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
Abstract 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 brai...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-10-01
|
| Series: | Military Medical Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40779-020-00278-0 |
| _version_ | 1818333687013441536 |
|---|---|
| author | 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 |
| author_facet | 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 |
| author_sort | Muhammad R. Baig |
| collection | DOAJ |
| description | Abstract 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 (mTBI) 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 psychotherapy. Methods 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 mTBI. Discussion 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 veterans. Trial registration NCT04280965 . |
| first_indexed | 2024-12-13T13:55:35Z |
| format | Article |
| id | doaj.art-22e2e4652259446a9397acd880379b00 |
| institution | Directory Open Access Journal |
| issn | 2054-9369 |
| language | English |
| last_indexed | 2024-12-13T13:55:35Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Military Medical Research |
| spelling | doaj.art-22e2e4652259446a9397acd880379b002022-12-21T23:42:54ZengBMCMilitary Medical Research2054-93692020-10-017111010.1186/s40779-020-00278-0Quetiapine augmentation of prolonged exposure therapy in veterans with PTSD and a history of mild traumatic brain injury: design and methodology of a pilot studyMuhammad R. Baig0Robert D. Beck1Jennifer L. Wilson2Jennifer A. Lemmer3Adeel Meraj4Eric C. Meyer5Jim Mintz6Alan L. Peterson7John D. Roache8Mental Health, South Texas Veterans Healthcare SystemMental Health, South Texas Veterans Healthcare SystemMental Health, South Texas Veterans Healthcare SystemMental Health, South Texas Veterans Healthcare SystemMental Health, South Texas Veterans Healthcare SystemDepartment of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War VeteransDepartment of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San AntonioMental Health, South Texas Veterans Healthcare SystemDepartment of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San AntonioAbstract 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 (mTBI) 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 psychotherapy. Methods 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 mTBI. Discussion 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 veterans. Trial registration NCT04280965 .http://link.springer.com/article/10.1186/s40779-020-00278-0QuetiapineTrauma-focused psychotherapyPosttraumatic stress disorderMild traumatic brain injuryVeterans |
| spellingShingle | 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 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 Military Medical Research Quetiapine Trauma-focused psychotherapy Posttraumatic stress disorder Mild traumatic brain injury Veterans |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Quetiapine Trauma-focused psychotherapy Posttraumatic stress disorder Mild traumatic brain injury Veterans |
| url | http://link.springer.com/article/10.1186/s40779-020-00278-0 |
| work_keys_str_mv | AT muhammadrbaig quetiapineaugmentationofprolongedexposuretherapyinveteranswithptsdandahistoryofmildtraumaticbraininjurydesignandmethodologyofapilotstudy AT robertdbeck quetiapineaugmentationofprolongedexposuretherapyinveteranswithptsdandahistoryofmildtraumaticbraininjurydesignandmethodologyofapilotstudy AT jenniferlwilson quetiapineaugmentationofprolongedexposuretherapyinveteranswithptsdandahistoryofmildtraumaticbraininjurydesignandmethodologyofapilotstudy AT jenniferalemmer quetiapineaugmentationofprolongedexposuretherapyinveteranswithptsdandahistoryofmildtraumaticbraininjurydesignandmethodologyofapilotstudy AT adeelmeraj quetiapineaugmentationofprolongedexposuretherapyinveteranswithptsdandahistoryofmildtraumaticbraininjurydesignandmethodologyofapilotstudy AT ericcmeyer quetiapineaugmentationofprolongedexposuretherapyinveteranswithptsdandahistoryofmildtraumaticbraininjurydesignandmethodologyofapilotstudy AT jimmintz quetiapineaugmentationofprolongedexposuretherapyinveteranswithptsdandahistoryofmildtraumaticbraininjurydesignandmethodologyofapilotstudy AT alanlpeterson quetiapineaugmentationofprolongedexposuretherapyinveteranswithptsdandahistoryofmildtraumaticbraininjurydesignandmethodologyofapilotstudy AT johndroache quetiapineaugmentationofprolongedexposuretherapyinveteranswithptsdandahistoryofmildtraumaticbraininjurydesignandmethodologyofapilotstudy |