loss:HEAL)
The major goal of this 4-site, double blind, placebo-controlled intervention trial is to assess the efficacy of medication (Citalopram) alone or with psychotherapy (Complicated Grief Therapy) to treat the symptoms of complicated grief.
Complicated grief (CG) is a debilitating condition that is estimated to affect millions of
people in the United States alone. We conducted the first randomized controlled study to
address this condition (MH60783) and confirmed efficacy of a targeted psychotherapy,
complicated grief treatment (CGT). Participants in our prior study continued stable
antidepressant medication while receiving CGT or Interpersonal Psychotherapy (IPT).
Individuals taking antidepressants had better outcome in both treatments, though CGT was
superior to IPT when administered with (60% responders v. 40%) or without (42% v.19%)
antidepressants. Studies of antidepressant medication alone have shown mixed results with
SSRIs appearing to be promising. However, there has been no randomized controlled study of
SSRIs for CG. Determining the efficacy of SSRI treatment for CG, when administered with and
without CGT, is of great public health importance.
We assembled 4 groups of investigators with strong track records in bereavement research and
extensive experience with intervention studies and multicenter projects, to conduct a study
of citalopram (CIT) efficacy. We plan to enroll participants with a primary diagnosis of
Complicated Grief and randomly assign them (n=480; 50 at Columbia) to receive treatment with
CIT, Placebo (PBO), CIT + CGT or PBO + CGT over a period of approximately 16 weeks. We want
to determine whether citalopram shows a better response than placebo, when administered
either with or without CGT. We will also address the question of whether CIT performs as
well when administered alone as it does when administered with CGT.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Factorial Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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