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Combination of Paroxetine CR and Quetiapine for the Treatment of Refractory Generalized Anxiety Disorder

Information source: Massachusetts General Hospital
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Anxiety Disorder

Intervention: Continued Paroxetine CR (Drug); Quetiapine (Drug); Placebo (Drug)

Phase: Phase 4

Status: Completed

Sponsored by: Massachusetts General Hospital

Official(s) and/or principal investigator(s):
Naomi M Simon, MD, Principal Investigator, Affiliation: Massachusetts General Hospital
Kathryn Connors, MD, Principal Investigator, Affiliation: Duke University

Summary

The purpose of this study is to examine the safety and efficacy of quetiapine for generalized anxiety disorder patients who remain symptomatic despite treatment with paroxetine CR.

Clinical Details

Official title: Combination of Paroxetine CR and Quetiapine for the Treatment of Refractory Generalized Anxiety Disorder

Study design: Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment

Primary outcome: Hamilton Anxiety Scale (HAM-A) Score at Study Endpoint.

Secondary outcome:

Remission (HAM-A ≤ 7)

Response, Clinical Global Impression of Improvement (CGI-I)

Depressive Symptoms, Montgomery-Asberg Depression Rating Scale (MADRS)

The Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q).

Detailed description: Generalized anxiety disorder (GAD) is a relatively common condition affecting 5% of the population, with a typically chronic course and associated with significant psychosocial impairment and decreased quality of life (Schweizer, 1995). Although a number of therapeutic agents demonstrate some efficacy in the treatment of generalized anxiety disorder, only a minority of anxious patients experience remission with initial treatment. The purpose of this study is to examine the efficacy of one strategy, the addition of quetiapine, for the treatment of patients with GAD who remain refractory despite an adequate treatment trial with a selective serotonin reuptake inhibitor (SSRI). This is an investigator-initiated augmentation study of an already approved drug for a different indication. Quetiapine is a novel antipsychotic agent with potent effects at the serotonergic, as well as dopaminergic receptor, and a more favorable side effect profile than standard neuroleptics, including a low potential to cause extrapyramidal symptoms. This is a two phase, 18-week research study in which participants who remain symptomatic at the end of one phase (10 weeks) enter into the next phase. In phase I, all participants receive paroxetine CR (Paxil CR) for 10 weeks. Participants who continue to have anxiety symptoms will enter the 8-week Phase II, in which they continue taking Paxil CR and they will also be randomly assigned (by chance, like a flip of a coin) to receive quetiapine (Seroquel) or placebo (contains no active medication).

Eligibility

Minimum age: 18 Years. Maximum age: 72 Years. Gender(s): Both.

Criteria:

Inclusion Criteria:

- Male and female outpatients, age 18-72.

- Primary diagnosis of generalized anxiety disorder.

- Patients on concurrent benzodiazepines will be entered into the trial if they remain

symptomatic despite stable doses for at least one month Exclusion Criteria:

- Pregnant or lactating women or other women of child bearing potential not using

acceptable means of birth control

- Patients with a primary diagnosis of major depression, dysthymia, panic disorder or

social phobia.

- Patients with current or history of bipolar disorder, schizophrenia or other

psychotic conditions

- Patients with post-traumatic stress disorder or obsessive-compulsive disorder current

in the past 6 months.

- Patients with a history of alcohol or substance abuse or dependence within the last

six months.

- Patients with significant unstable medical illness.

- Ongoing psychotherapy directed toward the treatment of generalized anxiety disorder.

- History of hypersensitivity to paroxetine CR, paroxetine or quetiapine.

- History of cataracts.

- Concurrent use of psychotropic medications including buspirone and antidepressants.

Patients must have discontinued buspirone or antidepressant therapy at least two weeks prior to study entry, and fluoxetine at least four weeks prior, but no patient will be taken off effective medication.

- Concomitant use of herbs and dietary supplements with known psychotropic properties,

including St John's Wort, Kava, Valerian, Gingko, Ginseng, ephedra and weight loss supplements. Other than such agents with known psychotropic properties, no over the counter medications are exclusionary.

Locations and Contacts

Massachusetts General Hospital, Boston, Massachusetts 02114, United States

Duke University Medical Center, Durham, North Carolina 27710, United States

Additional Information

The Center for Anxiety and Traumatic Stress Disorders at Massachusetts General Hospital

Starting date: February 2004
Last updated: March 20, 2014

Page last updated: August 23, 2015

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