Comparison of Two Treatments for Post-Traumatic Stress Disorder

NCT ID: NCT00127673

Last Updated: 2022-05-24

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-09-30

Study Completion Date

2011-08-31

Brief Summary

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This study will compare the short- and long-term effectiveness of two different treatments for people with post-traumatic stress disorder.

Detailed Description

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Exposure to traumatic events, such as automobile accidents and assault, can cause individuals to develop persistent psychological difficulties such as post-traumatic stress disorder (PTSD). PTSD is an anxiety disorder characterized by avoidance, hyperarousal symptoms, and mental re-experiencing of the traumatic event. PTSD is a serious condition that may cause social and psychological impairment; therefore, safe and effective treatments are needed. Both CBT and antidepressant therapy have been shown to effectively treat PTSD symptoms; however, comparisons of the treatments are limited. This study will compare the short- and long-term effectiveness of CBT and the antidepressant sertraline.

Participants will either be randomly assigned to CBT or sertraline, or they will be able to choose one of the two treatments, which will be given for 10 weeks, followed by 24 months of follow-up assessments. Participants in the CBT group will have 10 weekly sessions of therapy. During the therapy sessions, participants will be encouraged to confront their general fears and the memory of their trauma through repeated storytelling. Participants will also be encouraged to practice the techniques learned in therapy in everyday life. Participants in the antidepressant group will take sertraline daily for 10 weeks. These participants will be seen weekly by a psychiatrist who will offer general encouragement and support, monitor response to medication, and record any side effects participants may be experiencing. The medication may be adjusted according to a dosing schedule and based on the study doctor's judgment. At the end of 10 weeks, participants in the antidepressant group will have the choice of either tapering the medication gradually to minimize the chance of withdrawal symptoms or staying on the medication for up to 24 months. Participants who do not respond to their assigned or chosen treatment will be offered the other treatment for 10 weeks. Self-report scales and questionnaires will be used to assess participants' PTSD symptoms, depression, anxiety, and social functioning. These assessments will occur at 3, 6, 12, and 24 months after the study treatment period.

Conditions

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Post-Traumatic Stress Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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CBT no choice

Participants will receive no choice cognitive behavioral therapy (CBT no choice)

Group Type ACTIVE_COMPARATOR

Cognitive behavioral therapy (CBT)

Intervention Type BEHAVIORAL

CBT will include 10 weekly sessions of individual cognitive behavioral therapy.

CBT choice

Participants will receive choice cognitive behavioral therapy (CBT choice)

Group Type ACTIVE_COMPARATOR

Cognitive behavioral therapy (CBT)

Intervention Type BEHAVIORAL

CBT will include 10 weekly sessions of individual cognitive behavioral therapy.

sertraline no choice

Participants will receive no choice sertraline (sertraline no choice)

Group Type ACTIVE_COMPARATOR

Sertraline

Intervention Type DRUG

The dose of sertraline will be up to 200 mg daily for 10 weeks. There will also be weekly meetings with study psychiatrist.

sertraline choice

Participants will receive choice sertraline (sertraline choice)

Group Type ACTIVE_COMPARATOR

Sertraline

Intervention Type DRUG

The dose of sertraline will be up to 200 mg daily for 10 weeks. There will also be weekly meetings with study psychiatrist.

Interventions

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Sertraline

The dose of sertraline will be up to 200 mg daily for 10 weeks. There will also be weekly meetings with study psychiatrist.

Intervention Type DRUG

Cognitive behavioral therapy (CBT)

CBT will include 10 weekly sessions of individual cognitive behavioral therapy.

Intervention Type BEHAVIORAL

Other Intervention Names

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Zoloft Prolonged exposure (PE)

Eligibility Criteria

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Inclusion Criteria

* DSM-IV diagnosis of PTSD
* Experienced traumatic event at least 12 weeks prior to study entry
* Willingness to discontinue current CBT or antidepressant treatment

Exclusion Criteria

* Current diagnosis of schizophrenia or delusional disorder
* Medically unstable bipolar disorder, depression with psychotic features, or depression requiring psychiatric treatment
* Current diagnosis of alcohol or substance dependence within 3 months prior to study entry
* Ongoing intimate relationship with the perpetrator of the traumatic event
* History of nonresponse to either CBT or sertraline
* Medical contraindication for sertraline
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Mental Health (NIMH)

NIH

Sponsor Role collaborator

Case Western Reserve University

OTHER

Sponsor Role lead

Responsible Party

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Norah Feeny

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Norah C. Feeny, PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Psychology, Case Western Reserve University

Lori A. Zoellner, PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Psychology, University of Washington

Locations

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Department of Psychology, University of Washington

Seattle, Washington, United States

Site Status

Countries

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United States

References

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Gauthier GM, PeConga EK, Mohr JL, Feeny NC, Zoellner LA. Prospective stability of memory for peritraumatic dissociation and anxiety: Replication and extension examining PTSD treatment modality and response. Psychol Trauma. 2025 Feb;17(2):429-437. doi: 10.1037/tra0001790. Epub 2024 Nov 7.

Reference Type DERIVED
PMID: 39509231 (View on PubMed)

Rosencrans PL, Zoellner LA, Feeny NC. A network approach to posttraumatic stress disorder: Comparing interview and self-report networks. Psychol Trauma. 2024 Feb;16(2):340-346. doi: 10.1037/tra0001151. Epub 2021 Oct 21.

Reference Type DERIVED
PMID: 34672659 (View on PubMed)

Graham B, Garcia NM, Bergman HE, Feeny NC, Zoellner LA. Prolonged Exposure and Sertraline Treatments for Posttraumatic Stress Disorder Also Improve Multiple Indicators of Social Functioning. J Trauma Stress. 2020 Aug;33(4):488-499. doi: 10.1002/jts.22570. Epub 2020 Jul 13.

Reference Type DERIVED
PMID: 32662191 (View on PubMed)

Zoellner LA, Roy-Byrne PP, Mavissakalian M, Feeny NC. Doubly Randomized Preference Trial of Prolonged Exposure Versus Sertraline for Treatment of PTSD. Am J Psychiatry. 2019 Apr 1;176(4):287-296. doi: 10.1176/appi.ajp.2018.17090995. Epub 2018 Oct 19.

Reference Type DERIVED
PMID: 30336702 (View on PubMed)

Le QA, Doctor JN, Zoellner LA, Feeny NC. Effects of treatment, choice, and preference on health-related quality-of-life outcomes in patients with posttraumatic stress disorder (PTSD). Qual Life Res. 2018 Jun;27(6):1555-1562. doi: 10.1007/s11136-018-1833-4. Epub 2018 Mar 14.

Reference Type DERIVED
PMID: 29541927 (View on PubMed)

Le QA, Doctor JN, Zoellner LA, Feeny NC. Cost-effectiveness of prolonged exposure therapy versus pharmacotherapy and treatment choice in posttraumatic stress disorder (the Optimizing PTSD Treatment Trial): a doubly randomized preference trial. J Clin Psychiatry. 2014 Mar;75(3):222-30. doi: 10.4088/JCP.13m08719.

Reference Type DERIVED
PMID: 24717377 (View on PubMed)

Le QA, Doctor JN, Zoellner LA, Feeny NC. Minimal clinically important differences for the EQ-5D and QWB-SA in Post-traumatic Stress Disorder (PTSD): results from a Doubly Randomized Preference Trial (DRPT). Health Qual Life Outcomes. 2013 Apr 12;11:59. doi: 10.1186/1477-7525-11-59.

Reference Type DERIVED
PMID: 23587015 (View on PubMed)

Related Links

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http://faculty.washington.edu/zoellner/PTSDTx.htm

Click here for more information about the effectiveness of CBT and sertraline for PTSD

Other Identifiers

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R01MH066348

Identifier Type: NIH

Identifier Source: secondary_id

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R01MH066347

Identifier Type: NIH

Identifier Source: org_study_id

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