A Pilot Study of Mifepristone in Combat-Related PTSD.
A Pilot Study of Mifepristone in Combat-Related PTSD.
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DOI：
10.1155/2012/393251
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发表时间：
2012-01-01
影响因子：
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通讯作者：
Yehuda, Rachel
中科院分区：
文献类型：
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作者：
Golier, Julia A;Caramanica, Kimberly;Yehuda, Rachel
背景。我们获得了试点数据，以检验短期米非司酮治疗男性退伍军人PTSD的临床和神经内分泌影响。方法。8名患有军事相关创伤后应激障碍的男性退伍军人完成了一项随机双盲试验，他们接受了为期一周的米非司酮（600mg/天）或安慰剂治疗。主要的临床结果测量是PTSD症状的改善和二个定义的临床反应状态，在一个月的随访中由CAPS测量。其他结果测量包括自我报告的创伤后应激障碍症状严重程度，CAPS-2症状亚量表评分，早晨血浆皮质醇和ACTH水平。结果。米非司酮与CAPS-2总分的显著改善相关。在一个月的随访中，米非司酮组的4名退伍军人和安慰剂组的4名退伍军人中有1名获得了临床反应；米非司酮组四名退伍军人中有三名和米非司酮组四名退伍军人中有一名缓解。米非司酮治疗与皮质醇和ACTH水平的急性升高以及淋巴细胞胞质糖皮质激素受体数量的减少有关。结论。进一步的对照试验表明，米非司酮的影响和其持久性PTSD。如果有效，短期药物治疗创伤后应激障碍可能有无数的用途。
Background. We obtained pilot data to examine the clinical and neuroendocrine effects of short-term mifepristone treatment in male veterans with PTSD. Methods. Eight male veterans with military-related PTSD completed a randomized, double-blind trial of one week of treatment with mifepristone (600mg/day) or placebo. The primary clinical outcome measures were improvement in PTSD symptoms and dichotomously defined clinical responder status as measured by the CAPS at one-month follow-up. Additional outcome measures included self-reported measures of PTSD symptom severity, CAPS-2 symptom subscale scores, and morning plasma cortisol and ACTH levels. Results. Mifepristone was associated with significant improvements in total CAPS-2 score. At one-month follow-up, all four veterans in the mifepristone group and one of four veterans in the placebo group achieved clinical response; three of four veterans in the mifepristone group and one of four veterans in the mifepristone group remitted. Mifepristone treatment was associated with acute increases in cortisol and ACTH levels and decreases in cytosolic glucocorticoid receptor number in lymphocytes. Conclusions. Further controlled trials of the effects of mifepristone and their durability are indicated in PTSD. If effective, a short-term pharmacological treatment in PTSD could have myriad uses.