Paroxetine-CR to Treat Post-Traumatic Stress Disorder (PTSD) Symptomatic After Initial Exposure Therapy
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Purpose
Both pharmacotherapeutic and psychosocial interventions have domenstrated efficacy for PTSD. However, although these interventions can be helpful, many patients remain symptomatic despite initial treatment. In this study, we will examine the relative efficacy of the addition of paroxetine-CR compared to placebo for patients remaining symptomatic despite a brief and intensive course of cognitive-behavioral therapy (CBT).
| Condition | Intervention | Phase |
|---|---|---|
|
Stress Disorders, Post-Traumatic |
Drug: Cognitive-behavioral therapy and paroxetine-CR |
Phase 2 Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double-Blind Primary Purpose: Treatment |
| Official Title: | Randomized Trial of Paroxetine-CR for the Treatment of Patients With Post-Traumatic Stress Disorder (PTSD) Remaining Symptomatic After Initial Exposure Therapy |
- Short PTSD Rating Interview (SPRINT)
- Davidson Trauma Scale (DTS)
- Clinical Global Impressions Severity Scale (CGI-S)
- Clinical Global Impressions Improvement Scale (CGI-I)
- Posttraumatic Diagnostic Scale (PDS)
- Beck Depression Inventory (BDI)
- Quality of Life Enjoyment and Satisfaction Questionnaire/General Activities Subscale (Q-LES-Q/GA)
- Sheehan Disability Scale (SDS)
- Connor-Davidson Resilience Scale (CD-RISC)
- Post-Traumatic Cognitions Inventory (PTCI)
- Severity of Symptoms Scale (SOSS)
- Pittsburgh Sleep Quality Index (PSQI)
- World Assumptions Scale (WAS)
- Mood-SR Lifetime
| Estimated Enrollment: | 60 |
| Study Start Date: | December 2002 |
| Estimated Study Completion Date: | June 2006 |
This is a systematic controlled study examining the use of augmentation with pharmaotherapy for PTSD patients remaining symptomatic despite CBT (exposure therapy). The aims of the study include examination of: (1) the efficacy of paroxetine-CR compared to placebo as additions to ongoing exposure therapy in patients who failed to respond to brief, intensive CBT; (2) the tolerability of paroxetine-CR compared to placebo as additions to ongoing exposure therapy in patients who failed to respond to brief, intensive CBT; (3) the outcome of patients at 6 months follow-up to randomized treatment. Patients will initially have intensive (8 sessions over 4 weeks) prolonged exposure therapy. Patients who remain symptomatic will be randomzied to receive either flexibly-dosed paroxetine-CR (12.5 mg/d - 62.5 mg/d) or placebo in conjunction with additional 5 sessions of prolonged exposure over 10 weeks.
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Male or female outpatients at least 18 years of age with a primary (the condition that is most central to the patient's current distress) psychiatric diagnosis of PTSD as defined by DSM-IV criteria
- Patients must have remained symptomatic (CGI-S > or = 3) and a score of at least 6 on the SPRINT after a minimum of 7 sessions of prolonged exposure (delivered within 6 weeks) to be eligible for randomized treatment.
Exclusion Criteria:
- Serious medical illness or instability for which hospitalization may be likely within the next 3 months
- Pregnant or lactating women or those of childbearing potential not using medically accepted forms of contraception
- Concurrent use of other psychotropic medications
- Lifetime diagnosis of schizophrenia or any other psychotic disorder, mental retardation, organic mental disorders, or bipolar disorder
- Obsessive-Compulsive Disorder, eating disorders, or alcohol/substance abuse disorders within the last 6 months
- A current primary diagnosis of major depression, dysthymia, social anxiety disorder, and generalized anxiety disorder
- A history of hypersensitivity or poor response to paroxetine or those using antidepressants, buspirone, or beta-blockers within 2 weeks of randomization
- Concurrent dynamic or supportive psychotherapy if started within 2 months prior to onset of study entry
Contacts and Locations| United States, California | |
| University of California at San Diego | |
| San Diego, California, United States, 92093 | |
| United States, Massachusetts | |
| Massachusetts General Hospital | |
| Boston, Massachusetts, United States, 02114 | |
| United States, North Carolina | |
| Duke University Medical Center | |
| Durham, North Carolina, United States, 27705 | |
| United States, Pennsylvania | |
| University of Pennsylvania | |
| Philadelphia, Pennsylvania, United States, 19122 | |
| Principal Investigator: | Jonathan Davidson, M.D. | Duke University |
More Information
No publications provided by Duke University
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| ClinicalTrials.gov Identifier: | NCT00215163 History of Changes |
| Other Study ID Numbers: | 4304-02-12 |
| Study First Received: | September 20, 2005 |
| Last Updated: | December 18, 2006 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by Duke University:
|
PTSD Anxiety CBT |
Exposure Paroxetine Paroxetine-CR |
Additional relevant MeSH terms:
|
Stress Disorders, Post-Traumatic Stress Disorders, Traumatic Anxiety Disorders Mental Disorders Paroxetine Serotonin Uptake Inhibitors Neurotransmitter Uptake Inhibitors Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action |
Pharmacologic Actions Serotonin Agents Physiological Effects of Drugs Antidepressive Agents, Second-Generation Antidepressive Agents Psychotropic Drugs Central Nervous System Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on May 16, 2013