Nefazodone in post-traumatic stress disorder:
results from six open-label
trials
by
Hidalgo R, Hertzberg MA, Mellman T, Petty F, Tucker P,
Weisler R, Zisook S,
Chen S, Churchill E, Davidson J
Duke University Medical Center,
Durham, North Carolina, USA.
Int Clin Psychopharmacol 1999 Mar; 14(2):61-8
ABSTRACT
Nefazodone, an antidepressant which blocks serotonin (5-HT)2 receptors and
5-HT reuptake, was evaluated in the treatment of post-traumatic stress disorder
(PTSD) in six open-label studies involving both civilians and combat veterans.
Our objective was to report this available pooled data to characterize the
response of this drug in PTSD. Specifically, we looked at response rates using
three different criteria, the effect of nefazodone on each PTSD cluster and
individual symptoms and, lastly, variables that might predict response. One
hundred and five outpatients with chronic PTSD were treated with nefazodone
titrated up to 600 mg/day, 92 of whom were entered in an intent to treat
analysis. We used the percentage drop in score between baseline and endpoint on
main scale as a common measure to evaluate outcome. The response criterion of a
drop in score of at least 30%, 40% and 50% revealed response rates of 46, 36 and
26%, respectively. Nefazodone showed a broad spectrum of action on PTSD
symptoms. This profile might make nefazodone a useful drug to treat PTSD.
Predictors of response include age, sex and trauma type. Double-blind,
placebo-controlled clinical trials in PTSD are in progress to assess the utility
of nefazodone as a treatment in this disorder.
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5-HT2
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PTSD: SSRIs versus Non-SSRIs
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