Combination Treatment for Posttraumatic Stress Disorder (PTSD) After the World Trade Center (WTC) Attack
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Purpose
This randomized controlled trial evaluates efficacy of combined prolonged exposure (PE) and the selective serotonin reuptake inhibitor (SSRI) paroxetine in the treatment of survivors of the World Trade Center (WTC) attacks.
| Condition | Intervention | Phase |
|---|---|---|
|
Posttraumatic Stress Disorder |
Drug: Paroxetine Behavioral: Prolonged Exposure Therapy |
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: | Combination Treatment for PTSD After the WTC Attack |
- Clinician Administered PTSD Scale (CAPS) [ Time Frame: Weeks 0,5,10 ] [ Designated as safety issue: No ]PTSD severity, minimum = 0 = no symptoms of PTSD maximum = 136 = extremely severe symptoms of PTSD
- Number of Participants Who Met Remission Criterion [ Time Frame: Weeks 5,10 ] [ Designated as safety issue: No ]remission defined as: CAPS less than or equal to 20 and Clinical Global Impression (CGI)-change score=1
- Treatment Response at Weeks 5 and 10 [ Time Frame: weeks 5,10 ] [ Designated as safety issue: No ]
responder status: CGI-change score of 1 or 2
1=very much improved, 2= much improved
- Hamilton Depression Scale 0 = no Depression Symptoms 40 = Extreme Depression Symptoms [ Time Frame: weeks 0,5,10 ] [ Designated as safety issue: No ]total score at weeks 0, 5, 10
- Quality of Life Enjoyment and Satisfaction Scale Total Score at Week 0,5,10 [ Time Frame: weeks 0,5,10 ] [ Designated as safety issue: No ]Measures life enjoyment and satisfaction across 16 domains 16 = very poor quality of life to 80 =very good quality of life
| Enrollment: | 37 |
| Study Start Date: | March 2004 |
| Study Completion Date: | February 2010 |
| Primary Completion Date: | February 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Paroxetine
Paroxetine and Prolonged Exposure Therapy
|
Drug: Paroxetine
Paroxetine (controlled release) 12.5-50 milligrams (mg) daily for 22 weeks
Other Name: Paxil controlled release (CR)
Behavioral: Prolonged Exposure Therapy
Weekly for 10 weeks
Other Name: Cognitive Behavioral Therapy
|
|
Placebo Comparator: Placebo pill
Placebo pill plus Prolonged Exposure Therapy
|
Behavioral: Prolonged Exposure Therapy
Weekly for 10 weeks
Other Name: Cognitive Behavioral Therapy
|
Detailed Description:
Selective serotonin reuptake inhibitor (SSRI) medication is often recommended in combination with cognitive behavioral therapies for PTSD, but combined initial treatment of PTSD has not been studied under controlled conditions. Also, there are few studies of either treatment in survivors of terrorism. This randomized controlled trial evaluates efficacy of combined prolonged exposure (PE) and the SSRI paroxetine in the treatment of survivors of the World Trade Center (WTC) attacks.
Eligibility| Ages Eligible for Study: | 18 Years to 70 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Posttraumatic Stress Disorder, chronic, related to World Trade Center Attacks
- Age 18-70
- CAPS score greater than 45
- Willingness to consent
- For women, negative pregnancy test and using adequate birth control
Exclusion Criteria:
- Prominent suicidal ideation
- Current psychotic disorder
- Unstable medical illness
- Women who are pregnant or nursing mothers
- Alcohol or substance use disorder in the past 3 months
- History of seizure disorder
- conditions that contraindicate use of paroxetine
- inability to tolerate a drug free period prior to beginning the study of 4 weeks for MAOIs or fluoxetine and 2 weeks for other psychotropic drugs, except zolpidem for insomnia.
Contacts and Locations| United States, New York | |
| New York State Psychiatric Institute | |
| New York, New York, United States, 10032 | |
| Principal Investigator: | Franklin Schneier, MD | New York State Psychiatric Institute |
More Information
No publications provided by Research Foundation for Mental Hygiene
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Franklin Schneier, Research Psychiatrist, Research Foundation for Mental Hygiene |
| ClinicalTrials.gov Identifier: | NCT01130103 History of Changes |
| Other Study ID Numbers: | R01MH068173, R01MH068173 |
| Study First Received: | May 24, 2010 |
| Results First Received: | July 9, 2012 |
| Last Updated: | November 30, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Research Foundation for Mental Hygiene:
|
PTSD anxiety disorders trauma |
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 June 17, 2013