Efficacy of Sertraline in Preventing Relapse of Posttraumatic Stress Disorder: Results of a 28-Week Double-Blind, Placebo-Controlled Study

Davidson, Jonathan; Pearlstein, Teri; Londborg, Peter D.; Brady, Kathleen T.; Rothbaum, Barbara O.; Bell, Jonathan; Maddock, Richard J.; Hegel, Mark T.; Farfel, Gail

doi:10.1176/appi.ajp.158.12.1974

Cited by 202 publications

(110 citation statements)

References 41 publications

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“…In a relapse-prevention study, patients who had responded to 24 weeks of open-label treatment with sertraline were randomized to either sertraline or placebo for an additional 28 weeks. Relapse rates were significantly lower in the sertraline group (Davidson et al 2001a). In an open-label study, patients who had completed 12-week DBPC studies of sertraline versus placebo received sertraline for an additional 24 weeks.…”

Section: Post-traumatic Stress Disorder (Ptsd)mentioning

confidence: 96%

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Bandelow

Zohar

Hollander

et al. 2008

The World Journal of Biological Psychiatry

718

410

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In this report, which is an update of a guideline published in 2002 (Bandelow et al. 2002, recommendations for the pharmacological treatment of anxiety disorder, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are presented. Since the publication of the first version of this guideline, a substantial number of new randomized controlled studies of anxiolytics have been published. In particular, more relapse prevention studies are now available that show sustained efficacy of anxiolytic drugs. The recommendations, developed by the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders, a consensus panel of 30 international experts, are now based on 510 published randomized, placebo-or comparator-controlled clinical studies (RCTs) and 130 open studies and case reports. First-line treatments for these disorders are selective serotonin reuptake inhibitors (SSRIs), serotonin-noradrenaline reuptake inhibitors (SNRIs) and the calcium channel modulator pregabalin. Tricyclic antidepressants (TCAs) are equally effective for some disorders, but many are less well tolerated than the SSRIs/ SNRIs. In treatment-resistant cases, benzodiazepines may be used when the patient does not have a history of substance abuse disorders. Potential treatment options for patients unresponsive to standard treatments are described in this overview. Although these guidelines focus on medications, non-pharmacological were also considered. Cognitive behavioural therapy (CBT) and other variants of behaviour therapy have been sufficiently investigated in controlled studies in patients with anxiety disorders, OCD, and PTSD to support them being recommended either alone or in combination with the above medicines.

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Section: Post-traumatic Stress Disorder (Ptsd)mentioning

confidence: 96%

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Bandelow

Zohar

Hollander

et al. 2008

The World Journal of Biological Psychiatry

718

410

View full text Add to dashboard Cite

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“…All other medications for PTSD are considered off-label use. RCTs have provided strong evidence for the effectiveness of sertraline, paroxetine, and venlafaxine in the treatment of PTSD [40][41][42][43]. These agents, along with others affecting the serotonin system, are hypothesized to be effective because of their effect on the altered serotonergic receptors in the amygdala and other parts of the fear circuitry.…”

Section: Initiating Effective Pharmacotherapymentioning

confidence: 99%

Pharmacotherapy for posttraumatic stress disorder: Review with clinical applications

Jeffreys

Capehart²,

Friedman³

2012

JRRD

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Abstract-Posttraumatic stress disorder (PTSD) is a prevalent psychiatric diagnosis among veterans and has high comorbidity with other medical and psychiatric conditions. This article reviews the pharmacotherapy recommendations from the 2010 revised Department of Veterans Affairs/Department of Defense Clinical Practice Guideline (CPG) for PTSD and provides practical PTSD treatment recommendations for clinicians. While evidence-based, trauma-focused psychotherapy is the preferred treatment for PTSD, pharmacotherapy is also an important treatment option. First-line pharmacotherapy agents include selective serotonin reuptake inhibitors and the selective serotonin-norepinephrine reuptake inhibitor venlafaxine. Second-line agents have less evidence for their usefulness in PTSD and carry a potentially greater side effect burden. They include nefazodone, mirtazapine, tricyclic antidepressants, and monoamine oxidase inhibitors. Prazosin is beneficial for nightmares. Benzodiazepines and antipsychotics, either as monotherapy or used adjunctively, are not recommended in the treatment of PTSD. Treating co-occurring disorders, such as major depressive disorder, substance use disorders, and traumatic brain injury, is essential in maximizing treatment outcomes in PTSD. The CPG provides evidence-based treatment recommendations for treating PTSD with and without such cooccurring disorders.

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“…Response to medication may take 1-3 months. More sustained treatment can provide further gains and reduced likelihood of relapse (Davidson et al, 2002). Should the first SSRI treatment prove ineffective or intolerable, a second SSRI or venlafaxine should be tried (Davidson et al, 2006).…”

Section: Monotherapymentioning

confidence: 99%

The Transformation of Post-Traumatic Stress Disorder: From Neurosis to Neurobiology

Mletzko¹,

Dunlop²

2011

Anxiety and Related Disorders

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Efficacy of Sertraline in Preventing Relapse of Posttraumatic Stress Disorder: Results of a 28-Week Double-Blind, Placebo-Controlled Study

Abstract: The results provide evidence for the ability of sertraline both to sustain improvement in PTSD symptoms and to provide prophylactic protection against relapse.

Cited by 202 publications

References 41 publications

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Pharmacotherapy for posttraumatic stress disorder: Review with clinical applications

The Transformation of Post-Traumatic Stress Disorder: From Neurosis to Neurobiology

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