Open Trial of Nefazodone for Combat-Related Posttraumatic Stress Disorder
J Clin Psychiatry 1998;59(9):460-464
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Because of its ability to block 5-HT2 receptors
postsynaptically and inhibit 5-HT reuptake presynaptically and/or its enhancement of sleep
quality, nefazodone may be useful for symptom management in posttraumatic stress disorder
Method: Ten patients with combat-related DSM-IV posttraumatic stress
disorder (PTSD) entered an open-label 12-week trial of nefazodone with a 4-week follow-up,
beginning with 100 mg/day and increasing as necessary to achieve a maximal response or
until reaching a maximum dosage of 600 mg/day.
Results: Nefazodone was well tolerated, and no significant changes in
sexual function were reported. Based on Clinical Global Impressions-Improvement scores,
all 10 patients were rated as much improved. All PTSD symptoms (except self-reported PTSD
reexperiencing symptoms), sleep, and clinician-rated depression significantly improved at
week 12. At follow-up, significant changes were maintained, and self-reported PTSD
reexperiencing symptoms had also significantly improved. Effect sizes for all changed
symptoms were moderate to large at week 12 and at follow-up. Self-reported and
clinician-rated anger significantly improved. Self-reported depression failed to improve.
Improvement in social and occupational functioning was minimal.
Conclusion: These preliminary data suggest that nefazodone may be
effective in reducing the 3 primary PTSD symptom clusters and may be particularly helpful
in improving sleep and decreasing anger.