Tramadol Extended-Release (ER) for Posttraumatic Stress Disorder (PTSD)
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Purpose
This is a six-week pilot study testing the efficacy of tramadol extended-release (ER) for posttraumatic stress disorder (PTSD). Men and women aged 21-55 years with combat-related PTSD (n=20) or PTSD resulting from a civilian trauma (n=20) will be recruited. Blinded tramadol ER will begin with a 100 mg daily dose for the first week, with an option to increase to 200 mg/day for the 2nd week. Dose adjustments, using a range of 100-300 mg tramadol ER per day (or 1 to 3 placebo tabs), are permitted thereafter. The primary hypothesis is that tramadol ER 100 to 300 mg every morning for 6 weeks will reduce the symptoms of PTSD relative to placebo. The primary outcome measures will be PTSD symptoms as rated by the Clinician-Administered PTSD Scale (CAPS) and Clinicians Global Impressions scale at baseline and weeks one, two, four, and six. Assignment to blinded medication arms will be stratified to ensure equivalence of the two arms (men and women, military and civilian trauma).
| Condition | Intervention | Phase |
|---|---|---|
|
Post-Traumatic Stress Disorder |
Drug: Tramadol Drug: Placebo |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | A Double-Blind, Placebo-Controlled, Flexible-Dose Pilot Clinical Trial of Once-Daily Extended-Release Tramadol for the Treatment of PTSD |
- Efficacy as measured by a reduction in PTSD symptoms. [ Time Frame: Baseline and weeks 1, 2, 4, and 6 ] [ Designated as safety issue: No ]Efficacy will be determined by change in PTSD symptoms as measured by the Clinician-Administered PTSD Scale (CAPS) and Clinicians Global Impressions scale.
- Efficacy as measured by a reduction in anxiety, "nervousness", irritability, mood, sleep, and pain. [ Time Frame: Baseline and weeks 1, 2, 4, and 6. ] [ Designated as safety issue: No ]Efficacy will be determined by change in anxiety, "nervousness", irritability, mood, sleep, and pain as measured by self-rated 100-mm visual analog scales.
- Efficacy as measured by a reduction in depressive symptoms. [ Time Frame: Baseline and weeks 1, 2, 4, and 6. ] [ Designated as safety issue: No ]Efficacy will be determined by change in depressive symptoms as measured by the Quick Inventory of Depressive Symptoms - Self Report.
| Estimated Enrollment: | 40 |
| Study Start Date: | September 2011 |
| Estimated Study Completion Date: | September 2013 |
| Estimated Primary Completion Date: | September 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Tramadol ER |
Drug: Tramadol
Tramadol hydrochloride Extended Release(ER) will be supplied as tablets of Ultram® ER 100mg. Tramadol ER (100-300mg) or matching placebo will be self-administered by oral route every morning (with or without food) for 6 weeks. Patients will be instructed to take it the same way (either with food or without food) each time they take their dose. Each patient will be provided with 1 week supply of Tramadol ER or matching placebo on visits 2 (week 0) and 3 (week 1) and 2 weeks supply on visits 4 (week 2) and 5 (week 4).
Other Name: Ultram® ER
|
| Placebo Comparator: Sugar pill |
Drug: Placebo
Matching placebo will be self-administered by oral route every morning (with or without food) for 6 weeks. Patients will be instructed to take it the same way (either with food or without food) each time they take their dose. Each patient will be provided with 1 week supply of Tramadol ER or matching placebo on visits 2 (week 0) and 3 (week 1) and 2 weeks supply on visits 4 (week 2) and 5 (week 4).
|
Eligibility| Ages Eligible for Study: | 21 Years to 55 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Men and women, military veterans and non-veterans, aged 21-55 years
- Active PTSD as determined by diagnostic evaluation and standardized interview [SCID]
- In the case of non-veterans with non-military trauma, index trauma must have occurred no more than 12 months preceding screening for study
- Literacy and ability to give informed consent
- In women of child-conceiving potential, a negative pregnancy test and use of an approved birth control method
- Glasgow Coma Scale (GCS) coma score of 15, Extension of GCS with 7-point Amnesia Scale score of 6 (amnesia for traumatic event of 30 min or fewer) or 7 (no amnesia for impact of head) (Nell et al 2000)
- Clinically judged to be at low risk for adverse sequelae from taking tramadol
Exclusion Criteria:
- Pregnant or nursing women
- Homeless persons
- Suicidal or homicidal ideation with plans or intent
- History of opioid dependence or abuse
- Psychosis or history thereof, substance dependence or abuse (other than tobacco dependence; lifetime opioid abuse is exclusionary) within the past 60 days, anorexia nervosa, antisocial personality disorder, or other psychiatric disorder judged by the investigator to be more clinically significant than PTSD
- Serious or unstable illness, endocrinopathy, or metabolic instability, including renal insufficiency, liver disease, hydrocephalus, history of stroke, history of seizures, history of brain tumor
- Use of non-study medications except those approved by the PI
- Newly started in psychotherapy (< 3months)
- History of hypersensitivity, allergy, or other significant adverse effects from tramadol
Contacts and Locations| Contact: Heather Dodge | 513-861-3100 ext 5539 | heather.dodge@va.gov |
| United States, Ohio | |
| Cincinnati VA Medical Center | Recruiting |
| Cincinnati, Ohio, United States, 45220 | |
| Principal Investigator: Thomas Geracioti, MD | |
| Principal Investigator: | Thomas Geracioti, MD | University of Cincinnati |
More Information
No publications provided
| Responsible Party: | INTRuST, Post-Traumatic Stress Disorder - Traumatic Brain Injury Clinical Consortium |
| ClinicalTrials.gov Identifier: | NCT01517711 History of Changes |
| Other Study ID Numbers: | INTRuST-Tramadol |
| Study First Received: | January 23, 2012 |
| Last Updated: | October 25, 2012 |
| Health Authority: | United States: Institutional Review Board United States: Federal Government |
Keywords provided by INTRuST, Post-Traumatic Stress Disorder - Traumatic Brain Injury Clinical Consortium:
|
pharmacotherapy combat disorders |
Additional relevant MeSH terms:
|
Stress Disorders, Post-Traumatic Stress Disorders, Traumatic Anxiety Disorders Mental Disorders Tramadol Narcotics Central Nervous System Depressants Physiological Effects of Drugs |
Pharmacologic Actions Analgesics Sensory System Agents Peripheral Nervous System Agents Central Nervous System Agents Therapeutic Uses Analgesics, Opioid |
ClinicalTrials.gov processed this record on May 22, 2013