Social Phobia Clinical Trial
Official title:
The Use of Quetiapine (Seroquel) in the Treatment of Social Phobia: Effects on Cue Reactivity in Response to Virtual Reality Public Speaking Environment
This is a pilot study that will focus on the collection of preliminary data to determine the efficacy of quetiapine for individuals with social phobia. We hypothesize that individuals will react with less self-reported anxiety and physiological reactivity in the drug condition than in the placebo condition. If true, this would constitute a strong signal for a significant treatment effect for quetiapine in social phobia. A positive treatment effect in this study would provide rationale for further investigation of the efficacy of quetiapine for cue reactivity for individuals with social phobia. Further study would include increased sample size in order to obtain statistical power and replication of findings. We will utilize the IR formulation of quetiapine.
Primary Objective:
The purpose of this study is to evaluate the use of quetiapine to diminish cue reactivity to
a Virtual Reality environment for individuals with Social Phobia. The following primary and
secondary outcome measures will be administered to subjects during each Virtual Reality
exposure in treatment and non-treatment conditions. The outcome measures have demonstrated
adequate reliability and validity in the detection of clinical change for individuals with
social phobia in open label studies using quetiapine (Schutters, van Megen, and Westenberg,
2005). The Personal Report of Confidence as a Speaker (PRCS; Paul, 1966) will be utilized as
the primary measure to establish individual diagnosis and severity level. Pertaub and Slater
(2002) demonstrated the sensitivity of the PRCS in measuring anxiety responses to virtual
audiences. A total score of 21 or greater on the PRCS will be required for study inclusion
(Carrigan and Levis, 1999). Carrigan and Lewis (1999) reported a mean score of 23.73 on the
30-item PRCS for individuals reporting fear of public speaking. Subjective units of distress
ratings and measures of blood pressure and heart rate will be obtained within session in
order to measure immediate changes in subject's cue reactivity to VRE stimuli. The outcome
measures include:
Primary Measure: Personal Report of Confidence as a Speaker (PRCS)
Secondary Measures:
Liebowitz Social Anxiety Scale (LSAS) Clinical Global Impressions-Improvement Scale (CGI)
Brief Social Phobia Scale Social Phobia Inventory Fear of Negative Evaluation Scale Hamilton
Rating Scale for Anxiety In session-Subjective Units of Distress Blood Pressure and heart
rate monitored within session
Design:
A crossover, double-blind within subjects design will be used. The two conditions are
placebo and drug prior to exposure to social anxiety cues in the virtual environment. Each
subject will be in both conditions over the course of two visits. Each subject will be in
only one condition on the first visit and will then cross-over to the other condition on the
second visit. Order will be counter-balanced across subjects. The treatment phase of the
study will include the two afore mentioned visits, totaling 60 minutes each. This will
include the treatment and pre-post assessment
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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