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Quetiapine augmentation of prolonged exposure therapy in veterans with PTSD and a history of mild traumatic brain injury: design and methodology of a pilot study

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Military Medical Research 2021年第1期8卷 121-131页

作者： Muhammad R.Baig Robert D.Beck jennifer L.Wilson jennifer a.lemmer Adeel Meraj Eric C.Meyer Jim Mintz Alan L.Peterson John D.Roache Mental Health South Texas Veterans Healthcare System116 A7400 Merton Minter BIvdSan AntonioTX 78229USA Polytrauma Rehabilitation Center South Texas Veterans Healthcare SystemSan AntonioTXUSA Department of Psychiatry and Behavioral Sciences University of Texas Health Science Center at San AntonioSan AntonioTXUSA Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans WacoTXUSA Central Texas Veterans Healthcare System WacoTXUSA Department of Psychology and Neuroscience Baylor UniversityWacoTXUSA Department of Epidemiology and Biostatistics University of Texas Health Science Center at San AntonioSan AntonioTXUSA Department of Psychology University of Texas at San AntonioSan AntonioUSA Department of Pharmacology University of Texas Health Science Center at San AntonioSan AntonioTXUSA

Background: Selective serotonergic reuptake inhibitors(SSRIs) are first-line pharmacologic treatments for patients with posttraumatic stress disorder(PTSD), but must be given over extended period of time before the onset of action. The use of SSRIs in PTSD patients with mild traumatic brain injury(m TBI) is problematic since SSRIs could exacerbate post-concussion syndrome(PCS) symptoms. VA/DOD guidelines identify trauma-focused psychotherapy as the best evidence-based treatment for PTSD, but overall effectiveness is limited by reduced levels of patient engagement and retention. A previous study from this research group suggested that quetiapine monotherapy, but not risperidone or valproate, could increase engagement in trauma-focused ***: We report the study protocol of a pilot study funded under the South-Central Mental Illness Research, Education, and Clinical Center pilot study program from the U.S. Department of Veterans Affairs. This randomized, open-label study was designed to evaluate the feasibility of completing a randomized trial of quetiapine vs. treatment as usual to promote patient engagement in PTSD patients with a history of m ***: We expect that the success of this ongoing study should provide us with the preliminary data necessary to design a full-scale randomized trial. Positive efficacy results in a full-scale trial should inform new VA guidelines for clinical practice by showing that quetiapine-related improvements in patient engagement and retention may be the most effective approach to assure that VA resources achieve the best possible outcome for *** registration: NCT04280965.

关键词： Quetiapine Trauma-focused psychotherapy Posttraumatic stress disorder Mild traumatic brain injury Veterans

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