Study Description and Background

Few evidence-based treatment options exist for patients with posttraumatic stress disorder (PTSD) inadequately responsive to standard medication treatments, such as treatment with serotonin specific reuptake inhibitors (SSRIs).

Although many agents have been studied in the management of PTSD, treatment augmentation with lithium remains almost wholly unexplored. Potential benefits of lithium include a broad clinical utility; reported clinical benefits for aggression, suicidality, and mood; and positive effects on brain areas that can be affected by PTSD.

Recent estimates suggest that 14% of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) service members will suffer from symptoms of PTSD.¹ Since 1997, the average annual growth in all users of VA specialty mental health services has averaged 37,000 Veterans per year, including 22,000 per year with PTSD.² There is a clear need to better characterize PTSD refractory to standard treatments and to expand the therapeutic arsenal available to patients and clinicians managing this disorder.

References

1. Tanielian T, Jaycox, LH, eds. Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery. Santa Monica, CA: RAND Corp.; 2008
2. Rosenheck RA, Fontana AF. Recent trends In VA treatment of posttraumatic stress disorder and other mental disorders. Health Aff (Millwood) 2007;26:1720-7.

Hypotheses, Study Aims, and Short-term Goals

Primary aim:

1. Establish the safety and tolerability of lithium augmentation of psychopharmacological treatment as usual for combat Veterans with PTSD.

Exploratory aim:

1. Preliminarily investigate the efficacy of lithium augmentation for hyperarousal symptoms of PTSD, overall PTSD symptom severity, and suicidality among combat Veterans with PTSD.

Progress Report

We are currently recruiting and enrolling participants.

Long-term Goals:
Putting Research into Practice

We hope that findings will establish the tolerability and safety of lithium augmentation for PTSD symptoms in combat Veterans, and collect evidence suggesting effectiveness for hyperarousal and suicidality in the context of PTSD.

Additionally, we hope that preliminary data will provide justification for future study designed to further explore lithium’s potential role in PTSD.

Because of the extensive clinical experience that already exists with lithium, positive findings supporting the use of lithium to treat PTSD could be incorporated easily and rapidly into clinical practice, helping many Veterans with PTSD who currently respond inadequately to existing treatment options.

Research Contact

Latoya Conner

CONTACT PHONE: 303.399.8020 x 5616

CONTACT EMAIL: Latoya.Conner@va.gov

Research Team

Principal Investigator:

Hal S. Wortzel, MD

Co–Investigators:

Kimberly Nordstrom, MD

Pamela Staves, RN, MS, NP

Thomas Beresford, MD

Lisa Brenner, PhD, ABPP

Peter Gutierrez, PhD

Jeri Forster, PhD

Gina Signoracci, PhD

Primary Study Coordinator:

Latoya Conner