A Study of Psilocybin for PTSD

NCT06407635 | Active Not Recruiting Phase 1 FDA Drug

• 1 other identifier: IRB00407008
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

The proposed open-label, controlled study at the Johns Hopkins Center for Psychedelic and Consciousness Research (CPCR) will test the following primary hypotheses in adult patients with chronic PTSD who are currently taking a serotonin reuptake inhibitor: psilocybin therapy will be feasible and safe for participants, significantly remediate PTSD symptoms, and enhance wellbeing and quality of life. In addition, the study will examine whether elements of evidence-based trauma-focused psychotherapy enhance treatment response when paired with psilocybin.

Conditions

Post Traumatic Stress Disorder

Outcome Measures

Primary Outcomes (5)

• Incidence of Adverse Events

  Adverse event monitoring throughout the study.

  8 months

• Columbia Suicide Severity Rating Scale (C-SSRS)

  Used to assess severity of suicide ideation during every study visit. The C-SSRS has a score range of 0-5, with 0 being the least severe and 5 being the most severe. The scale has ten categories, all of which are binary responses (yes/no) that indicate the presence or absence of a behavior.

  8 months

• Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual (DSM)-5 (CAPS-5)

  The CAPS-5 assessment consists of 30 items that are designed to measure the frequency and intensity of PTSD symptoms, covering all 20 DSM-5 PTSD symptoms. Each item is scored on a 5-point scale (0-4), with 0 being absent and 4 being extreme/incapacitating. Higher scores indicate higher severity of PTSD symptoms.

  8 months

• Ecological Momentary Assessment (EMA) of PTSD Checklist for DSM-5 (PCL-5)

  The PTSD Checklist for DSM-5 (PCL-5; is a self-report psychometric instrument widely employed in both clinical and research settings to assess the presence and severity of PTSD symptoms as outlined in the DSM-5. The PCL-5's 20 items correspond to the DSM-5 symptom criteria for PTSD. For this study, PCL-5 symptoms are assessed using Ecological Momentary Assessment (EMA), such that respondents will be asked to rate the degree to which they have been bothered by each symptom within a preceding time-frame (e.g., preceding 2 hours, preceding day) on a Likert scale ranging from 0 (Not at all) to 4 (Extremely). A total symptom severity score (range - 0-80) can be obtained by summing the scores for each of the 20 items with higher scores indicating greater symptom severity.

  3 months

• World Health Organization Quality of Life Brief Version (WHOQOL-BREF)

  An internationally recognized and validated tool for evaluating an individual's perception of their position in life, within the context of their culture and value system, and relative to their personal goals, expectations, standards, and concerns. Consists of multiple domains and facets, covering physical health, psychological health, social relationships, and environment. Each of these domains is assessed through several questions that the respondent answers on a five-point Likert scale. These scores are then used to compute an overall score, which is transformed linearly to a 0-100-scale with higher scores indicating a better perceived quality of life.

  8 months

Secondary Outcomes (3)

• Beck Depression Inventory II (BDI-II)

  8 months

• Sheehan Disability Scale (SDS)

  8 months

• Posttraumatic Maladaptive Beliefs Scale (PMBS)

  3 months

Study Arms (2)

Trauma-focused psychotherapy treatment condition

EXPERIMENTAL

Individuals in this arm will undergo procedures related to trauma-focused psychotherapy (combined with standard psychological support) beginning after receipt of psilocybin.

Drug: Psilocybin; Other: Trauma-focused psychotherapy; Other: Standard psychological support

Standard psychological support treatment condition

ACTIVE COMPARATOR

This condition represents typical support following the experimental administration of psilocybin therapy.

Drug: Psilocybin; Other: Standard psychological support

Interventions

Psilocybin DRUG

The two psilocybin doses will be administered approximately 2 weeks apart in the form of an oral capsule. The first dose will be 25mg. For the second dosing session, participants will either remain on 25 mg of psilocybin, or will receive a dose of 40 mg, depending on the strength of subjective effects experienced during the first dosing session, as well as clinical judgment and participant preference.

Standard psychological support treatment condition; Trauma-focused psychotherapy treatment condition

Trauma-focused psychotherapy OTHER

Components of trauma-focused psychotherapy will include Cognitive Processing Therapy and in vivo exposure. Such components of evidence-based psychotherapy may lower the safety risk profile for this vulnerable population and enhance the effect size and maintenance of psilocybin therapy.

Trauma-focused psychotherapy treatment condition

Standard psychological support OTHER

Standard psychological support involves providing a safe and emotionally supportive environment to participants throughout the course of their participation, and being attentive and responsive to their emotional needs. It includes continued review and discussion of experiences that participants encountered during the psilocybin sessions and the way that those experience relate to the participant's life and clinical status.

Standard psychological support treatment condition; Trauma-focused psychotherapy treatment condition

Eligibility Criteria

• Age: 21 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Be at least 21 years old
• Have given written informed consent
• Have a confirmed DSM-5 diagnosis of Post-Traumatic Stress Disorder with symptom duration \>= 6 months
• Have a baseline CAPS-5 score of \>=35
• Currently taking a serotonin reuptake inhibitor (SSRI or SNRI) at a stable dose for at least 3 months.
• Be judged by study team clinicians to be at low acute risk for suicidality
• Be medically stable as determined by screening for medical problems via a personal interview, a medical questionnaire, a physical examination, an electrocardiogram (ECG), and routine medical blood and urinalysis laboratory tests
• Agree to consume approximately the same amount of caffeine-containing beverage (e.g., coffee, tea) that he/she consumes on a usual morning, before arriving at the research unit on the mornings of drug session days. If the participant does not routinely consume caffeinated beverages, he/she must agree not to do so on session days.
• Agree to refrain from using alcohol, anxiolytics, stimulants, sedatives or hypnotics, opioids, dissociatives, cannabinoids, or other unapproved substances within 24 hours of psilocybin administration. Caffeine and nicotine are exceptions.
• Agree not to take any as needed (PRN) medications on the mornings of drug sessions
• Agree to stop taking 5HT2A antagonist medications at least 5 half-lives before psilocybin dosing.
• Agree not to take sildenafil (Viagra®), tadalafil, or similar medications within 72 hours of each drug administration.
• Have no classic psychedelic use in the past five years.
• Have at least a high school level of education or equivalent (e.g. GED).
• Weigh at least 40kg.

You may not qualify if:

• Women who are pregnant (as indicated by a positive urine pregnancy test assessed at intake and before each drug session) or nursing; women who are of child- bearing potential and sexually active who are not practicing an effective means of birth control.
• Cardiovascular conditions: coronary artery disease, stroke, angina, hypertension with resting blood pressure systolic \>139 or diastolic \>89, a clinically significant ECG abnormality (e.g., atrial fibrillation), prolonged corrected QT interval (QTc) interval (i.e., QTc \> 450 msec), artificial heart valve, or transient ischemic attack (TIA) in the past year
• Family history of Torsades de Pointes and sudden cardiac death
• Epilepsy with history of seizures
• Insulin-dependent diabetes; if taking oral hypoglycemic agent, then no history of hypoglycemia
• Currently taking a Monoamine Oxidase Inhibitor
• Current or past history of meeting DSM-5 criteria for schizophrenia spectrum or other psychotic disorders (except substance/medication-induced or due to another medical condition), or Bipolar I or II Disorder
• Current or history within one year of meeting DSM-5 criteria for a severe alcohol, tobacco, or other drug use disorder (excluding caffeine)
• Current or history within one year of meeting DSM-5 criteria for Borderline Personality Disorder.
• Have a first degree relative with schizophrenia spectrum or other psychotic disorders (except substance/medication-induced or due to another medical condition), or Bipolar I.
• Has a psychiatric condition judged to be incompatible with establishment of rapport or safe exposure to psilocybin
• History of a medically significant suicide attempt
• Unwilling or unable to pause concurrent psychotherapy during the study.
• Determined to be at risk for re-exposure to the index trauma or other significant trauma in daily life.

Sponsors & Collaborators

• Johns Hopkins University: lead
• Steven & Alexandra Cohen Foundation: collaborator
• Usona Institute: collaborator

Study Sites (1)

Johns Hopkins Center for Psychedelic and Consciousness Research

Baltimore, Maryland, 21224, United States

Location

MeSH Terms

Conditions

Stress Disorders, Post-Traumatic

Interventions

Psilocybin

Condition Hierarchy (Ancestors)

Stress Disorders, Traumatic; Trauma and Stressor Related Disorders; Mental Disorders

Intervention Hierarchy (Ancestors)

Indole Alkaloids; Alkaloids; Heterocyclic Compounds; Indoles; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring; Tryptamines; Indolizidines; Indolizines

Study Officials

• Sandeep Nayak, MD

  Johns Hopkins University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 6, 2024
• First Posted: May 9, 2024
• Study Start: June 7, 2024
• Primary Completion: May 1, 2026
• Study Completion (Estimated): May 1, 2027
• Last Updated: October 31, 2025

Record last verified: 2025-10

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)