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Antidepressant Medication and Cognitive Behavioral Therapy to Help HIV Infected Adults With Depression to Adhere to Antiretroviral Therapy

This study is currently recruiting participants.
Information provided by National Institute of Mental Health (NIMH)

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Descriptive Information Fields
Brief Title  Antidepressant Medication and Cognitive Behavioral Therapy to Help HIV Infected Adults With Depression to Adhere to Antiretroviral Therapy
Official Title  Antidepressant and Behavioral Adherence Intervention for Depressed HIV Patients
Brief Summary

This study will compare the effectiveness of antidepressant therapy alone versus antidepressant therapy combined with cognitive behavioral therapy in helping HIV infected adults with depression to take their medications on schedule.

Detailed Description

Antiretroviral therapy (ART) is a type of medication treatment for HIV that impairs the virus's ability to multiply. When used properly, it has been shown to be successful in reducing HIV-related deaths. A high adherence rate to ART is required to adequately suppress the virus, limit drug resistance, and reduce transmission. HIV infected people who are depressed often experience increased difficulty with adhering to their ART regimen. Antidepressant therapy has been shown to effectively treat depression. However, antidepressant therapy alone may not be sufficient for maintaining ART adherence. Another mental health treatment, such as cognitive behavioral therapy (CBT), may be needed to improve the likelihood of ART adherence. This study will compare the effectiveness of antidepressant therapy alone versus antidepressant therapy combined with CBT in improving ART adherence among HIV infected adults with depression who are experiencing difficulty with adhering to their medication regimen.

This study will last 24 weeks. Participants will be randomly assigned to receive antidepressant therapy alone or antidepressant therapy plus CBT. Study visits for all participants will occur at baseline and Weeks 1, 2, 4, 8, 16, and 24. At these visits, depressive symptoms will be evaluated and medication adherence will be recorded. Antidepressant therapy will be tailored to each individual dependent on the participant's past medical history with antidepressant medication. Participants will take their antidepressant medication on a daily basis for the duration of the study. Participants receiving CBT will attend five individual treatment sessions followed by one to three booster treatment sessions; these sessions will coincide with the study visits.

Study Phase Phase I
Study Type  Interventional
Study Design  Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Efficacy Study
Primary Outcome Measure  Microelectronic medication adherence [ Time Frame: Measured at Weeks 16 and 24 ] [ Designated as safety issue: No ]
Secondary Outcome Measure  Self-reported depression [ Time Frame: Measured at Weeks 16 and 24 ] [ Designated as safety issue: Yes ]
Condition  Depression
HIV Infection
Intervention  Drug: Antidepressant medication
Behavioral: Cognitive behavioral therapy (CBT)
MEDLINE PMIDs
Links
Recruitment Information Fields
Recruitment Status  Recruiting
Enrollment  70
Start Date  June 2007
Completion Date June 2009
Eligibility Criteria 

Inclusion Criteria:

  • Meets criteria for major depression, dysthymia, or subthreshold major depression
  • Antidepressant medication has been recommended by the clinic psychiatrist
  • Agrees to start antidepressant medication
  • Currently taking ART for HIV infection
  • Less than 90% adherence rate to ART regimen
  • Capable of walking and in stable health
  • Speaks fluent English or Spanish

Exclusion Criteria:

  • Antidepressant medication therapy is needed immediately
  • Meets criteria for current drug dependency
  • Current diagnosis of psychotic disorder or bipolar depression
Gender Both
Ages 18 Years to 60 Years
Accepts Healthy Volunteers No
Contacts ††
Contact: Glenn J. Wagner, PhD         gwagner@rand.org    
Location Countries  United States
Administrative Information Fields
NCT ID  NCT00509340
Organization ID R34 MH77503
Secondary IDs †† DAHBR 9A-ASNM
Study Sponsor  National Institute of Mental Health (NIMH)
Collaborators ††
Investigators 
Principal Investigator:     Glenn J. Wagner, PhD     RAND    
Information Provided By National Institute of Mental Health (NIMH)
Verification Date February 2008
First Received Date  July 30, 2007
Last Updated Date February 29, 2008

 †    Required WHO trial registration data element.
††   WHO trial registration data element that is required only if it exists.




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