The purpose of this study is to evaluate whether valproic acid in combination with fear memory reactivation is useful to enhance treatment stability of exposure therapy for specific phobia.
* There will be one screening visit (visit 1), one intervention visit (visit 2) and one follow-up visit (90 days after visit 2) (visit 3). * On visit 2 all participants will undergo 30 min exposure therapy in virtual reality with pre-defined spider situations. * Duration for an individual participant will be at most 15 weeks depending on the time passing between screening (visit 1) and intervention visit (visit 2). * Change in phobic fear to baseline (visit 1) will be assessed on 90 day follow-up (visit 3). * Documentation of all study relevant source data of every study participant will be done by completing the study specific electronic case report forms (eCRF, SoSci Survey) and study specific case report forms on paper (Adverse Events, Serious Adverse Events and concomitant medication). Data in the eCRF can be validated for completeness and discrepancies automatically. An audit trail system maintains a record of initial entries and changes (reasons for changes, time and date of changes, user identification of entry and changes). * Quality insurance will be done by an external site monitoring (including study progress, accuracy and completeness of eCRF, fulfillment of protocol requirements, applicable local authority regulations and investigator's obligations). * Monitoring includes 100% of safety parameters, primary endpoints, informed consent documents and the Trial Master File on the Initiation Visit and on Close Out. * Standard Operating Procedures to address study activities such as patient recruitment, informed consent, study interventions, data collection, data management, data analysis, and reporting for adverse events exist.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
100
Once oral administration of 500mg before exposure therapy.
Once oral administration of 500mg before exposure therapy.
Fear reactivation before exposure therapy.
Psychiatric University Clinics, University Basel
Basel, Switzerland
Change in performance in Behavioral Approach Test (BAT) in real-life (in vivo)
Time frame: Baseline (visit 1: 7-21 days before visit 2: intervention) and follow up (visit 3: 90 days after visit 2: intervention
Change in performance in BAT in virtual reality (in virtuo)
Time frame: Baseline (visit 1: 7-21 days before visit 2: intervention) and follow up (visit 3: 90 days after visit 2: intervention
Change in subjective reactions in BAT in virtual reality (in virtuo)
Time frame: Baseline (visit 1: 7-21 days before visit 2: intervention) and follow up (visit 3: 90 days after visit 2: intervention
Change in psychophysiological reactions in BAT in virtual reality (in virtuo)
Time frame: Baseline (visit 1: 7-21 days before visit 2: intervention) and follow up (visit 3: 90 days after visit 2: intervention
Change in subjective reactions to fear-related picture cue presentation quantified by visual analog scales (VAS) for valence, arousal and fear
Time frame: Baseline (visit 1: 7-21 days before visit 2: intervention) and follow up (visit 3: 90 days after visit 2: intervention
Change in psychophysiological reactions to fear-related picture cue presentation quantified by electrodermal activity (EDA), heart rate (HR), startle response
Time frame: Baseline (visit 1: 7-21 days before visit 2: intervention) and follow up (visit 3: 90 days after visit 2: intervention
Performance in working and recognition memory of pictures task
Time frame: Follow up (visit 3: 90 days after visit 2: intervention)
Valence, arousal, and mood ratings of pictures of working and recognition memory of pictures task
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No fear reactivation before exposure therapy.
Time frame: Follow up (visit 3: 90 days after visit 2: intervention)
Change in strength of phobic fear quantified by self-report questionnaires
Time frame: Baseline (7-21 days before visit 2: intervention), intervention (visit 2: 7-21 days after visit 1: baseline) and follow up (visit 3: 90 days after visit 2: intervention)
Change in mood and state-anxiety quantified by self-report questionnaires
Time frame: Baseline (7-21 days before visit 2: intervention), intervention (visit 2: 7-21 days after visit 1: baseline) and follow up (visit 3: 90 days after visit 2: intervention)
Change in performance during exposure in virtuo quantified by eye tracking
Time frame: Intervention (visit 2: 7-21 days after visit 1: baseline)
Change in subjective reactions during exposure in virtuo quantified by subjective units of discomfort (SUD) ratings
Time frame: Intervention (visit 2: 7-21 days after visit 1: baseline)
Change in psychophysiological reactions during exposure in virtuo quantified by EDA and HR
Time frame: Intervention (visit 2: 7-21 days after visit 1)
Change in clinical relevance of phobic symptoms measured by Diagnostic Interview for Psychiatric Disorders (DIPS), section for specific phobia
Time frame: Baseline (visit 1: 7-21 days before visit 2: intervention) and follow up (visit 3: 90 days after visit 2: intervention)