Clinical Evaluation of BRL29060A (Paroxetine Hydrochloride Hydrate) in Posttraumatic Stress Disorder (PTSD)
Post-Traumatic Stress Disorder, Stress Disorders, Post-Traumatic
About this trial
This is an interventional treatment trial for Post-Traumatic Stress Disorder focused on measuring PTSD (Posttraumatic Stress Disorder), CAPS, fMRI, Paroxetine
Eligibility Criteria
Inclusion Criteria:
- Patients who are primarily diagnosed with PTSD (Posttraumatic Stress Disorder: 309.81) using DSM-IV-TR criteria. The CAPS-DX (Clinician-Administered PTSD Scale-DX) and M.I.N.I. (The Mini International Neuropsychiatric Interview, Japanese version 5.0.0. [2003]) will be used for diagnosis
- Pathologic condition: Patients who experienced a motor vehicle accident (MVA) with severe or potential severe physical injury more than 3 months ago but less than 12 months ago
- Patients aged 20 and <65 at the time of signing the Informed consent
- Male and female patients
- Inpatient/outpatient status: Both are permitted
- Patients who are able to give written informed consent in person (i.e., patients who are capable of giving written informed consent on their own)
- Patients whose combined score of the CAPS-SX standard B, C, and D is over 50
Exclusion Criteria:
- Patients primarily diagnosed with a DSM-IV-TR Axis I disorder other than PTSD (e.g. major depressive disorder, dysthymic disorder, specific phobia [simple phobia], obsessive-compulsive disorder, panic disorder, etc.) within 6 months of week -4 (start of baseline phase)
- Patients presenting with a current major depressive episode that preceded the diagnosis of PTSD
- Patients receiving disability payments due to PTSD or other psychiatric diseases
- Patients currently engaged in compensation litigation whereby personal gain would be achieved from prolonged symptoms of PTSD or any other psychiatric disorders
- Patients who meet the DSM-IV-TR criteria for substance abuse or dependence (alcohol or drugs) within 6 months of Week -4 (start of baseline phase)
- Patients with history of a suicide attempt within 6 months before Week -4 (start of baseline phase), or have, in the opinion of the investigator, "C. high risk of suicide" according to the MINI at Week -4
- Patients who are pregnant, lactating or of childbearing potential and are likely to become pregnant
- Patients receiving electro-convulsive therapy (ECT) prior to Week -4 (start of baseline phase)
- Patients receiving another investigational product within 12 weeks before Week -4 (start of baseline phase)
- Patients with a history or complication of manic psychosis
- Patients with a history or complication of convulsive disorder (epilepsy, etc.)
- Patients with a diagnosis or complication of a cognitive disorder (MMSE <=24 points)
- Patients with a history and complication of serious cerebral organic disorder. (e.g. cerebrovascular disorder, meningitis, degenerative disease and other neurological disorders and seizures; however, bleeding in the upper arachnoid membrane should not be excluded)
- Patients unable or unwilling to undergo the fMRI procedure (e.g., cerebrovascular clipping surgery, pacemaker, any internal metals with magnetism, and claustrophobia)
- Patients with glaucoma
- Patients with a known tendency for bleeding or those with predisposing conditions
- Patients with a history of hypersensitivity to paroxetine
- Patients with serious physical symptoms (cardiac, hepatic and renal dysfunction, or hematopoietic dysfunction, etc.). For seriousness, Grade 3 of "Criteria for seriousness of adverse reactions to drugs, etc. (Yakuan No.80)" is used as an index
- Patients with a history or complication of cancer or malignant tumour
- Patients with chronic hepatitis type B and/or C which is positive of hepatitis B surface antigen (HBsAg) and/or hepatitis C antibody
- Others whom the investigator or sub-investigator considers ineligible for or unable to participate in the investigation
- Criteria at Week 0 (start of Treatment Phase):
Subjects whose drug compliance rate for Drug 1 (Run-in Phase placebo) is <80% between Week -4 and Week 0;
Subjects whose CAPS-SX total score of the standard B, C, and D at Week 0 varied by 25% or more compared with those at Week -2
Sites / Locations
- GSK Investigational Site
- GSK Investigational Site
- GSK Investigational Site
- GSK Investigational Site
- GSK Investigational Site
- GSK Investigational Site
- GSK Investigational Site
- GSK Investigational Site
- GSK Investigational Site
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
paroxetine
placebo
Drug 2 (20 mg/day or placebo) will be administered once daily after supper for the first two weeks after the run-in phase. If the investigator/subinvestigator judges that a sufficient response is achieved, Drug 2 will be continued for the remaining period. If a sufficient response is not achieved with Drug 2 but treatment is well tolerated, the dose will be titrated to one step higher level until a sufficient response is achieved [i.e., Drug 3 (30 mg/day or placebo) → Drug 4 (40 mg/day or placebo) → Drug 5 (50 m/day or placebo)] at intervals of at least two weeks by once daily administration after supper. Once a sufficient response is achieved, that dose will be continued.
placebo