Age of ≥ 18 years of age and able to give written IC
Participant agrees to be randomized
DSM-5 diagnosis of PTSD, confirmed with clinical interview (CAPS-5)
Treatment-resistant PTSD
* CAPS-5 score ≥ 30
* Nonresponse to two evidence-based treatments for PTSD recommended by a recent clinical practice guidelines delivered with fidelity and at an effective dose, at least one of which is a full course of trauma-focused psychotherapy
You may not be if
Bipolar disorder, psychotic disorder, or current alcohol/drug dependence that requires clinical attention.
Female participant being a WOCBP and who does not want to use a non-hormonal contraceptive method (condom) during the intervention period and up to 1 month after the intervention.
Female participants that are pregnant or breastfeeding. Pregnancy is excluded using a negative highly sensitive pregnancy test before the first dose of the study medication during the baseline visit.
Female participants that have a history of unexplained vaginal bleeding or endometrial changes.
Chronic adrenal insufficiency.
Current use of:
* Medications containing CYP3A4-inhibitors, as an interaction of CYP3A4-inhibitors and mifepristone leads to higher mifepristone plasma levels and increases the chance of having side effects. This also includes the consumption of grapefruit juice during the intervention
* Medications containing CYP3A4-inductors, as an interaction of CYP3A4-inductors and mifepristone leads to lower mifepristone plasma levels and decreases the chance of having a beneficial effect. This also includes the consumption of St John's worth/hypericum perforatum during the intervention.
* Medications containing CYP3A4 substrates.
* Medications containing CYP2C8/9 substrates.
* Medications containing P-gp and BCRP transported drugs
* Glucocorticoid antagonists within 1 week before possible start of trial treatment.
* Systemic corticosteroids. Topical corticosteroid treatment are acceptable, with the exception of inhaled corticosteroids (inhalators).
* Unstable drug dosages (e.g. tapering of antidepressants).
Clareo Health | REVERSE: Improving Treatment-resistant Post Traumatic Stress Disorder (PTSD) with Glucocorticoid Receptor (GR) Antagonism
