Why are we doing this study?

Available medical research suggests that escitalopram (Lexapro) is often effective for Body Dysmorphic Disorder (BDD). It is currently considered a first-choice treatment for BDD.

In this study, we are assessing how people who initially improve after 14 weeks of treatment with Lexapro do when Lexapro is either discontinued or continued for another 6 months. This is a very important question that patients and doctors often ask and which this study will help to answer.

What is Escitalopram?

Escitalopram (Lexapro) is a marketed medication that's used to treat depression and other disorders. Lexapro also often helps decrease obsessive thoughts and compulsive behaviors, anxiety, and social anxiety. Lexapro and other similar medications have been shown to be effective for a majority of people who have Body Dysmorphic Disorder.

What will it entail for me?

The study consists of 2 phases:

Phase 1: After an initial evaluation, you will receive Lexapro for 14 weeks. Each study visit will take about 45 minutes a week for the first month and about 45 minutes every other week for the rest of the 14 weeks.

Phase 2: If you improve sufficiently in Phase 1, you will continue to Phase 2. In Phase 2, you will either continue taking Lexapro for another six months or you will be switched to placebo ("sugar pill"). You will be assigned to one of these groups "randomly," and neither you nor the study researchers will know whether you are continuing on Lexapro or placebo.

Studyevaluations during Phase 2 will take about 45 minute each and occur every other week.

At each study visit, we will ask you questions about your symptoms and how you are tolerating the medication. We will very carefully monitor you and your symptoms.

During Phase 2, if your BDD symptoms return, you will be referred to another doctor for continued treatment. She will provide you with treatment for three more months.

You will be paid $25 for each visit during Phase 2, with exception to the

final visit for which you will be paid $50. By participating in this study, you will receive an evaluation, treatment with Lexapro from experts in BDD, and careful monitoring of your body image concerns and symptoms. Your participation will be of benefit to others, as it will contribute to efforts to learn more about the treatment of BDD which is a distressing and understudied disorder.

If you live closer to Boston, Massachusetts, please call our collaborators (Sabine Wilhelm, MD) at Massachusetts General Hospital at 617-726-5374. Massachusetts General Hospital is also part of this study and is offering evaluation and study treatment for adults with BDD who qualify.