Clinical Trials Logo

Clinical Trial Summary

This study will evaluate the risks and benefits of treatment with a selective serotonin reuptake inhibitor or serotonin-norepinephrine reuptake inhibitor in children and adolescents with a pre-specified anxiety disorder, depressive disorder, eating disorder, or obsessive-compulsive disorder.


Clinical Trial Description

The Antidepressant Safety in Kids (ASK) study is part of the Child and Adolescent Psychiatry Trials Network (CAPTN).

Selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine reuptake inhibitor (SNRI) medications are prescribed to approximately 2 to 3% of American children. Evidence suggests that these medications are beneficial for treating obsessive-compulsive disorder (OCD), anxiety disorders, and major depressive disorder. Following hearings in February and September of 2004, the FDA mandated Black Box warnings for all antidepressants, cautioning prescribers about the risk of treatment-emergent suicidal tendency in children and adolescents treated with these drugs. Although prescribing waned somewhat following the warning, many children continue to receive SSRIs and SNRIs for a variety of conditions that do not have empirically validated alternative treatments. Therefore, there is a pressing need to clearly understand the safety, tolerability, and effectiveness of SSRIs and SNRIs in children and adolescents.

Specific Aim:

The purpose of this study is to evaluate the safety, tolerability, and effectiveness of SSRI and SNRI medications for children and adolescents with anxiety disorders, depressive disorders, eating disorders, or obsessive-compulsive disorder. The study will characterize predictors of outcome, including demographic, disease severity, comorbidity, concomitant treatment, and genetic variation. This information will help clinicians to better understand the balance of risk and benefit associated with antidepressants and to answer the question of which treatment is best for which child.

Three specific aims include the following:

1. To evaluate the within-subject benefit of antidepressant treatment over acute (12 weeks) and maintenance (an additional 6 months) of treatment;

2. To evaluate the adverse event profile for harm to self, harm to others, and psychiatric and nonpsychiatric adverse events;

3. To evaluate potential moderators and mediators of benefits and adverse events.

Design:

This will be a prospective longitudinal cohort study of 2,420 consecutively enrolled patients who are prescribed an SSRI or SNRI (Citalopram [Celexa], Escitalopram [Lexapro], Fluoxetine [Prozac/Prozac Weekly], Fluvoxamine [Luvox], Paroxetine, [Paxil/Paxil-Cr], Sertraline [Zoloft], Venlafaxine [Effexor/Effexor XR], Duloxetine [Cymbalta]). Patients will be drawn from the practices of approximately 200 CAPTN participants in the United States and Canada.

Study Timeline:

This study will have two phases: 1) an acute treatment phase following initiation of treatment with any SSRI or SNRI of the clinician's choosing and 2) a long-term follow-up phase. The acute treatment phase will last 12 weeks and the long-term follow-up phase will occur 6 and 9 months after initiation of treatment.

Treatment:

Flexible upward titration of any of the commercially available SSRI or SNRI medications. As decided by the treating doctor, titration will depend on the severity of illness, degree of response, and adverse event profile. With few exceptions, concomitant treatments are permitted.

Assessment:

Study assessment milestones will occur at baseline, Week 12, and Months 6 and 9 or at study entry. CAPTN uses a "no query rule" electronic data capture system. The parent and child will complete a pen and paper workbook consisting primarily of the DISC Predictive Scales (DPS-IV) and the Pediatric Adverse Event Rating Scale (PAERS). Based on this information and on clinical interview, the treating clinician will complete the fully web-based EDC modules at baseline and at all treatment and end-of-study visits. ;


Study Design

Observational Model: Cohort, Time Perspective: Prospective


Related Conditions & MeSH terms


NCT number NCT00395213
Study type Observational
Source Duke University
Contact
Status Completed
Phase Phase 4
Start date May 2007
Completion date July 2009

See also
  Status Clinical Trial Phase
Completed NCT03535805 - Transdiagnostic, Cognitive and Behavioral Intervention for in School-aged Children With Emotional and Behavioral Disturbances N/A
Active, not recruiting NCT05006976 - A Naturalistic Trial of Nudging Clinicians in the Norwegian Sickness Absence Clinic. The NSAC Nudge Study N/A
Recruiting NCT05419934 - EMDR Therapy in Young Children, a Double-blinded Randomized Controlled Trial N/A
Active, not recruiting NCT04136054 - Better Sleep in Psychiatric Care - Anxiety and Affective Disorders N/A
Completed NCT04091139 - Research of Unified Protocol for the Treatment of Common Mental Disorders in Adolescents in Hong Kong Phase 2/Phase 3
Completed NCT04647318 - Physiological Response to Self-compassion Versus Relaxation N/A
Active, not recruiting NCT05114824 - Acceptability and Feasibility of an 8-week Online Mindfulness-Based Cognitive Therapy Program Among Undergraduate Students N/A
Recruiting NCT05843695 - Enhancing Psychotherapy for Veterans and Service Members With PTSD and Anxiety N/A
Completed NCT05078450 - Mood Lifters Online for Graduate Students and Young Professionals N/A
Not yet recruiting NCT06162624 - Pilot Effectiveness Trial of an ACT Self-help Workbook Tailored Specifically for Prisons N/A
Not yet recruiting NCT05747131 - Emotion Detectives In-Out: Feasibility and Efficacy of a Blended Version of the Unified Protocol for Children N/A
Not yet recruiting NCT05863637 - Intensive Short-Term Dynamic Psychotherapy (ISTDP) for Anxiety Diagnoses in a Primary Care Setting N/A
Not yet recruiting NCT05225701 - Efficacy of a Transdiagnostic Guided Internet-Delivered Intervention for Emotional, Trauma and Stress-Related Disorders. N/A
Completed NCT02579915 - Developing a Low-Intensity Primary Care Intervention for Anxiety Disorders (AIM-PC) N/A
Recruiting NCT02186366 - Efficacy Study of Abdominal Massage Therapy to Treat Generalized Anxiety Disorder of Deficiency of Both Heart and Spleen Type N/A
Recruiting NCT02376959 - Effect of Spiritist "Passe" Energy Therapy in Reducing Anxiety in Volunteers N/A
Not yet recruiting NCT02126787 - Short-term, Intensive Psychodynamic Group Therapy Versus Cognitive-behavioral Group Therapy in the Day Treatment N/A
Withdrawn NCT01953042 - Benefits of a Psychoeducation Program for Those Awaiting Treatment for OCD and OCD Spectrum Disorders N/A
Completed NCT02134730 - School-based Universal Prevention for Anxiety and Depression in Sweden: A Cluster-randomized Trial N/A
Completed NCT01333098 - Antiglucocorticoid Therapy for Cognitive Impairment in Late-life Anxiety Disorders Phase 1/Phase 2