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Cortisol Augmentation of a Psychological Treatment in Warfighters With Post Traumatic Stress Disorder (PTSD)

Primary Purpose

PTSD

Status
Unknown status
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Prolonged Exposure therapy
Hydrocortisone
Prolonged Exposure therapy
Sponsored by
Bronx VA Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for PTSD

Eligibility Criteria

18 Years - 89 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • A primary diagnosis of chronic PTSD according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic criteria, resulting from a deployment-related traumatic event, and a minimum PTSD severity of 50 (CAPS).
  • The veteran must either be unmedicated or on a stable psychotropic regimen (i.e., 1 or more months on the same regimen).

Exclusion Criteria:

  • Lifetime history of psychotic disorder, bipolar disorder, or obsessive compulsive disorder.
  • Moderate or severe traumatic brain injury (TBI).
  • A medical or mental health problem other than PTSD that requires immediate clinical attention.
  • Substance abuse or dependence within the last 3 months.
  • Suicidal risk (as determined by response of 5 or 6 on the suicidality items of the Montgomery Asberg Depression Rating Scale (MADRS)) and/or assessed suicide risk on the basis of clinical judgment.
  • Persons on a psychotropic medication regimen that has not been consistent for one month.
  • Presence of diabetes mellitus or any current unstable medical illness or condition that represents a contraindication to taking glucocorticoids (this will be determined by history and/or abnormal laboratory findings at medical clearance).
  • Unwillingness to discontinue other specialized psychotherapy for PTSD during the 10 weeks of study treatment and the 6 week follow-up. (Self-help (non-trauma focused) groups or supportive counseling can be continued but not initiated.)
  • Pregnant women or those planning to become pregnant within the study period will not be enrolled. Female participants must agree to use an effective method of birth control (i.e., oral contraceptive, Norplant, diaphragm, condom, or spermicide, abstinence) during the course of the study to ensure they do not become pregnant during the course of the study.

Sites / Locations

  • James J. Peters Veterans Affairs Medical CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Prolonged Exposure therapy with Hydrocortisone

Prolonged Exposure therapy with placebo

Arm Description

Outcomes

Primary Outcome Measures

PTSD symptom severity as assessed by the Clinician Administered PTSD Scale (CAPS)
PTSD symptom severity as assessed by the Clinician Administered PTSD Scale (CAPS)
PTSD symptom severity as assessed by the Clinician Administered PTSD Scale (CAPS)

Secondary Outcome Measures

Cognitive performance (learning and retention in an episodic memory task, attention and working memory)
Cognitive performance (learning and retention in an episodic memory task, attention and working memory)
Cognitive performance (learning and retention in an episodic memory task, attention and working memory)
Other measures of clinical outcome, psychological state and functioning
Other measures of clinical outcome, psychological state and functioning
Other measures of clinical outcome, psychological state and functioning
Biological measures associated with PTSD severity
Biological measures associated with PTSD severity
Biological measures associated with PTSD severity

Full Information

First Posted
March 11, 2010
Last Updated
February 4, 2013
Sponsor
Bronx VA Medical Center
Collaborators
Lightfighter Trust
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1. Study Identification

Unique Protocol Identification Number
NCT01090518
Brief Title
Cortisol Augmentation of a Psychological Treatment in Warfighters With Post Traumatic Stress Disorder (PTSD)
Official Title
Cortisol Augmentation of a Psychological Treatment in Warfighters With Post Traumatic Stress Disorder (PTSD)
Study Type
Interventional

2. Study Status

Record Verification Date
February 2013
Overall Recruitment Status
Unknown status
Study Start Date
February 2010 (undefined)
Primary Completion Date
November 2013 (Anticipated)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Bronx VA Medical Center
Collaborators
Lightfighter Trust

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study seeks to examine the efficacy of hydrocortisone administration in the augmentation of the therapeutic effects of Prolonged Exposure (PE) therapy, an empirically tested treatment shown to be effective in the the treatment of posttraumatic stress disorder (PTSD). The augmentation builds on both the translation of neuroscience findings demonstrating the effects of glucocorticoids (GCs) on learning, and on empirical clinical findings from other investigators demonstrating beneficial effects of GCs in reducing traumatic memories in trauma-exposed persons.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
PTSD

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
50 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Prolonged Exposure therapy with Hydrocortisone
Arm Type
Active Comparator
Arm Title
Prolonged Exposure therapy with placebo
Arm Type
Placebo Comparator
Intervention Type
Behavioral
Intervention Name(s)
Prolonged Exposure therapy
Intervention Description
10 weekly sessions
Intervention Type
Drug
Intervention Name(s)
Hydrocortisone
Intervention Description
30mg 20 minutes prior to each PE session including imaginal exposure (8 total)
Intervention Type
Behavioral
Intervention Name(s)
Prolonged Exposure therapy
Intervention Description
10 weekly sessions
Primary Outcome Measure Information:
Title
PTSD symptom severity as assessed by the Clinician Administered PTSD Scale (CAPS)
Time Frame
week 0
Title
PTSD symptom severity as assessed by the Clinician Administered PTSD Scale (CAPS)
Time Frame
week 10
Title
PTSD symptom severity as assessed by the Clinician Administered PTSD Scale (CAPS)
Time Frame
week 16
Secondary Outcome Measure Information:
Title
Cognitive performance (learning and retention in an episodic memory task, attention and working memory)
Time Frame
week 0
Title
Cognitive performance (learning and retention in an episodic memory task, attention and working memory)
Time Frame
week 10
Title
Cognitive performance (learning and retention in an episodic memory task, attention and working memory)
Time Frame
week 16
Title
Other measures of clinical outcome, psychological state and functioning
Time Frame
week 0
Title
Other measures of clinical outcome, psychological state and functioning
Time Frame
week 10
Title
Other measures of clinical outcome, psychological state and functioning
Time Frame
week 16
Title
Biological measures associated with PTSD severity
Time Frame
week 0
Title
Biological measures associated with PTSD severity
Time Frame
week 10
Title
Biological measures associated with PTSD severity
Time Frame
week 16

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
89 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: A primary diagnosis of chronic PTSD according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic criteria, resulting from a deployment-related traumatic event, and a minimum PTSD severity of 50 (CAPS). The veteran must either be unmedicated or on a stable psychotropic regimen (i.e., 1 or more months on the same regimen). Exclusion Criteria: Lifetime history of psychotic disorder, bipolar disorder, or obsessive compulsive disorder. Moderate or severe traumatic brain injury (TBI). A medical or mental health problem other than PTSD that requires immediate clinical attention. Substance abuse or dependence within the last 3 months. Suicidal risk (as determined by response of 5 or 6 on the suicidality items of the Montgomery Asberg Depression Rating Scale (MADRS)) and/or assessed suicide risk on the basis of clinical judgment. Persons on a psychotropic medication regimen that has not been consistent for one month. Presence of diabetes mellitus or any current unstable medical illness or condition that represents a contraindication to taking glucocorticoids (this will be determined by history and/or abnormal laboratory findings at medical clearance). Unwillingness to discontinue other specialized psychotherapy for PTSD during the 10 weeks of study treatment and the 6 week follow-up. (Self-help (non-trauma focused) groups or supportive counseling can be continued but not initiated.) Pregnant women or those planning to become pregnant within the study period will not be enrolled. Female participants must agree to use an effective method of birth control (i.e., oral contraceptive, Norplant, diaphragm, condom, or spermicide, abstinence) during the course of the study to ensure they do not become pregnant during the course of the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Rachel Yehuda, PhD
Phone
718-741-4000
Ext
6964
Email
rachel.yehuda@va.gov
Facility Information:
Facility Name
James J. Peters Veterans Affairs Medical Center
City
Bronx
State/Province
New York
ZIP/Postal Code
10468
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Rachel Yehuda, PhD

12. IPD Sharing Statement

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Cortisol Augmentation of a Psychological Treatment in Warfighters With Post Traumatic Stress Disorder (PTSD)

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