Stress Disorder, Post Traumatic Clinical Trial
Official title:
A Cognitive Enhancer May Facilitate Behavioral Exposure Therapy for Veterans With PTSD
This study will determine whether a combination of virtual reality exposure therapy and D-cycloserine will reduce post-traumatic stress disorder symptoms in Iraq war veterans.
Post-traumatic stress disorder (PTSD) is a type of anxiety disorder affecting people who
have witnessed or experienced a traumatic event. Veterans of war are at an increased risk
for developing PTSD because of their experiences with war and combat. Symptoms of PTSD often
include flashbacks or nightmares, depression, anxiety or uneasiness, and feeling emotionally
numb or distant toward others. Fortunately, PTSD can be treated, usually with some
combination of anti-depressants, anti-anxiety medication, and therapy. Virtual reality
exposure (VRE) therapy is a new type of treatment that helps people to overcome anxiety
about trauma by facing situations with the use of virtual reality. D-cycloserine is a
medication that has been found to enhance the effects of psychotherapy in recent studies.
This study will determine the effectiveness of VRE therapy plus D-cycloserine at reducing
PTSD symptoms in Iraq war veterans.
During this study, all participants will undergo one educational session and five VRE
sessions. The first session will involve gathering information, learning common reactions to
trauma, and participating in a breathing relaxation approach. The following five sessions
will involve reviewing memories of Iraq and watching virtual Iraq sequences. Each
participant will wear a head-mounted display during which they will view scenario settings
such as cities, humvee convoys, and scenes related to combat. Participants will be randomly
assigned to receive D-cycloserine, alprazolam (anti-anxiety drug), or placebo one half-hour
before each VRE session.
Prior to the first treatment session, participants will undergo a startle reaction
procedure. This will entail hearing sudden tones that last a fraction of a second, and
viewing virtual reality scenes. Three small electrodes, attached to each participant's face,
will measure the number of eye blinks during the procedure. At several times throughout the
study, heart rate and skin conductance will also be measured with electrodes. Collection of
saliva samples and measurement of blood pressure will also occur several times during this
study. Before, during, and immediately after treatment, participants will complete
questionnaires. Participants will be contacted 3, 6, and 12 months after treatment to assess
symptoms and to schedule a time for an interview, additional questionnaires, and the virtual
reality-based assessment.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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