Neurosteroids in PTSD - Biomarkers to Therapeutics

MHBB-021-17S

The purpose of this research is to determine if a study medication called Dehydroepiandrosterone (DHEA) helps to reduce PTSD symptoms in OEF/OIF/OND Veterans. In addition to finding out if DHEA is effective for treating PTSD symptoms, this research seeks to determine if DHEA is effective in treating other symptoms, such as depression and anxiety. Depression and anxiety are symptoms that are frequently present in Veterans who are experiencing PTSD. Another purpose of this research is to takes pictures of the brain using magnetic resonance imaging (MRI) and blood levels of various small molecules including neurosteroids and also proteins, which may be affected by the study drug and/or related to symptoms in Veterans with PTSD. This study seeks to determine if DHEA is changed to other compounds after it is taken by mouth and the safety and effectiveness of DHEA in Veterans with PTSD. This is an "add-on" study and Veterans enrolled in the study will continue to take all of their current medications without any changes (also called "usual care"), and DHEA or a sugar pill (also called a "placebo") will then be added to their current medication regimen.

2019-07-08

2020-11-16

2020-11-16

Terminated

Early phase I

5

Inclusion Criteria: * OEF/OIF/OND era Veterans * PTSD diagnosis (CAPS-5 score 33). * Negative pregnancy test if female. * Sexually active subjects are required to use a medically acceptable form of birth control if they are of childbearing potential and could become pregnant during the study. * A medically acceptable form of birth control includes non-hormonal intrauterine devices, surgical sterilization, or double barrier methods (e.g., diaphragm with contraceptive jelly, condom with contraceptive foam, cervical caps with contraceptive jelly). * Sexual abstinence with agreement to continue abstinence or to use a medically acceptable method of contraception should sexual activity occur is permissible. * Female participants must have had a normal mammogram within the last year (if older than 40) * Female participants must have had a normal pelvic exam within the last year * No change in medications less than 4 weeks before baseline assessment * No anticipated need to alter medications for PTSD for the 6-week study duration (as determined by study physician's review of records and/or discussion with prescribing physician). * Ability to fully participate in the informed consent process Exclusion Criteria: * Unstable medical or neurological illness, including seizures, renal impairment or CVA and inability to participate in neuroimaging (fMRI). * Use of oral contraceptives or other hormonal supplements, as it is unclear if DHEA metabolism to other neurosteroids such as estradiol may potentially impact contraceptive efficacy. * Significant suicidal or homicidal ideation. * Current DSM-5 diagnosis of bipolar disorder, schizophrenia, or other psychotic disorder (including major depression with psychotic features), or cognitive disorder due to a general medical condition. * Female patients who are pregnant or breast-feeding. * Known allergy to study medication. * History of moderate or severe TBI. * Substance dependence within past three months, per DSM-5 criteria (excluding caffeine and nicotine). * Abnormal prostate specific antigen (PSA; \>2.5ng/ml in males age 49 or less; \>4ng/ml in males age 50 or greater) or history of prostate cancer, breast cancer, or uterine cancer. * A family history of prostate, breast or endometrial cancer in a first-degree relative. * Presence of any factors/conditions, medical or non-medical, that may interfere with conduction of study assessments in the judgment of the study team. * Serious or unstable cardiovascular, hepatic, renal, metabolic, respiratory, or hematologic illness, symptomatic peripheral vascular disease, or other medical condition or psychiatric conditions or behaviors that would compromise participation and/or likely to lead to worsening of symptoms during the course of the study in the opinion of study physician and research team. * Are non-ambulatory or require the use of crutches or a walker. * Taking Narcotic medications or benzodiazepines for any reason.

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2023-05-06