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Treatment of Smoking Among Individuals With PTSD

11 oktober 2017 uppdaterad av: University of Pennsylvania

Treatment of Smoking Among Individuals With PTSD: A Phase II, Randomized Study of Varenicline and Cognitive Behavioral Therapy

This study will examine the effect of combining prolonged exposure, a cognitive-behavioral treatment program for post-traumatic stress disorder (PTSD) with medication (varenicline) and counseling treatments for smoking cessation. Subjects will be randomly assigned to a 3-month treatment of either: 1) varenicline and smoking cessation counseling alone, or 2) prolonged exposure, varenicline, and smoking cessation counseling. Assessments will be completed at the end of treatment and 6-month follow-up.

We hypothesize that, at the end of treatment and at follow-up, abstinence rates and decrease in cigarettes smoked will be greater among participants who receive the combined treatment for both PTSD and smoking.

Studieöversikt

Studietyp

Interventionell

Inskrivning (Faktisk)

142

Fas

  • Fas 2

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

    • Pennsylvania
      • Philadelphia, Pennsylvania, Förenta staterna, 19104
        • University of Pennsylvania School of Medicine, Dept of Psychiatry, Center for Treatment and Study of Anxiety

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år till 75 år (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • Male or female treatment-seeking cigarette smokers between 18-75 years old who smoke an average of ≥10 cigarettes/day during past year;
  • Current diagnosis of chronic PTSD (symptom duration > 3 months) with clinically significant trauma-related symptoms (PSS-I >= 20)
  • Live a commutable distance to the University of Pennsylvania and agree to follow-up visits;
  • Agree not to use other forms of smoking cessation treatment or treatment for PTSD during the study period;
  • If taking SRIs or other medications at intake, have been on stable medication and dose regimen for past 3 months and agree to maintain current regimen if possible;
  • Demonstrate the capacity to provide informed consent;
  • Speak and read English.

Exclusion Criteria:

  • History of drug or alcohol abuse or dependence in past 3 months or any unwillingness to not smoke marijuana during the first 13 weeks of the study;
  • Current and continuing intimate relationship with a physically or sexually abusive partner;
  • Current suicidal ideation with intent and/or plan that, in the judgment of the investigator, should be the focus of treatment;
  • Prior serious suicide attempt, as judged by the evaluator to have a high degree of lethality;
  • Current or past history of psychosis (bipolar disorder or schizophrenia);
  • History of significant cardiovascular disease or uncontrolled hypertension in past 6 months;
  • Women who are pregnant, likely to become pregnant (i.e., sexually active and not using contraception), or nursing.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Enda

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Integrated Treatment
Prolonged Exposure + Varenicline + Medication Management Counseling
75-90 minute weekly psychotherapy sessions x 12 weeks, focused on gradually confronting distressing trauma-related memories and reminders
Andra namn:
  • Kognitiv beteendeterapi
1 mg tablets, orally, twice daily x 12 weeks
Andra namn:
  • Chantix
15-minutes weekly counseling x 12 weeks, focused on medication adherence and smoking cessation
Aktiv komparator: Varenicline
Varenicline + Medication Management Counseling
1 mg tablets, orally, twice daily x 12 weeks
Andra namn:
  • Chantix
15-minutes weekly counseling x 12 weeks, focused on medication adherence and smoking cessation

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Number of Participants With 7-day Point Prevalence Smoking Abstinence
Tidsram: At 3-month follow-up (6-month post-quit day)
Number of participants reporting seven-day point prevalence abstinence (PPA), which was defined as self-reported abstinence for 7 days prior to the assessment, serum cotinine level of <15ng/ml, and CO < 10 ppm.
At 3-month follow-up (6-month post-quit day)

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Blood Serum Cotinine
Tidsram: At end of 3-month follow-up
Level of cotinine in blood
At end of 3-month follow-up
Posttraumatic Symptom Scale Interview (PSS-I) at Post-Treatment
Tidsram: Post-treatment, occurring 12 weeks after the start of treatment (week 0)

Posttraumatic Symptom Scale Interview at post-treatment assessment, which measures severity of post-traumatic stress disorder (PTSD) symptoms Total scores are displayed and represent summed scores on 17 individual items the scale, and scale range for total scores is 0 to 51.

Higher scores indicate higher/worse levels of PTSD.

Post-treatment, occurring 12 weeks after the start of treatment (week 0)
Posttraumatic Symptom Scale Interview (PSS-I) Total Score at 3-Month Follow-Up
Tidsram: 3-month follow-up

Posttraumatic Symptom Scale Interview at 3-month follow-up assessment, which measures severity of post-traumatic stress disorder (PTSD) symptoms Total scores are displayed and represent summed scores on 17 individual items the scale, and scale range for total scores is 0 to 51.

Higher scores indicate higher/worse levels of PTSD.

3-month follow-up
Hamilton Depression Scale (HAM-D) Total Score at Post-Treatment
Tidsram: Post-Treatment assessment, occurring 12 weeks after the start of treatment (week 0)

Hamilton Depression scale (HAM-D) at post-treatment assessment, which measures severity of depression symptoms Total scores are displayed and represent summed scores on 17 individual items the scale, and scale range for total scores is 0 to 50.

Higher scores indicate higher/worse levels of depression.

Post-Treatment assessment, occurring 12 weeks after the start of treatment (week 0)
Hamilton Depression Scale (HAM-D) Total Score at 3-Month Follow-Up
Tidsram: 3-month follow-up

Hamilton Depression scale (HAM-D) at 3-month followup assessment, which measures severity of depression symptoms Total scores are displayed and represent summed scores on 17 individual items the scale, and scale range for total scores is 0 to 50.

Higher scores indicate higher/worse levels of depression.

3-month follow-up
TLFB - Total Cigarettes Smoked Week Before Appointment (at Post-Treatment)
Tidsram: Week before Post-Treatment visit occurring at week 12, i.e. number of cigarettes smoked for the week prior to this week 12 visit
Timeline Followback - Total number of cigarettes smoked the week before Post-Treatment visit
Week before Post-Treatment visit occurring at week 12, i.e. number of cigarettes smoked for the week prior to this week 12 visit
TLFB - Cigarettes Smoked Week Before 3-Month Follow-up
Tidsram: 3-month follow-up
Timeline followback - Number of cigarettes smoked the week before 3-month follow-up visit
3-month follow-up

Samarbetspartners och utredare

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Publikationer och användbara länkar

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Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 januari 2009

Primärt slutförande (Faktisk)

1 december 2015

Avslutad studie (Faktisk)

1 december 2015

Studieregistreringsdatum

Först inskickad

8 juli 2009

Först inskickad som uppfyllde QC-kriterierna

8 juli 2009

Första postat (Uppskatta)

10 juli 2009

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

14 november 2017

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

11 oktober 2017

Senast verifierad

1 oktober 2017

Mer information

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