About this trial
The goal of this clinical trial is to learn if combining suvorexant (a sleep medication) with a shorter form of prolonged exposure therapy called PE-PC works to treat PTSD symptoms and improve sleep in Veterans and military personnel with PTSD and insomnia, with and without mild-to-moderate traumatic brain injury (TBI). The main questions it aims to answer are:
Does suvorexant, when combined with PE-PC therapy, reduce PTSD symptoms more than PE-PC with a placebo (a look-alike substance that contains no drug)? Does suvorexant, when combined with PE-PC therapy, improve psychosocial and physical functioning more than PE-PC with a placebo?
Researchers will compare PE-PC combined with suvorexant to PE-PC combined with a placebo to see if adding suvorexant improves PTSD symptoms, sleep, and overall functioning in Veterans.
Participants will:
Receive weekly PE-PC therapy sessions for 8 weeks Take suvorexant (10-20 mg) or a placebo each night during the 8-week treatment period.
Complete repeated assessments of PTSD symptoms, sleep, and psychosocial and physical functioning throughout the study.
Eligibility criteria
Qualifiers
Adults 18-75 years who are U.S. military Veterans; able to read/understand English and provide written informed consent;
Exposure to a DSM-5 Criterion A traumatic event;
Current PTSD, duration > 3 months, CAPS-5 total score ≥ 12
Insomnia diagnosis indicated by ISI score >14
Disqualifiers
DSM-5 alcohol, marijuana, and/or other substance use disorder in the last 3 months. Mild alcohol and marijuana use not meeting criteria for disorder permissible;
Lifetime bipolar disorder I or II, schizophrenia, schizoaffective disorder, obsessive-compulsive disorder, or major depressive disorder with psychotic features;
Exposure to trauma in the last 3 months;
Prominent suicidal or homicidal ideation, any suicidal behavior in the past 3 months on the Columbia Suicide Severity Rating Scale (C-SSRS)83, or increased risk of suicide that necessitates additional therapy or inpatient treatment;
Trial design
Treatments tested in this trial
- Suvorexant
- Placebo
- Prolonged Exposure Therapy for Primary Care (PE-PC)
Treatment groups
Sponsors and collaborators
Northern California Institute of Research and Education
Lead sponsor
Lowcountry Center for Veterans Research
Collaborator