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Published VersionCC BY V4.0, Open Access
Journal article
Tackling the global problem of traumatic stress in low-income countries: a pilot clinical trial comparing reconsolidation therapy to paroxetine in Nepal
BMC Psychiatry, Vol.21, pp.1-9
2021
PMID: 34479508
Abstract
Background:
Traumatic stress is a global mental health problem requiring novel, easily implemented treatment solutions. We compared the effectiveness and efficiency of Reconsolidation Therapy (RT) to the well-established antidepressant paroxetine, in reducing symptoms of traumatic stress among patients from Nepal, a low-income country.
Methods:
Forty-six adults with posttraumatic stress disorder (PTSD) were randomized to one of two groups. The reconsolidation blocker propranolol was administered 90 min before briefly recalling a traumatic memory with a therapist, weekly for six consecutive weeks. This was compared to daily paroxetine for 26 weeks. Self-reported PTSD symptoms were assessed blindly at the 7th, 13th, and 26th weeks.
Results:
An intent-to-treat analysis revealed a robust pre- to post-treatment main effect (beta(1) = - 4.83, 95% CI = [- 5.66, - 4.01], p < .001), whereby both groups improved, with Cohen's effect sizes of d = 2.34 (95% CI = [1.57, 3.12]) for paroxetine, and of 2.82 (95% CI = [1.98, 3.66]) for RT after 7 weeks, suggesting treatment effectiveness for both groups in a real-world setting. Three and six-month follow-up yielded further significant improvement in both groups, which did not differ from each other.
Conclusion:
RT also displayed promising efficiency, considering that it had been discontinued weeks earlier while the paroxetine treatment was continued, as recommended. RT could be taught in low-income countries as part of the local therapeutic resources to treat the core symptoms of PTSD, provided that such results are replicated on a broader scale.
Details
- Title
- Tackling the global problem of traumatic stress in low-income countries: a pilot clinical trial comparing reconsolidation therapy to paroxetine in Nepal
- Authors
- Alain Brunet (Corresponding Author) - McGill UniversityRam P. Sapkota - Douglas Mental Health University InstituteBhushan Guragain - Centre for Victims of Torture (Nepal)Jacques Tremblay - Douglas Mental Health University InstituteDaniel Saumier - Douglas Mental Health University InstituteLaurence J. Kirmayer - McGill University
- Publication details
- BMC Psychiatry, Vol.21, pp.1-9
- Publisher
- BioMed Central Ltd.
- Date published
- 2021
- DOI
- 10.1186/s12888-021-03441-6
- ISSN
- 1471-244X
- PMID
- 34479508
- Copyright note
- This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
- Grant note
- This research was funded by a grant from Grand Challenges Canada. RPS currently receives postdoctoral fellowship from the McGill Health Brains for Healthy Minds program.
- Organisation Unit
- Thompson Institute
- Language
- English
- Record Identifier
- 991105744302621
- Output Type
- Journal article
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