PTSD and Prozac Study Almost Complete

Posttraumatic stress disorder (PTSD) affects about 10% of people who experience a traumatic event. In the United States, the lifetime prevalence of the condition is around 7%. PTSD is characterized by three main symptoms—intense and intrusive memories of the event, a heightened state of emotional arousal, and avoidance of reminders. The experience of violence during wartime is one of the most common causes of PTSD. Combat soldiers often undergo weeks and months of unrelenting stress and anxiety, punctuated by moments of panic. The recent wars in Iraq and Afghanistan, for example, have resulted in a surge of veterans experiencing numerous mental health issues, including PTSD and depression. Because this condition is both chronic and predictive of additional psychiatric conditions, early and effective intervention is critical.

A number of therapies have been advanced for the prevention or management of PTSD symptoms. Antidepressant medications, especially selective serotonin reuptake inhibitors (SSRIs), are among the first treatment choices for combat-related stress and anxiety. However, several studies have demonstrated an effectiveness rate for antidepressants of only about 60%. Research is ongoing into possible diagnostic criteria that will help identify potential responders to SSRI medications. In addition, research into novel drugs may soon reveal PTSD-specific formulations that are far more effective than traditional pharmaceuticals. Because PTSD is a unique and highly focused mental health condition, cognitive-behavioral therapy is always an essential component of a positive outcome.

A study underway at the Darnall Army Medical Center in Texas seeks to answer questions about the relative effectiveness of Prozac (fluoxetine) in the treatment of PTSD. The study will conclude in August 2012. Researchers hope to compile data for 300 participants. The inclusion criteria include combat veteran status and a diagnosis of PTSD. All participants will receive either placebo or Prozac for the first 12 weeks of the study. After this initial segment, they will all receive Prozac for an additional period of 20 weeks. Participants who show little or no improvement may be given a complementary medication. As part of the study, the veterans will also receive the standard psychotherapeutic treatment for PTSD administered at Darnall’s Resilience and Restoration Center.

Military combat is not the only trigger for PTSD, but it may be the most profound. Studies conducted during the Vietnam era demonstrated limited effectiveness of drug treatments for the condition. The Darnall Army Medical Center study hopes to add more empirical data to the discussion, clarifying whether or not an SSRI such as Prozac really qualifies as a first-choice drug in the management of PTSD symptoms.

References

  1. Post-traumatic stress disorder (PTSD). (n.d.). Mayo Clinic. Retrieved June 4, 2012, from http://www.mayoclinic.com/health/post-traumatic-stress-disorder/DS00246
  2. Predictors of Treatment Response to Fluoxetine in PTSD Following a Recent History of War Zone Stress Exposure. (n.d.).  ClinicalTrials.gov. Retrieved June 4, 2012, from http://clinicaltrials.gov/ct2/show/NCT00633685?intr=%22Fluoxetine%22&rank=5
  3. Steckler, T., & Risbrough, V. (2012). Pharmacological treatment of PTSD – established and new approaches. Neuropharmacology, 62(2), 617-627. Retrieved June 4, 2012, from the Science Direct database.
  4. Wampold, B., Imel, Z., Laska, K., Benish, S., Miller, S., Fluckiger, C., et al. (2010). Determining what works in the treatment of PTSD. Clinical Psychology Review, 30(8), 923-933. Retrieved June 4, 2012, from the Science Direct database.

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