Sertraline Treatment of Posttraumatic Stress Disorder: Results of 24 Weeks of Open-Label Continuation Treatment
J Clin Psychiatry 2001;62(5):325-331
© Copyright 2017 Physicians Postgraduate Press, Inc.
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Background: Posttraumatic stress disorder
(PTSD) is typically associated with a high degree of chronicity,
comorbidity, and psychosocial disability. The efficacy of
sertraline in the acute treatment of PTSD has been confirmed
based on the results of 2 large, placebo-controlled studies, but
almost no prospective long-term treatment studies have been
Method: One hundred twenty-eight patients
who completed 12 weeks of double-blind, placebo-controlled,
acute-phase treatment for DSM-III-R-defined PTSD with sertraline
were continued into a 24-week open-label continuation phase.
Efficacy was evaluated using the endpoint change in the 17-item
Clinician Administered PTSD Scale Part 2 (CAPS-2) severity score,
the 15-item patient-rated Impact of Event Scale, and the Clinical
Global Impressions-Improvement and -Severity of Illness scales as
primary outcome measures. Treatment response was defined as >=
30% decrease in the CAPS-2 total severity score (compared with
acute-phase baseline score) and a Clinical Global
Impressions-Improvement score of 1 or 2.
Results: Ninety-two percent of acute-phase
responders maintained their response during the full 6 months of
continuation treatment. In addition, 54% of acute-phase
nonresponders converted to responder status during continuation
therapy. Over the 36-week course of acute and continuation
therapy, 20% to 25% of the improvement in the CAPS-2 severity
score occurred during the continuation phase. Sertraline was well
tolerated, with 8.6% of patients discontinuing due to adverse
events. A high pretreatment CAPS-2 score (> 75) predicted a
longer time to response and a greater likelihood that response
occurred after 12 weeks of acute treatment.
Conclusion: The acute efficacy of sertraline is
sustained in the vast majority of patients, and at least half of
nonresponders to acute treatment will eventually respond to