Stress Disorders, Post-Traumatic Clinical Trial
Official title:
Randomized Trial of Paroxetine-CR for the Treatment of Patients With Post Traumatic Stress Disorder Remaining Symptomatic After Initial Exposure Therapy
The purpose of the study is to evaluate the effectiveness and tolerability of controlled-release paroxetine (Paxil-CR) compared to placebo (an inactive substance) for individuals who continue to have symptoms of post traumatic stress disorder (PTSD) despite receiving prolonged exposure therapy.
Post Traumatic Stress Disorder (PTSD) is common in the general population with the National
Comorbidity Survey reporting a lifetime prevalence of about 8% in the United States
(Kessler, et al 1995). PTSD is associated with marked symptomatic distress as well as
significant impairment, dysfunction and reduction in overall quality of life (Kessler,
2000). Both pharmacotherapeutic interventions, including serotonin selective reuptake
inhibitors (SSRIs), and psychosocial interventions such as cognitive-behavior therapy (CBT)
have demonstrated efficacy for PTSD (Davidson, 2001; Foa, 2000) However, although these
interventions can be helpful, many patients remain symptomatic despite initial treatment.
There is little data available to guide practice regarding the efficacy of "next step"
strategies for patients remaining symptomatic despite treatment.
In this study the researchers will examine the relative efficacy of the addition of the
SSRI, paroxetine-CR, compared to placebo for patients remaining symptomatic despite a brief
and intensive course of CBT.
This is a two phase, 14-16 week research study in which participants who remain symptomatic
at the end of one phase (4-6 weeks) enter into the next phase. In phase I, all participants
receive prolonged exposure (PE) therapy. Participants who continue to have significant
distress because of posttraumatic stress disorder after 8 sessions of therapy will enter
Phase II. In Phase II subjects will receive 5 more sessions of PE therapy and be randomly
assigned (by chance, like a flip of a coin) to receive paroxetine-cr (Paxil-CR) or placebo
(contains no active medication). Participants receive this combined treatment over the next
10 weeks.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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