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Trial registered on ANZCTR
Registration number
ACTRN12606000413527
Ethics application status
Approved
Date submitted
31/08/2006
Date registered
21/09/2006
Date last updated
21/09/2006
Type of registration
Prospectively registered
Titles & IDs
Public title
Treatment Evaluation of Alcohol and Mood
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Scientific title
A double blind placebo controlled trial of citalopram for the treatment of coexisting alcohol dependence and major depressive syndrome for patients receiving naltrexone and clinical casemanagement: impact on drinking and mood symptomotology
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Universal Trial Number (UTN)
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Trial acronym
TEAM
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Alcoholism
1380
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Depression
1381
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Condition category
Condition code
Mental Health
1472
1472
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0
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Depression
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Mental Health
1473
1473
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0
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Addiction
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Investigate the effectiveness of 12 weeks treatment of oral citalopram (20mg daily for week one, 40mg daily during weeks 2-12, with the option to increase to 60mg daily at week six) in a group of patients being treated over the same period of time with naltrexone (25mg daily for week one, 50mg daily during weeks 2-12, with the option to increase to 100mg at week six). All patients will attend clinical case management appointments at weeks 1, 2, and 3 with appointments then every three weeks until week 24.
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Intervention code [1]
1322
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Treatment: Drugs
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Comparator / control treatment
Placebo (equivalent dosage protocol)
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Control group
Placebo
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Outcomes
Primary outcome [1]
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The primary outcome measure for alcohol use will be the percent days abstinent
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Assessment method [1]
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Timepoint [1]
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Measured every three weeks during the trial, with primary outcome measures at pharmacotherapy termination, and then 12 weeks and 12 months post-pharmacotherapy.
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Primary outcome [2]
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The primary outcome measure for depressive symptoms will be scores on the Montgomery and Asberg Depression Rating Scale (MADRS) score.
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Assessment method [2]
2041
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Timepoint [2]
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Measured every three weeks during the trial, with primary outcome measures at pharmacotherapy termination, and then 12 weeks and 12 months post-pharmacotherapy.
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Secondary outcome [1]
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The secondary outcome drinking measures will be based on sessional drinking data and will include mean drinks per drinking day and percentage of heavy drinking days during the follow-up period.
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Assessment method [1]
3525
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Timepoint [1]
3525
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These will be measured every three weeks during the trial, with primary ouctome measures at pharmacotherapy termination, and then 12 weeks and 12 months post-pharmacotherapy.
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Secondary outcome [2]
3526
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Secondary depression outcome measures will be based on MADRS scores and Symptoms Checklist-90 (SCL-90) data, and will include catergorisation of responders and non-responders using a criterion of a MADRS score of 10 or less.
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Assessment method [2]
3526
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Timepoint [2]
3526
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These will be measured every three weeks during the trial, with primary ouctome measures at pharmacotherapy termination, and then 12 weeks and 12 months post-pharmacotherapy.
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Eligibility
Key inclusion criteria
Currently meets the DSM-IV (APA 1994) criteria for alcohol dependence (i.e. the presence of at least 3/7 DSM-IV criteria for alcohol dependence in the month prior to presentation; -currently meets the the DSM-IV criteria for major depression (i.e. the presence of at least 5/9 DSM-IV criteria for major depression in month prior to presentation and has no history of manic episodes);-has a MADRS score of 20 plus at presentation.
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Minimum age
17
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Any history of daily or nearly daily intravenous drug use for more than 2 weeks, or use of any opioid drugs in the previous 4 weeks; -a history of psychosis of any sort;-a clear history of mania or hypomania based on the DSM-IV criteria;-signifcant current risk of suicide or homicide;-severe psychiatric symptoms requiring hospitalisation;-evidence of any significant cerebral, renal, thyroid or cardiac disease;-taken disulfiram, calcium carbimide, naltrexone, or antidepressant medication during the past 4 weeks;-a history of alcoholic liver disease;-if premenopausal female: pregnancy, nursing or refusing to use a reliable method of birth control;-in prison or on home detention at any time during the past 4 weeks.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation concealment by central randomisation (by phone). All participants are assigned a unique research number. An administrator will be responsible for applying a random list to the unique research number and then randomising patients in a double-blind fashion to receive 12 weeks of citalopram or placebo in addition to naltrexone.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Stratified allocation by gender and primary versus secondary depression status, in blocks.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Factorial
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Other design features
Patients, research clinicians, senior medical officers, and investigators will all be blinded to treatment allocation. (Note: research clinicians are responsible for recruitment, assessment, casemanagement and followup).
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Phase
Phase 2
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/10/2006
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
220
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
389
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New Zealand
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State/province [1]
389
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Funding & Sponsors
Funding source category [1]
1612
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Government body
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Name [1]
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Ministry of Health
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Address [1]
1612
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Country [1]
1612
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Funding source category [2]
1613
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University
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Name [2]
1613
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University of Otago
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Address [2]
1613
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Country [2]
1613
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New Zealand
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Primary sponsor type
Individual
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Name
Professor Doug Sellman
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Address
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Country
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Secondary sponsor category [1]
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Individual
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Name [1]
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Karen de Zwart
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Address [1]
1415
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Country [1]
1415
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Northland District Health Board (Community Alcohol and Drug Service - Whangarei);
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Ethics committee address [1]
3057
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Ethics committee country [1]
3057
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New Zealand
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Date submitted for ethics approval [1]
3057
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Approval date [1]
3057
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26/04/2006
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Ethics approval number [1]
3057
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MEC/05/12/170
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Ethics committee name [2]
3058
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Waitemata District Health Board (Community Alcohol and Drug Service - Auckland);
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Ethics committee address [2]
3058
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Ethics committee country [2]
3058
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New Zealand
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Date submitted for ethics approval [2]
3058
0
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Approval date [2]
3058
0
26/04/2006
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Ethics approval number [2]
3058
0
MEC/05/12/170
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Ethics committee name [3]
3059
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Waikato District Health Board (Community Alcohol and Drug Service - Hamilton);
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Ethics committee address [3]
3059
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Ethics committee country [3]
3059
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New Zealand
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Date submitted for ethics approval [3]
3059
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Approval date [3]
3059
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26/04/2006
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Ethics approval number [3]
3059
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MEC/05/12/170
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Ethics committee name [4]
3060
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Canterbury District Health Board (Community Alcohol and Drug Service - Christchurch);
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Ethics committee address [4]
3060
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Ethics committee country [4]
3060
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New Zealand
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Date submitted for ethics approval [4]
3060
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Approval date [4]
3060
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26/04/2006
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Ethics approval number [4]
3060
0
MEC/05/12/170
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Ethics committee name [5]
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Otago District Health Board (Community Alcohol and Drug Service - Dunedin).
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Ethics committee address [5]
3061
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Ethics committee country [5]
3061
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New Zealand
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Date submitted for ethics approval [5]
3061
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Approval date [5]
3061
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26/04/2006
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Ethics approval number [5]
3061
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MEC/05/12/170
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Summary
Brief summary
The combination of alcohol dependence and depression is very common in people presenting to alcohol and drug services. Pharmacotherapy offers a significant step forward in treatment. Effective antidepressant medications have been available for a number of decades, but medications which assist with relapse prevention in alcohol dependence (antidipsotropics), other than the long-established disulfiram, have only been developed more recently. There have been no published randomised controlled trials investigating the combination of these medications in people with both problems. This study will investigate the effectiveness of 12 weeks treatment of citalopram (an antidepressant) compared with placebo in a group of patients presenting to one of five alcohol and drug treatment clinics in New Zealand, who are all being treated over the same time period with naltrexone (an antidipsotropic) and clinical case management. They will all have both alcohol dependence and major depression. All participants will receive standard clinical case management, which will cover the initial 12 weeks of combined pharmacotherapy, followed by a further 12 weeks of active monitoring and support. This study will make an important contribution to evaluating the place of antidepressants in clinical practice for patients with co-occurring alcohol dependence and depression.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
27929
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Contact person for public queries
Name
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Karen de Zwart
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Address
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TEAM Study Co-Ordinator
National Addiction Centre
Department of Psychological Medicine
Christchurch School of Medicine & Health Sciences
University of Otago
4 Oxford Terrace
PO Box 4345
Christchurch
http://www.addiction.org.nz
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Country
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New Zealand
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Phone
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+64 3 3640480
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Fax
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+64 3 3641225
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Email
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[email protected]
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Contact person for scientific queries
Name
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Professor Doug Sellman
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Address
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TEAM Principal Investigator
National Addiction Centre
Department of Psychological Medicine
Christchurch School of Medicine & Health Sciences
University of Otago
4 Oxford Terrace
PO Box 4345
Christchurch
http://www.addiction.org.nz
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Country
1439
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New Zealand
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Phone
1439
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+64 3 3640480
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Fax
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+64 3 3641225
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Email
1439
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
A randomized trial of combined citalopram and naltrexone for nonabstinent outpatients with co-occurring alcohol dependence and major depression.
2015
https://dx.doi.org/10.1097/JCP.0000000000000287
N.B. These documents automatically identified may not have been verified by the study sponsor.
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