Cortisol Augmentation of Prolonged Exposure Therapy - Full Text View

Purpose

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.

Condition	Intervention
PTSD	Behavioral: Prolonged Exposure therapy Drug: Hydrocortisone Drug: placebo

MedlinePlus related topics:

Memory

ChemIDplus related topics:

Hydrocortisone Cortisol 21-phosphate Cortisol succinate Hydrocortamate Hydrocortisone 21-sodium succinate Hydrocortisone acetate Hydrocortisone cypionate Hydrocortisone hemisuccinate Proctofoam-HC

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Parallel Assignment, Efficacy Study

Official Title:	Cortisol Augmentation of Prolonged Exposure Therapy

Further study details as provided by Bronx VA Medical Center:

Primary Outcome Measures:

Change in PTSD symptom severity as assessed by the Clinician Administered PTSD Scale (CAPS) [ Time Frame: pre-treatment evaluation, post-treatment evaluation ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Cognitive performance (learning and retention in an episodic memory task, attention and working memory) [ Time Frame: pre-treatment evaluation and post-treatment evaluation ] [ Designated as safety issue: No ]
Other measures of clinical outcome, psychological state and functioning [ Time Frame: pre-treatment evaluation and post-treatment evaluation ] [ Designated as safety issue: No ]
Biological measures associated with PTSD severity [ Time Frame: pre-treatment evaluation and post-treatment evaluation ] [ Designated as safety issue: No ]

Estimated Enrollment:

16

Arms	Assigned Interventions
1: Active Comparator Prolonged Exposure therapy with Hydrocortisone	Behavioral: Prolonged Exposure therapy 10 weekly sessions Drug: Hydrocortisone 10mg 45 minutes prior to each PE session (10 total)
2: Placebo Comparator Prolonged Exposure therapy with placebo	Behavioral: Prolonged Exposure therapy 10 weekly sessions Drug: placebo placebo

Eligibility

Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Veterans who experienced a criterion A trauma while deployed, and a current diagnosis of PTSD with a minimum of 6 months
Capable of understanding, reading and writing English

Exclusion Criteria:

Incapable and/or unwilling to provide written informed consent prior to participation
Unwilling and/or unable to discontinue current psychotherapy
Regular use of psychotropic medication including antidepressants (other than SRIs), benzodiazepines, lithium, mood stabilizers, over-the-counter supplements (melatonin, kava-kava, ephedra)
Regular use of oral or inhaled steroids
Significant illness (e.g., type I or II diabetes requiring the use of insulin, HIV, AIDS, seizure disorder, anemia, Lyme disease, etc.)
The veteran, the veteran's physician, or the study physician think that the veteran's clinical state necessitates the prompt initiation of pharmacotherapy or other treatment that would preclude involvement in the study
Morbid obesity (VMI>40)
Clinically significant laboratory abnormalities as determine during medical clearance procedures
For women, a positive pregnancy test
Heavy smoking (more than 2 packs a day)
Substance and/or alcohol abuse and/or dependence within the previous 6 months
Response of 3 or 4 on the suicidality items of the HDRS or an assessed serious suicide risk
Current psychosocial problems that might interfere with treatment compliance
A lifetime history of schizophrenia, schizoaffective disorder, bipolar disorder, obsessive compulsive disorder or PTSD due to a trauma not sustained in the combat theater

Contacts and Locations

No Contacts or Locations Provided

More Information

Responsible Party:	James J. Peters VA Medical Center ( Rachel Yehuda )
Study ID Numbers:	YEH-08-044
First Received:	September 11, 2008
Last Updated:	September 11, 2008
ClinicalTrials.gov Identifier:	NCT00751855
Health Authority:	United States: Federal Government

Study placed in the following topic categories:

Hydrocortisone

Cortisol succinate

Hydrocortisone acetate

Additional relevant MeSH terms:

Anti-Inflammatory Agents

Therapeutic Uses

Pharmacologic Actions

ClinicalTrials.gov processed this record on October 06, 2008

Sponsored by:	VISN3 Mental Illness Research, Education and Clinical Center
Information provided by:	Bronx VA Medical Center
ClinicalTrials.gov Identifier:	NCT00751855