Treating Nightmares in Posttraumatic Stress Disorder With Dronabinol
Primary Purpose
Posttraumatic Stress Disorder
Status
Recruiting
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
BX-1
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Posttraumatic Stress Disorder focused on measuring Nightmares, Posttraumatic Stress Disorder, Dronabinol
Eligibility Criteria
Inclusion Criteria:
- Diagnosis of posttraumatic stress disorder (PTSD) according to DSM 5 with a 20 item CAPS-5 total score ≥ 26
- At least two nightmares a week, an intensity score ≥ 2, with a CAPS-IV B2 (frequency and intensity for the last week) score ≥ 5
- Men and women between 18 and 65 years of age
- Written informed consent
- The patient has the capacity to give consent (He/she is able to understand the nature and anticipated effects/side effects of the proposed medical intervention)
- The patient is not breastfeeding
- Women of child-bearing potential must have a negative urine or serum pregnancy test
- All participants must use highly effective contraception
- The patient received stable pharmacological medication for at least 4 weeks prior to study entry (any changes in medication dose or frequency of therapy must be answered with no)
Exclusion Criteria:
- Lifetime cannabis use disorder
- Current substance/alcohol use disorder (≤ 3 months);
- Acute suicidality;
- Psychotic disorder;
- Bipolar disorder;
- Current anorexia nervosa;
- Current major depressive episodes and a MADRS score > 29;
- Dementia;
- Trauma-focused psychotherapy four weeks before the trial
- Initiation of sleep medication 4 weeks prior screening or initiation of alpha adrenergic agents 4 weeks prior to screening
- Acute or unstable medical illness.
- Epilepsy
- Relevant heart diseases
- Known HIV- and/or active Hepatitis-B- or Hepatitis-C-infection
- Current or past malignant illness
- The patient is unwilling to consent to saving, processing and propagation of pseudonymized medical data for study reasons
- Patients, who may be dependent on the sponsor, the investigator or the trial sites, have to be excluded from the trial
- The patient is legally detained in an official institution
- The patient does have a known allergy or contraindication against Dronabinol
- The patient does have clinically significant abnormalities in 12-lead ECG
- The patient does have clinically significant laboratory abnormalities
- The patient did participate in other interventional trials during the 3 months before and at the time of this trial
Sites / Locations
- Berlin St. HedwigRecruiting
- Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Klinik für Psychiatrie und PsychotherapieRecruiting
- Zentralinstitut für Seelische Gesundheit Mannheim
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
BX-1 (dronabinol)
Placebo
Arm Description
BX-1
Placebo of BX-1
Outcomes
Primary Outcome Measures
Frequency and intensity of nightmares
Frequency and intensity of nightmares, measured with the Clinician-Administered PTSD Scale-IV (CAPS-IV) B2 score for the last week, range 0-8. A lower score indicates less frequent and/or intense nightmares.
Secondary Outcome Measures
Change from baseline of the frequency and intensity of nightmares
Change from baseline of the frequency and intensity of nightmares, measured with the Clinician-Administered PTSD Scale-IV (CAPS-IV) B2 score for the last week, range 0-8.
Change from baseline of the CAPS-5 total score
Change from baseline of the CAPS-5 total score (overall PTSD symptoms, last week)
Change from baseline of the Pittsburgh Sleep Quality Index-Addendum for PTSD
Change from baseline of the Pittsburgh Sleep Quality Index-Addendum for PTSD (PSQI A) (PTSD related sleep symptoms)
Change from baseline of the Montgomery-Åsberg Depression Rating Scale
Change from baseline of the Montgomery-Åsberg Depression Rating Scale (MADRS, depressive symptoms)
Weekly mean of change from baseline of daily total sleep time
Weekly mean of change from baseline of the patients daily total sleep time (in minutes), assessed with sleep diaries
Weekly mean of change from baseline of the patients sleep onset latency at night
Weekly mean of change from baseline of the patients sleep onset latency at night (in minutes), assessed with sleep diaries
Weekly mean of change from baseline of the patients recuperation of night sleep
Weekly mean of change from baseline of the patients recuperation of night sleep (5-point Likert scale, 1 = very much; 5 = not at all), assessed with sleep diaries
Weekly mean of change from baseline of the patients time awake at night
Weekly mean of change from baseline of the patients time awake at night (in minutes), assessed with sleep diaries
Weekly mean of change from baseline of the patients number of nightmares last night
Weekly mean of change from baseline of the patients number of nightmares last night (0, 1, 3, 4 or more) assessed with sleep diaries
Weekly mean of change from baseline of the patients intensity of nightmares
Weekly mean of change from baseline of the patients intensity of nightmares (5-point Likert scale, 0 = not at all; 5 = extreme) assessed with sleep diaries
Change from baseline of PTSD symptoms assessed with the PTSD Checklist for DSM-5
Change from baseline of PTSD symptoms assessed with the PTSD Checklist for DSM-5 (PCL-5)
Change from baseline of the Borderline Symptom List 23
Change from baseline of the Borderline Symptom List 23 (BSL-23) score
Change from baseline of the Health-Related Quality of Life
Change from baseline of the Health-Related Quality of Life (EQ-5D) score
Overall patients status measured by the Patient Global Impression of Change
Overall patients status measured by the Patient Global Impression of Change (PGIC)
Change from baseline of the Social and Occupational Functioning Assessment Scale
Change from baseline of the Social and Occupational Functioning Assessment Scale (SOFAS)
Change from baseline of the Pittsburgh Sleep Quality Index
Change from baseline of the Pittsburgh Sleep Quality Index (PSQI)
Change from baseline of symptoms of PTSD and complex PTSD according to ICD-11 assessed with the International Trauma Questionnaire
Change from baseline of symptoms of PTSD and complex PTSD according to ICD-11 assessed with the International Trauma Questionnaire (ITQ)
Change from baseline of THC withdraw symptoms assessed with the Marijuana Withdrawal Checklist
Change from baseline of THC withdraw symptoms assessed with the Marijuana Withdrawal Checklist (MWC)
Responder analysis: proportion of patients showing improvement in nightmares
Responder analysis: proportion of patients showing improvement in nightmares (change from baseline) defined as decrease of CAPS-IV B2 ≥50% assessed at the end of treatment
Remitter analysis: proportion of patients showing full remission of nightmares
Remitter analysis: proportion of patients showing full remission of nightmares defined as CAPS-IV B2 = 0, assessed at the end of treatment
Full Information
NCT ID
NCT04448808
First Posted
June 16, 2020
Last Updated
April 29, 2022
Sponsor
Charite University, Berlin, Germany
Collaborators
Bionorica SE
1. Study Identification
Unique Protocol Identification Number
NCT04448808
Brief Title
Treating Nightmares in Posttraumatic Stress Disorder With Dronabinol
Official Title
Treating Nightmares in Posttraumatic Stress Disorder With Dronabinol: A Randomized Controlled Study (THC PTSD-trial)
Study Type
Interventional
2. Study Status
Record Verification Date
April 2022
Overall Recruitment Status
Recruiting
Study Start Date
October 1, 2020 (Actual)
Primary Completion Date
May 2023 (Anticipated)
Study Completion Date
July 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Charite University, Berlin, Germany
Collaborators
Bionorica SE
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This randomized controlled exploratory phase II trial will test the hypothesis that oral dronabinol improves nightmares (primary outcome) and other PTSD symptoms (secondary outcomes) to a greater extent than placebo over a ten week intervention phase in a parallel group design.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Posttraumatic Stress Disorder
Keywords
Nightmares, Posttraumatic Stress Disorder, Dronabinol
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Randomized controlled study (double-blind)
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
176 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
BX-1 (dronabinol)
Arm Type
Experimental
Arm Description
BX-1
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo of BX-1
Intervention Type
Drug
Intervention Name(s)
BX-1
Intervention Description
BX-1 (dronabinol), oral solution. All patients enrolled establish their individually tolerable dose by dose Titration.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo of BX-1, oral solution
Primary Outcome Measure Information:
Title
Frequency and intensity of nightmares
Description
Frequency and intensity of nightmares, measured with the Clinician-Administered PTSD Scale-IV (CAPS-IV) B2 score for the last week, range 0-8. A lower score indicates less frequent and/or intense nightmares.
Time Frame
10 weeks
Secondary Outcome Measure Information:
Title
Change from baseline of the frequency and intensity of nightmares
Description
Change from baseline of the frequency and intensity of nightmares, measured with the Clinician-Administered PTSD Scale-IV (CAPS-IV) B2 score for the last week, range 0-8.
Time Frame
1, 2, 3, 4,6 and 8 weeks
Title
Change from baseline of the CAPS-5 total score
Description
Change from baseline of the CAPS-5 total score (overall PTSD symptoms, last week)
Time Frame
6 and 10 weeks
Title
Change from baseline of the Pittsburgh Sleep Quality Index-Addendum for PTSD
Description
Change from baseline of the Pittsburgh Sleep Quality Index-Addendum for PTSD (PSQI A) (PTSD related sleep symptoms)
Time Frame
6 and 10 weeks
Title
Change from baseline of the Montgomery-Åsberg Depression Rating Scale
Description
Change from baseline of the Montgomery-Åsberg Depression Rating Scale (MADRS, depressive symptoms)
Time Frame
4 and 10 weeks
Title
Weekly mean of change from baseline of daily total sleep time
Description
Weekly mean of change from baseline of the patients daily total sleep time (in minutes), assessed with sleep diaries
Time Frame
during 10 weeks
Title
Weekly mean of change from baseline of the patients sleep onset latency at night
Description
Weekly mean of change from baseline of the patients sleep onset latency at night (in minutes), assessed with sleep diaries
Time Frame
during 10 weeks
Title
Weekly mean of change from baseline of the patients recuperation of night sleep
Description
Weekly mean of change from baseline of the patients recuperation of night sleep (5-point Likert scale, 1 = very much; 5 = not at all), assessed with sleep diaries
Time Frame
during 10 weeks
Title
Weekly mean of change from baseline of the patients time awake at night
Description
Weekly mean of change from baseline of the patients time awake at night (in minutes), assessed with sleep diaries
Time Frame
during 10 weeks
Title
Weekly mean of change from baseline of the patients number of nightmares last night
Description
Weekly mean of change from baseline of the patients number of nightmares last night (0, 1, 3, 4 or more) assessed with sleep diaries
Time Frame
during 10 weeks
Title
Weekly mean of change from baseline of the patients intensity of nightmares
Description
Weekly mean of change from baseline of the patients intensity of nightmares (5-point Likert scale, 0 = not at all; 5 = extreme) assessed with sleep diaries
Time Frame
during 10 weeks
Title
Change from baseline of PTSD symptoms assessed with the PTSD Checklist for DSM-5
Description
Change from baseline of PTSD symptoms assessed with the PTSD Checklist for DSM-5 (PCL-5)
Time Frame
6 and 10 weeks
Title
Change from baseline of the Borderline Symptom List 23
Description
Change from baseline of the Borderline Symptom List 23 (BSL-23) score
Time Frame
6 and 10 weeks
Title
Change from baseline of the Health-Related Quality of Life
Description
Change from baseline of the Health-Related Quality of Life (EQ-5D) score
Time Frame
6 and 10 weeks
Title
Overall patients status measured by the Patient Global Impression of Change
Description
Overall patients status measured by the Patient Global Impression of Change (PGIC)
Time Frame
6 and 10 weeks
Title
Change from baseline of the Social and Occupational Functioning Assessment Scale
Description
Change from baseline of the Social and Occupational Functioning Assessment Scale (SOFAS)
Time Frame
6 and 10 weeks
Title
Change from baseline of the Pittsburgh Sleep Quality Index
Description
Change from baseline of the Pittsburgh Sleep Quality Index (PSQI)
Time Frame
6 and 10 weeks
Title
Change from baseline of symptoms of PTSD and complex PTSD according to ICD-11 assessed with the International Trauma Questionnaire
Description
Change from baseline of symptoms of PTSD and complex PTSD according to ICD-11 assessed with the International Trauma Questionnaire (ITQ)
Time Frame
6 and 10 weeks
Title
Change from baseline of THC withdraw symptoms assessed with the Marijuana Withdrawal Checklist
Description
Change from baseline of THC withdraw symptoms assessed with the Marijuana Withdrawal Checklist (MWC)
Time Frame
6 and 10 weeks and Follow- Up Visit 9
Title
Responder analysis: proportion of patients showing improvement in nightmares
Description
Responder analysis: proportion of patients showing improvement in nightmares (change from baseline) defined as decrease of CAPS-IV B2 ≥50% assessed at the end of treatment
Time Frame
10 weeks
Title
Remitter analysis: proportion of patients showing full remission of nightmares
Description
Remitter analysis: proportion of patients showing full remission of nightmares defined as CAPS-IV B2 = 0, assessed at the end of treatment
Time Frame
10 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Diagnosis of posttraumatic stress disorder (PTSD) according to DSM 5 with a 20 item CAPS-5 total score ≥ 26
At least two nightmares a week, an intensity score ≥ 2, with a CAPS-IV B2 (frequency and intensity for the last week) score ≥ 5
Men and women between 18 and 65 years of age
Written informed consent
The patient has the capacity to give consent (He/she is able to understand the nature and anticipated effects/side effects of the proposed medical intervention)
The patient is not breastfeeding
Women of child-bearing potential must have a negative urine or serum pregnancy test
All participants must use highly effective contraception
The patient received stable pharmacological medication for at least 4 weeks prior to study entry (any changes in medication dose or frequency of therapy must be answered with no)
Exclusion Criteria:
Lifetime cannabis use disorder
Current substance/alcohol use disorder (≤ 3 months);
Acute suicidality;
Psychotic disorder;
Bipolar disorder;
Current anorexia nervosa;
Current major depressive episodes and a MADRS score > 29;
Dementia;
Trauma-focused psychotherapy four weeks before the trial
Initiation of sleep medication 4 weeks prior screening or initiation of alpha adrenergic agents 4 weeks prior to screening
Acute or unstable medical illness.
Epilepsy
Relevant heart diseases
Known HIV- and/or active Hepatitis-B- or Hepatitis-C-infection
Current or past malignant illness
The patient is unwilling to consent to saving, processing and propagation of pseudonymized medical data for study reasons
Patients, who may be dependent on the sponsor, the investigator or the trial sites, have to be excluded from the trial
The patient is legally detained in an official institution
The patient does have a known allergy or contraindication against Dronabinol
The patient does have clinically significant abnormalities in 12-lead ECG
The patient does have clinically significant laboratory abnormalities
The patient did participate in other interventional trials during the 3 months before and at the time of this trial
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Stefan Roepke, MD
Phone
004930450517545
Email
stefan.roepke@charite.de
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stefan Roepke, MD
Organizational Affiliation
Charite University, Berlin, Germany
Official's Role
Principal Investigator
Facility Information:
Facility Name
Berlin St. Hedwig
City
Berlin
ZIP/Postal Code
10115
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nikola Schoofs
Email
nikola.schoofs@charite.de
First Name & Middle Initial & Last Name & Degree
Nikola Schoofs
Facility Name
Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Klinik für Psychiatrie und Psychotherapie
City
Berlin
ZIP/Postal Code
12203
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Stefan Roepke
Phone
004930450517545
Email
stefan.roepke@charite.de
First Name & Middle Initial & Last Name & Degree
Stefan Roepke
Facility Name
Zentralinstitut für Seelische Gesundheit Mannheim
City
Mannheim
ZIP/Postal Code
86159
Country
Germany
Individual Site Status
Terminated
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Treating Nightmares in Posttraumatic Stress Disorder With Dronabinol
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