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Cognitive Behavioral Therapy Combined With Antidepressants to Reduce HIV Risk and Drug Relapse Among Depressed Intravenous Drug Users

Antidepressant Treatment to Reduce HIV Risk Among IDUs

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00183768
Enrollment
175
Registered
2005-09-16
Start date
1999-09-30
Completion date
2003-02-28
Last updated
2013-08-22

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Depression, HIV Infections, Substance-Related Disorders

Keywords

Cognitive Behavioral Treatment For Depression, Antidepressant Psychopharmacology, HIV Risk Behavior, Injection Drug Use

Brief summary

This study will evaluate the effectiveness of combining cognitive behavioral therapy (CBT) and antidepressants in reducing HIV risk behavior and drug relapse rates in depressed intravenous drug users.

Detailed description

Depression is common among injection drug users (IDUs); it is estimated that up to 50% of IDUs meet the diagnostic criteria for major depressive disorder, a severe form of depression. The combination of drug abuse and depression increases the likelihood of engaging in HIV high-risk behaviors such as unprotected sex and the use of unhygienic needles to inject drugs. Research has shown that IDUs who receive treatment for depression have lower rates of drug relapse and are less likely to engage in high-risk sexual behavior compared to IDUs who have not received treatment for depression. Combination treatment, which includes cognitive behavioral therapy (CBT) and antidepressant medication, has been shown to be the most effective treatment for depression. This study will evaluate the effectiveness of combination treatment in reducing HIV risk behaviors and drug relapse rates in cocaine or opiate addicted IDUs with a diagnosis of depression. In this 9-month study, participants will be randomly assigned to either a combination treatment group or an assessment only group that will receive no treatment. Participants assigned to combination treatment will receive the antidepressant Celexa, and will attend 8 CBT sessions and 7 psychopharmacology sessions. Each CBT session will last about 60 minutes and each psychopharmacology session will last about 15 minutes. If a participant does not respond well to Celexa, Wellbutrin or Effexor may be taken instead. Participants in both groups will attend 4 study visits during which they will complete standardized psychological questionnaires and interviews to assess depression levels, drug use, and high-risk sexual behaviors. Blood will be drawn at baseline and Month 9 for HIV testing.

Interventions

BEHAVIORALCognitive Behavioral Therapy
BEHAVIORALPsychopharmacology

Sponsors

National Institute of Mental Health (NIMH)
CollaboratorNIH
Butler Hospital
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No

Inclusion criteria

* Meets DSM-IV criteria for major depression, dysthymia, substance-induced major depression, or major depression plus dysthymia * Score of greater than 14 on the Hamilton Depression Rating Scale * Involved in HIV risk behaviors * Current opiate or cocaine use * Basic proficiency in English

Exclusion criteria

* Current suicidal risk or ideation * Current psychotic symptoms * Simultaneous medical disorder that might make psychopharmacological treatment medically inadvisable * History of bipolar disorder, schizophrenia, schizo-affective disorder, schizophreniform disorder, or paranoid disorder * Currently taking other medications for depression

Design outcomes

Primary

MeasureTime frame
HIV risk behavior; measured at Month 9

Secondary

MeasureTime frame
Depression severity; measured at Month 9

Countries

United States

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026