Augmentation of sertraline with prolonged exposure in the treatment of posttraumatic stress disorder

Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30329, USA.
Journal of Traumatic Stress (Impact Factor: 2.72). 10/2006; 19(5):625-38. DOI: 10.1002/jts.20170
Source: PubMed


The present study was designed to determine whether augmenting sertraline with prolonged exposure (PE) would result in greater improvement than continuation with sertraline alone. Outpatient men and women with chronic PTSD completed 10 weeks of open label sertraline and then were randomly assigned to five additional weeks of sertraline alone (n = 31) or sertraline plus 10 sessions of twice-weekly PE (n = 34). Results indicated that sertraline led to a significant reduction in PTSD severity after 10 weeks but was associated with no further reductions after five more weeks. Participants who received PE showed further reduction in PTSD severity. This augmentation effect was observed only for participants who showed a partial response to medication.

Download full-text


Available from: Shawn P Cahill,
68 Reads
  • Source
    • "However, controlled studies investigating the efficacy of this combined treatment strategy are scarce. Rothbaum et al. (2006) examined the effect of adding prolonged exposure (PE; Foa & Rothbaum, 1998) for SSRI non-responders. PTSD patients were provided with 10 weeks of open-label sertraline and those who did not remit were then randomized to either receive five additional weeks of sertraline alone or with 10 sessions of twice weekly PE. "
    [Show abstract] [Hide abstract]
    ABSTRACT: There is a good amount of evidence that exposure therapy is an effective treatment for posttraumatic stress disorder (PTSD). Notwithstanding its efficacy, there is room for improvement, since a large proportion of patients does not benefit from treatment. Recently, an interesting new direction in the improvement of exposure therapy efficacy for PTSD emerged. Basic research found evidence of the pharmacological enhancement of the underlying learning and memory processes of exposure therapy. The current review aims to give an overview of clinical studies on pharmacological enhancement of exposure-based treatment for PTSD. The working mechanisms, efficacy studies in PTSD patients, and clinical utility of four different pharmacological enhancers will be discussed: d-cycloserine, MDMA, hydrocortisone, and propranolol.
    European Journal of Psychotraumatology 10/2013; 4. DOI:10.3402/ejpt.v4i0.21626 · 2.40 Impact Factor
  • Source
    • "A recent Cochrane review published this year, found only four published trials of combination treatment and concluded that there was not sufficient evidence at this time to either support or refute the effectiveness of combined psychological and pharmacotherapy (Hetrick et al., 2010). One study demonstrated the benefits of psychotherapy augmentation in patients who have had a partial response to pharmacotherapy (Rothbaum et al., 2006). "
    Post Traumatic Stress Disorders in a Global Context, 01/2012; , ISBN: 978-953-307-825-0
  • Source
    • "To illustrate this effect, if it is assumed that a pharmacotherapy reduces symptoms of PTSD by 30% and a cognitive-behavioral intervention reduces symptoms by 60%, the combined result could hypothetically reduce symptoms by 90% or more. Though this was the hope of some initial studies of combined treatments (Cohen et al. 2007; Rothbaum et al. 2006), there is currently little evidence demonstrating such efficacy with PTSD patients (Foa et al. 2009). Such lackluster results did not arise from faulty logic or unwarranted hope, and they do not mean that the pursuit of greater treatment efficacy through combined treatments should be abandoned. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Combinations of pharmacologic and psychosocial interventions have garnered much enthusiasm over the past 30 years. Unfortunately, this enthusiasm is often disproportionate to the empirical support for these approaches. However, a new wave of basic, translational, and clinical research has demonstrated that the use of some substances - themselves having little to no therapeutic benefit - may help to increase or potentiate the effectiveness of certain psychological treatments. While these drugs have shown promise in the treatment of other anxiety disorders, they have yet to be thoroughly studied in PTSD populations. This article will describe the movement towards the use of pharmacologic substances as adjuncts to psychotherapy and will describe the rationale, initial support, implications, and future directions of their use in the treatment of PTSD.
    Journal of Contemporary Psychotherapy 06/2011; 42(2). DOI:10.1007/s10879-011-9195-z
Show more