Sertraline treatment of posttraumatic stress disorder: Results of 24 weeks of open-label continuation treatment

P. D. Londborg, M. T. Hegel, S. Goldstein, D. Goldstein, J. M. Himmelhoch, Richard J Maddock, W. M. Patterson, J. Rausch, G. M. Farfel

Research output: Contribution to journalArticle

110 Scopus citations

Abstract

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 reported. 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 continued treatment.

Original languageEnglish (US)
Pages (from-to)325-331
Number of pages7
JournalJournal of Clinical Psychiatry
Volume62
Issue number5
StatePublished - 2001
Externally publishedYes

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

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    Londborg, P. D., Hegel, M. T., Goldstein, S., Goldstein, D., Himmelhoch, J. M., Maddock, R. J., Patterson, W. M., Rausch, J., & Farfel, G. M. (2001). Sertraline treatment of posttraumatic stress disorder: Results of 24 weeks of open-label continuation treatment. Journal of Clinical Psychiatry, 62(5), 325-331.