Treating Nightmares in Posttraumatic Stress Disorder With the α-adrenergic Agents Clonidine and Doxazosin: A Randomized-Controlled Feasibility Study (ClonDoTrial)
试验速览
- 阶段
- 2 期
- 状态
- 暂停
- 入组人数
- 53
- 试验地点
- 5
- 主要终点
- Change of frequency and intensity of nightmares
研究概览
简要总结
This randomized controlled trial will test the hypothesis that oral Clonidine or Doxazosin improves nightmares (primary outcome), other PTSD symptoms and psychopathology (secondary outcomes) to a greater extent than placebo over a ten week intervention phase in a parallel group design.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 65 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Diagnosis of posttraumatic stress disorder (PTSD) according to DSM 5 with a 20 item CAPS-5 total score ≥ 26
- •At least two nightmares a week, an intensity score ≥ 2, with a CAPS-IV B2 (frequency and intensity for the last week) score ≥ 5
- •Men and women between 18 and 65 years of age
- •Written informed consent
- •The patient has the capacity to give consent (He/she is able to understand the nature and anticipated effects/side effects of the proposed medical intervention)
- •The patient is not breastfeeding
- •Women of child-bearing potential must have a negative urine or serum pregnancy test
- •All participants must use highly effective contraception
- •The patient received stable pharmacological medication for at least 4 weeks or at least five times the value of a elimination half-life prior to study baseline (any changes in medication dose or frequency of therapy must be answered with no).
排除标准
- •Disturbances of cardiac impulse formation and conduction, for example sick sinus syndrome or atrioventricular block second and third degree
- •Bradycardia, with a heart rate less than 50 beats per minute
- •Current major depressive episode and a MADRS score > 34
- •The patient does have a known allergy, hypersensitivity or contraindication against clonidine, doxazosin, or other types of quinazolines
- •History of severe orthostatic hypotension
- •Benign prostatic hyperplasia and concomitant congestion of the upper urinary tract, chronic urinary tract infection or bladder stones, hypotension (for benign prostate hyperplasia only)
- •Either overflow bladder or anuria with or without progressive renal insufficiency
- •Planned cataract surgery (risk of 'Intraoperative Floppy Iris Syndrome')
- •Intake of phosphodiesterase-5-inhibitors
- •Intake of methylphenidate
- •Severe hepatic impairment (ASAT or ALAT greater than two times normal)
- •Acute or unstable medical illness
- •Known HIV- and/or active Hepatitis-B- or Hepatitis-C-infection
- •Current or past malignant illness
- •The patient does have clinically significant abnormalities in 12-lead ECG
- •The patient does have clinically significant laboratory abnormalities
- •Current substance/alcohol use disorder (≤ 3 months)
- •Psychotic disorder
- •Bipolar disorder
- •Current anorexia nervosa
- •Acute suicidality (any suicidal ideation of type of 5 in the C-SSRS in the past month)
- •Intake of alpha adrenergic agents (Clonidine, doxazosin, or others) within 4 weeks prior to baseline (randomization)
- •Trauma-focused psychotherapy four weeks before the trial
- •Initiation of sleep medication 4 weeks prior to baseline
- •The patient is unwilling to consent to saving, processing and propagation of pseudonymized medical data for study reasons
- •Patients, who may be dependent on the sponsor, the investigator or the trial sites
- •The patient is legally detained in an official institution
- •The patient did participated in other interventional trials during the 3 months before and at the time of this trial
研究组 & 干预措施
Arm Clonidine
干预措施: Clonidine (Drug)
Arm Doxazosin
干预措施: Doxazosin (Drug)
Placebo
干预措施: Placebo (Drug)
结局指标
主要结局
Change of frequency and intensity of nightmares
时间窗: 10 weeks
Change of Frequency and intensity of nightmares, measured with the Clinician-Administered PTSD Scale-IV (CAPS-IV) B2 score for the last week, range 0-8, from baseline until directly after last intervention. A lower score indicates less frequent and/or intense nightmares.
次要结局
- Change of frequency and intensity of nightmares(1,2,3,4,5,6 and 8 weeks)
- Change from baseline of the CLINICIAN-ADMINISTERED PTSD SCALE FOR DSM-5 (CAPS-5) total score(6 and 10 weeks)
- Change from baseline of the Pittsburgh Sleep Quality Index-Addendum for PTSD(6 and 10 weeks)
- Change from baseline of the -Montgomery Asberg Depression Rating Scale (MDRS)(6 and 10 weeks)
- Weekly mean of change from baseline of daily total sleep time(during 10 weeks)
- Weekly mean of change from baseline of the patients sleep onset latency at night (in minutes), assessed with sleep diaries(during 10 weeks)
- Weekly mean of change from baseline of the patients recuperation of night sleep(during 10 weeks)
- Weekly mean of change from baseline of the patients time awake at night(during 10 weeks)
- Weekly mean of change from baseline of the patients number of nightmares last night(during 10 weeks)
- Weekly mean of change from baseline of the patients intensity of nightmares(during 10 weeks)
- Change from baseline of PTSD symptoms assessed with the PTSD Checklist for DSM-5(6 and 10 weeks)
- Change from baseline of the Borderline Symptom List 23 (BSL-23)(6 and 10 weeks)
- Change from baseline of the Health-Related Quality of Life (EQ-5D)(6 and 10 weeks)
- Overall patients status measured by the Patient Global Impression of Change (PGIC)(6 and 10 weeks)
- Change from baseline of the Social and Occupational Functioning Assessment Scale(6 and 10 weeks)
- Change from baseline of the Pittsburgh Sleep Quality Index (PSQI)(6 and 10 weeks)
- Change from baseline of symptoms of PTSD and complex PTSD according to ICD-11 assessed with the International Trauma Questionnaire (ITQ)(6 and 10 weeks)
- Responder analysis: proportion of patients showing improvement in nightmares(10 weeks)
- Remitter analysis: proportion of patients showing full remission of nightmares(10 weeks)
研究者
Stefan Roepke
Prof. Dr. Stefan Roepke, MD
Charite University, Berlin, Germany
