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Effect of Psilocybin and Structured Integrated Reframing Therapy on Gut-Brain Axis Biomarkers and Depression in Trauma-Related Major Depressive Disorder: Randomized Controlled Trial

Status: Recruiting
Location: See all (3) locations...
Intervention Type: Drug, Behavioral
Study Type: Interventional
Study Phase: Phase 3
SUMMARY

Trauma-related Major Depressive Disorder (MDD) is frequently associated with poor response to conventional antidepressants, persistent psychological distress, and alterations in gut-brain axis function. Existing assessment tools primarily diagnose depression or PTSD but provide limited guidance for integrated clinical management. This study aims to develop and validate the Trauma Anxiety Depression Emotion (TADE) management tool while simultaneously evaluating the effectiveness of psilocybin-assisted Structured Integrated Reframing Therapy (SIRT) in improving clinical and biological outcomes. This prospective, four-arm randomized controlled trial will compare conventional therapy, psilocybin therapy, SIRT, and psilocybin-assisted SIRT. Participants will undergo assessment using the newly developed TADE tool together with established psychometric scales including HAM-D, PCL-5, and GAD-7. Biological outcomes will include serum gut-brain axis and inflammatory biomarkers, including Short-Chain Fatty Acids (SCFAs), Interleukin-6 (IL-6), Interleukin-10 (IL-10), Zonulin, Occludin, and Glial Cell Line-Derived Neurotrophic Factor (GDNF). Assessments will be performed at baseline, during treatment, and at 12-week follow-up. The study aims to determine whether combining psilocybin with SIRT provides superior clinical improvement and favorable biological changes compared with either intervention alone while establishing the validity and clinical utility of the TADE management tool.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Maximum Age: 60
Healthy Volunteers: f
View:

• Adults aged 18-60 years.

• Diagnosis of Major Depressive Disorder (MDD) according to DSM-5 criteria.

• Trauma-related depression with clinically significant trauma symptoms.

• Hamilton Depression Rating Scale (HAM-D) score \>16.

• PTSD Checklist for DSM-5 (PCL-5) score \>33.

• Generalized Anxiety Disorder-7 (GAD-7) score \>10.

• Receiving a stable single SSRI antidepressant regimen for at least 6 weeks before enrollment with adequate treatment adherence.

• Able and willing to provide written informed consent.

• Willing to comply with all study procedures and follow-up visits.

• Women of childbearing potential must agree to use effective contraception throughout the study.

Locations
Other Locations
Pakistan
Institute of Health Science, Khyber Medical University
ACTIVE_NOT_RECRUITING
Islamabad
Hayatabad Medical Complex Peshawar
RECRUITING
Peshawar
Khyber Medical University
ACTIVE_NOT_RECRUITING
Peshawar
Contact Information
Primary
Bushra Riaz, PhD*
bushrariaz098@gmail.com
+92 3338000744
Backup
Dr Owais Qaiser, PhD*
drowaisqaisar.ibms@kmu.edu.pk
+92 3139625788
Time Frame
Start Date: 2026-04-01
Estimated Completion Date: 2027-11-22
Participants
Target number of participants: 60
Treatments
Active_comparator: Conventional Therapy (Control)
Participants will receive standard conventional treatment for trauma-related Major Depressive Disorder, consisting of a stable selective serotonin reuptake inhibitor (SSRI) regimen prescribed by the treating psychiatrist. No psilocybin or Structured Integrated Reframing Therapy (SIRT) will be administered. Treatment will continue for 8 weeks with routine clinical follow-up.
Experimental: Psilocybin Therapy
Participants will continue standard SSRI therapy and receive oral psilocybin administered under medical supervision in a controlled clinical setting. Two supervised dosing sessions will be conducted during the 8-week intervention period according to the study protocol. No SIRT will be provided.
Experimental: Structured Integrated Reframing Therapy (SIRT)
Participants will continue standard SSRI therapy and receive Structured Integrated Reframing Therapy (SIRT), a trauma-informed psychotherapy integrating Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), mindfulness, cognitive reframing, and communication-focused therapeutic techniques. Therapy will be delivered once weekly for 8 weeks by trained therapists.
Experimental: Psilocybin-Assisted Structured Integrated Reframing Therapy
Participants will continue standard SSRI therapy and receive both supervised oral psilocybin administration and Structured Integrated Reframing Therapy (SIRT). Psilocybin will be administered in two supervised dosing sessions during the 8-week intervention period, while SIRT will be delivered once weekly for 8 weeks. The combined intervention is intended to evaluate the synergistic effects of psychedelic-assisted psychotherapy on clinical outcomes and gut-brain axis biomarkers.
Sponsors
Collaborators: Hayatabad Medical Complex, KMU Institute of Health Science, Islamabad
Leads: Khyber Medical University Peshawar

This content was sourced from clinicaltrials.gov