Reboxetine Versus Fluvoxamine in the Treatment of Motor Vehicle Accident-related Posttraumatic Stress Disorder

Spivak, Baruch; Strous, Rael D.; Shaked, Ginette; Shabash, Evgeny; Kotler, Moshe; Weizman, Abraham

doi:10.1097/01.jcp.0000203195.65710.f0

Cited by 27 publications

(20 citation statements)

References 32 publications

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“…The superior tolerability profile for SRIs over tricyclic antidepressants, the emergence of definitive pharmacotherapy trials supporting the efficacy of SRIs for PTSD (Brady et al, 2000;Marshall et al, 2001;Tucker et al, 2001), the absence of definitive NRI trials for PTSD, and the negative preliminary findings with desipramine (Reist et al, 1989), all contributed to waning interest in NRI treatment for PTSD. More recently, the emergence of drugs that block the a 1 noradrenergic receptor, such as prazosin (Raskind et al, 2007) and risperidone (Berger et al, 2009;Rothbaum et al, 2008) as promising treatments for the re-experiencing and hyperarousal symptoms of PTSD, converges with evidence of (a) the capacity of NRIs to attenuate noradrenergic activation (Charney and Heninger, 1985) and (b) of preliminary support for the NRI, reboxetine for PTSD (Spivak et al, 2006). These findings indicate that after 25 years of research, noradrenergic hyperactivity remains an important target for the treatment of PTSD ( Van der Kolk, 2004).…”

Section: Discussionmentioning

confidence: 95%

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Noradrenergic vs Serotonergic Antidepressant with or without Naltrexone for Veterans with PTSD and Comorbid Alcohol Dependence

Petrakis

Ralevski

Desai

et al. 2011

Neuropsychopharmacol

111

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The wars in Iraq and Afghanistan are associated with high rates of post-traumatic stress disorder (PTSD) and comorbid alcohol use disorders. The pharmacotherapy of these comorbid conditions has received relatively little study. The current study compared the serotonin uptake inhibitor, paroxetine, to the norepinephrine uptake inhibitor, desipramine. It also evaluated the adjunctive efficacy of the Food and Drug Administration (FDA)-approved alcoholism pharmacotherapy, naltrexone, relative to placebo. Four groups of predominately male veterans (n=88) meeting current diagnostic criteria for both alcohol dependence (AD) and PTSD were randomly assigned under double-blind conditions to one of four groups: paroxetine+naltrexone; paroxetine+placebo; desipramine+naltrexone; desipramine+placebo. Main outcome measures included standardized scales that assessed symptoms of PTSD and alcohol consumption. Paroxetine did not show statistical superiority to desipramine for the treatment of PTSD symptoms. However, desipramine was superior to paroxetine with respect to study retention and alcohol use outcomes. Naltrexone reduced alcohol craving relative to placebo, but it conferred no advantage on drinking use outcomes. Although the serotonin uptake inhibitors are the only FDA-approved medications for the treatment of PTSD, the current study suggests that norepinephrine uptake inhibitors may present clinical advantages when treating male veterans with PTSD and AD. However, naltrexone did not show evidence of efficacy in this population. This study was registered with ClinicalTrials.gov, registration number NCT00338962 and URL: http://clinicaltrials.gov/ct2/show/NCT00338962?term=desipramine+AND+alcohol+dependence+AND+depression&recr=Closed&rank=1.

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Section: Discussionmentioning

confidence: 95%

“…A small, negative trial with desipramine in combat-related PTSD (Reist et al, 1989) was followed by a randomized comparison that showed the NRI reboxetine was of equal efficacy to an SRI (Spivak et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Noradrenergic vs Serotonergic Antidepressant with or without Naltrexone for Veterans with PTSD and Comorbid Alcohol Dependence

Petrakis

Ralevski

Desai

et al. 2011

Neuropsychopharmacol

111

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“…Fluvoxamine demonstrated efficacy for PTSD in open trials [979-983], and in a RCT was as effective as reboxetine (Level 2) [984]. …”

Section: Posttraumatic Stress Disordermentioning

confidence: 99%

Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

et al. 2014

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BackgroundAnxiety and related disorders are among the most common mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated.MethodsThese guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process. Data on the epidemiology, diagnosis, and treatment (psychological and pharmacological) were obtained through MEDLINE, PsycINFO, and manual searches (1980–2012). Treatment strategies were rated on strength of evidence, and a clinical recommendation for each intervention was made, based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines.ResultsThese guidelines are presented in 10 sections, including an introduction, principles of diagnosis and management, six sections (Sections 3 through 8) on the specific anxiety-related disorders (panic disorder, agoraphobia, specific phobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder), and two additional sections on special populations (children/adolescents, pregnant/lactating women, and the elderly) and clinical issues in patients with comorbid conditions.ConclusionsAnxiety and related disorders are very common in clinical practice, and frequently comorbid with other psychiatric and medical conditions. Optimal management requires a good understanding of the efficacy and side effect profiles of pharmacological and psychological treatments.

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“…Responders to the DBPC study sustained their initial response, and patients who failed in the initial study could become responders (Londborg et al 2001)(A). Á The SSRI fluvoxamine was as effective as reboxetine, a norepinephrine reuptake inhibitor (Spivak et al 2006…”

Section: Post-traumatic Stress Disorder (Ptsd)mentioning

confidence: 99%

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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Reboxetine Versus Fluvoxamine in the Treatment of Motor Vehicle Accident-related Posttraumatic Stress Disorder

Cited by 27 publications

References 32 publications

Noradrenergic vs Serotonergic Antidepressant with or without Naltrexone for Veterans with PTSD and Comorbid Alcohol Dependence

Noradrenergic vs Serotonergic Antidepressant with or without Naltrexone for Veterans with PTSD and Comorbid Alcohol Dependence

Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

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

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