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. 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. An intent-to-treat analysis revealed a robust pre- to post-treatment main effect (β1 = − 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. 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. ISRCTN34308454 (11/10/2017).

中文翻译：

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解决低收入国家的创伤应激全球问题：在尼泊尔进行的一项比较再巩固疗法与帕罗西汀的试点临床试验


创伤性应激是一个全球性的心理健康问题，需要新颖、易于实施的治疗解决方案。我们将再巩固疗法 (RT) 与成熟的抗抑郁药帕罗西汀在减轻低收入国家尼泊尔患者创伤应激症状方面的有效性和效率进行了比较。 46 名患有创伤后应激障碍 (PTSD) 的成年人被随机分为两组。在与治疗师短暂回忆创伤记忆之前 90 分钟给予再巩固阻滞剂普萘洛尔，每周一次，连续六周。将此结果与连续 26 周每日服用帕罗西汀进行比较。在第 7、13 和 26 周对自我报告的 PTSD 症状进行盲法评估。意向治疗分析揭示了治疗前和治疗后的稳健主效应（β1 = − 4.83，95% CI = [− 5.66，− 4.01]，p < .001），两组均因科恩效应而有所改善7 周后帕罗西汀的 d = 2.34 (95% CI = [1.57, 3.12]) 和 RT 的 d = 2.82 (95% CI = [1.98, 3.66])，表明现实世界中两组的治疗有效性环境。三个月和六个月的随访在两组中都取得了进一步的显着改善，并且彼此没有差异。考虑到放疗已在几周前停止，同时按照建议继续帕罗西汀治疗，放疗也显示出有希望的疗效。可以在低收入国家教授 RT，作为当地治疗资源的一部分来治疗 PTSD 的核心症状，前提是这些结果能够在更广泛的范围内复制。 ISRCTN34308454（2017 年 11 月 10 日）。