Study: Hepatitis C Drugs May Reduce PTSD Symptoms

Previous studies have shown that 6% of Americans will develop PTSD in their lifetime, which can disrupt lives and lead to or worsen existing health issues, like depression, anxiety, eating disorders, and suicidal thoughts.

A new analysis to examine and compare the effectiveness of the previously identified DAAs in PTSD symptom improvement has led to a potential new medication for PTSD in patients without hepatitis C virus infection.

Previous studies have shown that 6% of Americans will develop PTSD in their lifetime, which can disrupt lives and lead to or worsen existing health issues, like depression, anxiety, eating disorders, and suicidal thoughts.

The FDA has only approved of 2 medications to treat PTSD- sertraline and paroxetine, and both have shown limited effectiveness in reducing PTSD symptoms.

The new study revealed that the medication combination glecaprevir and pibrentasvir had the strongest connection with PTSD symptom improvement among the DAAs most prescribed in the VA.

“Many people have PTSD, but there few effective pharmacologic treatments and limited drug development for PTSD,” said co-principal investigator and study senior author Jaimie Gradus, associate professor of epidemiology, in a press release. “Existing effective treatments are mostly psychotherapy, and while they work well, there are also issues with them, including a lot of treatment drop-out and they’re time-intensive, so adding to the suite of treatment options for people is a high priority.”

The researchers also examined the same national cohort of VA patients as the prior study, but narrowed the group to include only patients who were diagnosed with hepatitis C.

“There really has been a lot of interest in finding new medications for PTSD in the field,” said co-principal investigator Brian Shiner, a psychiatrist and acting associate chief of staff for research at the White River Junction VA Medical Center, as well as associate professor of psychiatry at Dartmouth University’s Geisel School of Medicine, in a press release. “The idea to look at VA data in this way grew out of a conversation in the scientific literature between the VA PTSD Psychopharmacology Working Group and the National Institutes of Mental Health. Paula Schnurr from the National Center for PTSD connected Jaimie and I, and we were really fortunate to obtain funding to bring a team together to do this work.”

The team analyzed 254 VA patients who were diagnosed with PTSD and hepatitis C between October 1999 and September 2019. Each participant received 1 combination of FDA-approved hepatitis C medications, like glecaprevir and pibrentasvir (GLE/PIB), ledipasvir and sofosbuvir (LDV/SOF), and sofosbuvir and velpatasvir (SOF/VEL). The research team then monitored the patients’ symptoms for both PTSD and HCV between 2 clinical visits over 8 to 12 weeks.

After adjusting for variables that could potentially influence results, like opioid prescription use, liver disease diagnoses, emergency department care for psychiatric crises, the researchers found that the GLE/PIB medications were more strongly associated with PTSD symptom improvement that the LDV/SOF and SOF/VEL treatments, consistent with previous results.

“At BUSPH, we have been working with our VA colleagues to look at PTSD symptom improvement in routine care using medical records for several years,” Gradus said in a press release. “The level of improvement we see for GLE/PIB is impressive and over twice what we have seen for paroxetine and sertraline. I think we have done the best we can with medical records data, an important next step in this line of work will be a prospective placebo-controlled study in patients without hepatitis C virus infection.”

Shiner added that they recently received funding from the Department of Defense to study GLE/PIB as a potential treatment for PTSD in a prospective randomized placebo-controlled trial and will serve as principal investigator. “It will be several years until we see the results, but this is a very exciting case where we used VA patient data to identify a potential treatment for PTSD, which is a very important problem for veterans’ health. In this way, veterans have informed PTSD treatment development,” Shiner said in a press release.

REFERENCE

Hepatitis C drugs may reduce PTSD symptoms. BU School of Public Health. August 22, 2022. Accessed August 29, 2022. https://www.bu.edu/sph/news/articles/2022/hepatitis-c-drugs-may-reduce-ptsd-symptoms/

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