Perioperative Propranolol in Patients With Post Traumatic Stress Disorder (PTSD)

NCT ID: NCT01555554

Last Updated: 2021-07-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

59 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-05-31

Study Completion Date

2019-06-30

Brief Summary

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Understanding what treatments may facilitate perioperative care of Veterans with posttraumatic stress disorder (PTSD) is of great importance to the U.S. health care system.

Patients with PTSD are characterized by elevated central nervous system catecholamine concentrations and exaggerated and prolonged adrenergic responses to stress stimuli. At present, there are no data on the effects of perioperative beta blocker therapy in patients with PTSD, despite the rising significance of PTSD in Veteran populations.

This prospective, double-blind study proposes to randomize 150 Veterans with PTSD scheduled for orthopedic, thoracic or vascular surgery at the San Francisco VA Medical Center to either a 14-day course of propranolol or placebo. This study will then follow these Veterans for a one-year period to evaluate the effects of the intervention on Veterans' surgical outcomes.

The investigators hypothesize that patients with PTSD randomized to the propranolol group will demonstrate a reduced incidence of perioperative and postoperative morbidity and mortality.

Detailed Description

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Conditions

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Post-traumatic Stress Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Propranolol Hydrochloride

Group Type EXPERIMENTAL

Propranolol Hydrochloride

Intervention Type DRUG

Propranolol will be taken for a total of 14 days. On the morning of the surgery, prior to entry into the operating room, patients will receive the first dose of the study drug (the PDR recommended starting dose of Propranolol XL- Extended Release). Patients will take one 60 mg pill on the morning of surgery.

On post operative day #1, patients will take one pill of receive propranolol XL 80 mg (once daily by mouth).

On post operative days #2-#9, patients will take one pill of propranolol XL 120 mg (once daily by mouth).

On post operative days #10-11, patients will take one pill of propranolol XL 80 mg (once daily by mouth).

On post operative days #12-13, patients will take one pill of propranolol XL 60 mg (once daily by mouth).

This will complete the course of propranolol.

Placebo Group

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

The placebo pill will be taken for a total of 14 days. On the morning of the surgery, prior to entry into the operating room, patients will receive the first placebo pill to be taken once daily by mouth.

On post operative days #1-13, patients will take one placebo pill (once daily by mouth).

This will complete the course of the placebo.

Interventions

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Propranolol Hydrochloride

Propranolol will be taken for a total of 14 days. On the morning of the surgery, prior to entry into the operating room, patients will receive the first dose of the study drug (the PDR recommended starting dose of Propranolol XL- Extended Release). Patients will take one 60 mg pill on the morning of surgery.

On post operative day #1, patients will take one pill of receive propranolol XL 80 mg (once daily by mouth).

On post operative days #2-#9, patients will take one pill of propranolol XL 120 mg (once daily by mouth).

On post operative days #10-11, patients will take one pill of propranolol XL 80 mg (once daily by mouth).

On post operative days #12-13, patients will take one pill of propranolol XL 60 mg (once daily by mouth).

This will complete the course of propranolol.

Intervention Type DRUG

Placebo

The placebo pill will be taken for a total of 14 days. On the morning of the surgery, prior to entry into the operating room, patients will receive the first placebo pill to be taken once daily by mouth.

On post operative days #1-13, patients will take one placebo pill (once daily by mouth).

This will complete the course of the placebo.

Intervention Type OTHER

Other Intervention Names

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Inderal Inderal LA Avlocardyl Avlocardyl Retard Deralin Dociton Inderalici InnoPran XL Sumial Anaprilinum Bedranol SR Sandoz

Eligibility Criteria

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Inclusion Criteria

1. Subjects scheduled for any surgical procedure under general anesthesia or combined general-regional anesthesia, with the exception of open-heart or intracranial surgery. Regional anesthesia includes: 1) Epidural anesthesia, 2) Sub-arachnoid block (spinal), or 3)any regional nerve block
2. Anticipated postoperative hospital admission (defined as at least one overnight hospital stay)

Exclusion Criteria

Veterans will be excluded if:

1. They are on beta blocker therapy at the time of the preoperative baseline assessment
2. They report sensitivity or allergies to propranolol, or a history of PTSD exacerbation with prior propranolol therapy
3. Veterans who fulfill the AHA/ACC level I recommendation criteria for perioperative beta blocker therapy (e.g., metoprolol, atenolol) and should not be randomized to placebo group
4. Medical exclusions criteria: high grade heart block without pacemaker (all patients with 2nd and 3rd degree heart block), marked resting bradycardia (heart rate ≤ 55 beats per minute), blood pressure \< 100 mmHg, uncompensated congested heart failure, severe hyperactive airway disease, and Raynaud's disease
5. Pregnancy
6. Current use of medication that may involve potentially dangerous interaction with propranolol
7. Circumstances that, in the opinion of the principal investigator, would preclude participation in a study of this type (e.g. medical concerns or difficulty in long-term followup).
8. Open-heart surgery and intracranial surgery
Minimum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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United States Department of Defense

FED

Sponsor Role collaborator

Northern California Institute of Research and Education

OTHER

Sponsor Role collaborator

University of California, San Francisco

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Marek Brzezinski, M.D., Ph.D.

Role: PRINCIPAL_INVESTIGATOR

University of California, San Francisco

Locations

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San Francisco VA Medical Center

San Francisco, California, United States

Site Status

Countries

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United States

Other Identifiers

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W81XWH-10-2-0078

Identifier Type: -

Identifier Source: org_study_id

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