Open Access Study protocol

Tachikawa project for prevention of posttraumatic stress disorder with polyunsaturated fatty acid (TPOP): study protocol for a randomized controlled trial

Yutaka Matsuoka1234*, Daisuke Nishi134, Naohiro Yonemoto24, Kei Hamazaki45, Kenta Matsumura34, Hiroko Noguchi234, Kenji Hashimoto46 and Tomohito Hamazaki47

Author Affiliations

1 Department of Psychiatry, National Disaster Medical Center, 3256 Midoricho, 190-0014, Tachikawa, Tokyo, Japan

2 Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, 187-8551, Kodaira, Tokyo, Japan

3 National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, 187-8553, Kodaira, Tokyo, Japan

4 CREST, Japan Science and Technology Agency, 3256 Midoricho, 190-0014, Tachikawa, Tokyo, Japan

5 Department of Public Health, Faculty of Medicine, University of Toyama, 2630 Sugitani, 930-0194, Toyama, Toyama, Japan

6 Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, 1-8-1 Inohana, 260-8670, Chuo-ku, Chiba, Japan

7 Department of Clinical Sciences, Institute of Natural Medicine, University of Toyama, 2630 Sugitani, 930-0194, Toyama, Toyama, Japan

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BMC Psychiatry 2013, 13:8  doi:10.1186/1471-244X-13-8

Published: 5 January 2013

Abstract

Background

Preclinical and clinical studies suggest that supplementation with omega-3 fatty acids after trauma might reduce subsequent posttraumatic stress disorder (PTSD). To date, we have shown in an open trial that PTSD symptoms in critically injured patients can be reduced by taking omega-3 fatty acids, hypothesized to stimulate hippocampal neurogenesis. The primary aim of the present randomized controlled trial is to examine the efficacy of omega-3 fatty acid supplementation in the secondary prevention of PTSD following accidental injury, as compared with placebo. This paper describes the rationale and protocol of this trial.

Methods/design

The Tachikawa Project for Prevention of Posttraumatic Stress Disorder with Polyunsaturated Fatty Acid (TPOP) is a double-blinded, parallel group, randomized controlled trial to assess whether omega-3 fatty acid supplementation can prevent PTSD symptoms among accident-injured patients consecutively admitted to an intensive care unit. We plan to recruit accident-injured patients and follow them prospectively for 12 weeks. Enrolled patients will be randomized to either the omega-3 fatty acid supplement group (1,470 mg docosahexaenoic acid and 147 mg eicosapentaenoic acid daily) or placebo group. Primary outcome is score on the Clinician-Administered PTSD Scale (CAPS). We will need to randomize 140 injured patients to have 90% power to detect a 10-point difference in mean CAPS scores with omega-3 fatty acid supplementation compared with placebo. Secondary measures are diagnosis of PTSD and major depressive disorder, depressive symptoms, physiologic response in the experiment using script-driven imagery and acoustic stimulation, serum brain-derived neurotrophic factor, health-related quality of life, resilience, and aggression. Analyses will be by intent to treat. The trial was initiated on December 13 2008, with 104 subjects randomized by November 30 2012.

Discussion

This study promises to be the first trial to provide a novel prevention strategy for PTSD among traumatized people.

Trial registration

ClinicalTrials.gov Identifier NCT00671099

Keywords:
Fish oil; Omega-3 fatty acid; Docosahexaenoic acid; Eicosapentaenoic acid; Posttraumatic stress disorder; Accidental injury; Prevention