Enhancing Extinction Learning in Post Traumatic Stress Disorder (PTSD) (HELP)
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Purpose
Posttraumatic stress disorder (PTSD) is a condition that involves intense memories of a traumatic event and intense, persistent feelings of anxiety. There are several effective therapies for PTSD, but they are often time consuming. The investigators want to see if the investigators can shorten treatment time while keeping therapy effective by adding a medication called methylene blue, USP, taken orally as a pill, to the therapy. The specific aims are: 1) To see whether medication plus psychotherapy improves PTSD symptoms more than placebo plus psychotherapy or a waitlist; 2) To examine the long-term outcome of those receiving medication plus psychotherapy 1 and 3 months after treatment has ended; 3) To examine whether medication plus psychotherapy helps with depression, trauma-related cognitions, and functioning.
| Condition | Intervention | Phase |
|---|---|---|
|
Chronic Posttraumatic Stress Disorder |
Drug: Psychotherapy plus Methylene Blue, USP Behavioral: Psychotherapy plus Placebo Behavioral: Delayed Psychotherapy |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
- PTSD symptom severity [ Time Frame: Pre- and post-treatment, 1-month and 3-month follow-ups ] [ Designated as safety issue: No ]PTSD Symptom Scale - Interview Version
- Depression symptom severity [ Time Frame: Pre- and post-treatment, 1-month and 3-month follow-ups ] [ Designated as safety issue: No ]Quick Inventory of Depressive Symptomatology - Self-Report
- Trauma-related cognitions [ Time Frame: Pre- and post-treatment, 1-month and 3-month follow-ups ] [ Designated as safety issue: No ]Post-Traumatic Cognitions Inventory - Self-Report
- General physical and psychological health [ Time Frame: Pre- and post-treatment, 1-month and 3-month follow-ups ] [ Designated as safety issue: No ]Medical Outcomes Study Short Form 36, Version 2 - Self-report
- Functioning in work, social/leisure activities, and family/home life [ Time Frame: Pre- and post-treatment, 1-month and 3-month follow-ups ] [ Designated as safety issue: No ]Sheehan Disability Scale - Self-report
| Estimated Enrollment: | 42 |
| Study Start Date: | September 2009 |
| Estimated Study Completion Date: | April 2013 |
| Estimated Primary Completion Date: | December 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Psychotherapy plus Methylene Blue, USP |
Drug: Psychotherapy plus Methylene Blue, USP
This treatment involves daily visits with a therapist for 50 to 60 minutes for a total of six sessions. At the end of each session, 260 mg of methylene blue, USP will be given.
|
| Placebo Comparator: Psychotherapy Plus Placebo |
Behavioral: Psychotherapy plus Placebo
This treatment involves daily visits with a therapist for 50 to 60 minutes for a total of six sessions. At the end of each session, capsules containing the placebo will be given.
|
| Delayed Psychotherapy |
Behavioral: Delayed Psychotherapy
Individuals must wait approximately five to six weeks to start treatment. They will come in for two check-in appointments before starting treatment. Treatment will consist of ten twice-weekly psychotherapy sessions (90-120 min each session).
|
Detailed Description:
The psychotherapy the investigators are offering in this study is a type of cognitive behavioral therapy called imaginal exposure. In imaginal exposure, the investigators encourage the client to approach the memory of the trauma by recounting the trauma story to the therapist and discussing his or her reactions to the memory.
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Current primary PTSD diagnosis based on DSM-IV criteria, with a minimum duration of 12 weeks since the traumatic event.
- Between the age of 18 and 65.
Exclusion Criteria:
- Current diagnosis of schizophrenia, delusional disorder, or organic mental disorder as defined by the DSM-IV.
- Current diagnosis of bipolar disorder, depression with psychotic features, or depression severe enough to require immediate psychiatric treatment (i.e., serious suicide risk with intent and plan).
- Current diagnosis of alcohol or substance dependence within the 3 previous months.
- Unwilling or unable to discontinue current trauma-focused psychotherapy or psychotropic medication (at least 1 month medication free).
- Ongoing intimate relationship with the perpetrator (in assault-related PTSD cases).
- Unstable cardiovascular, autoimmune, endocrine, neurological, renal, hepatic, retinal, gastrointestinal, or hematological disorder or current seizure disorder.
- Pregnant or nursing females; females of childbearing potential who are unwilling or unable to use an acceptable method of contraception for the duration of active treatment.
- A history of hypersensitivity or allergy to MB.
- Any condition possibly affecting drug absorption (e.g., gastrectomy).
- Glucose-6-phosphate dehydrogenase deficiency.
- Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that, in the judgment of the Medical Directors, would make the participant inappropriate for entry.
Contacts and Locations| United States, Pennsylvania | |
| University of Pennsylvania | |
| Philadelphia, Pennsylvania, United States, 19104 | |
| United States, Texas | |
| University of Texas | |
| Austin, Texas, United States, 78712 | |
| United States, Washington | |
| University of Washington | |
| Seattle, Washington, United States, 98195 | |
| Principal Investigator: | Lori A Zoellner, PhD | University of Washington |
More Information
Additional Information:
No publications provided
| Responsible Party: | University of Washington |
| ClinicalTrials.gov Identifier: | NCT01188694 History of Changes |
| Other Study ID Numbers: | 37340-G, R34MH087375, 107654 |
| Study First Received: | July 20, 2010 |
| Last Updated: | December 18, 2012 |
| Health Authority: | United States: Food and Drug Administration United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Stress Disorders, Post-Traumatic Stress Disorders, Traumatic Anxiety Disorders Mental Disorders |
Methylene Blue Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 23, 2013