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

ABSTRACT 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.


Available from: Shawn P Cahill, May 25, 2015
  • [Show abstract] [Hide abstract]
    ABSTRACT: Control technology has found widespread use in medical applications, including pharmacology and drug dosing. Although mental and behavioural health applications have much in common with these systems, only a few seminal works have applied control technology to inform treatment with non-pharmacological interventions. Herein, a model-based, predictive control strategy is proposed to optimise treatment for post-traumatic stress disorder (PTSD). A mathematical model is developed that captures the dynamic relationship between five PTSD treatments and three commonly-employed PTSD assessment scales. The model supports an adaptive model predictive control strategy in which treatments are scheduled to achieve a therapeutic objective while recurrent assessment scale data are used to adaptively identify the patient model parameters. The model is corroborated against an independent data set, and the efficacy of the adaptive control strategy is demonstrated through Monte-Carlo simulations. While this work represents only a preliminary step towards a quantitative tool for clinical use, the simulated treatment results indicate that the proposed model and control approach could provide valuable insight towards designing personalised intervention schedules that increase treatment adherence, lower treatment costs and provide PTSD patients with more effective care.
    IET Control Theory and Applications 09/2014; 8(13):1196-1206. DOI:10.1049/iet-cta.2013.0615 · 1.84 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Pharmacological treatment is widely used for post-traumatic stress disorder (PTSD) despite questions over its efficacy. Aims To determine the efficacy of all types of pharmacotherapy, as monotherapy, in reducing symptoms of PTSD, and to assess acceptability. Method A systematic review and meta-analysis of randomised controlled trials was undertaken; 51 studies were included. Results Selective serotonin reuptake inhibitors were found to be statistically superior to placebo in reduction of PTSD symptoms but the effect size was small (standardised mean difference -0.23, 95% CI -0.33 to -0.12). For individual pharmacological agents compared with placebo in two or more trials, we found small statistically significant evidence of efficacy for fluoxetine, paroxetine and venlafaxine. Conclusions Some drugs have a small positive impact on PTSD symptoms and are acceptable. Fluoxetine, paroxetine and venlafaxine may be considered as potential treatments for the disorder. For most drugs there is inadequate evidence regarding efficacy for PTSD, pointing to the need for more research in this area. Royal College of Psychiatrists.
    The British journal of psychiatry: the journal of mental science 02/2015; 206(2):93-100. DOI:10.1192/bjp.bp.114.148551 · 7.34 Impact Factor
  • Source
    04/2015; 6. DOI:10.3402/ejpt.v6.27628