This study assessed the effect of open-label
fluvoxamine treatment for
posttraumatic stress disorder (
PTSD), depressive symptoms, and physiologic arousal to
trauma cues. Baseline psychometric ratings and physiologic assessments of heart rate and blood pressure responses to individualized, taped
trauma scripts were determined for 16 patients with
PTSD and 16 mentally healthy age- and gender-matched control subjects exposed to at least 1 serious
trauma. Patients with
PTSD had greater autonomic reactivity than control subjects at baseline, with physiologic measures correlating with the severity of the
PTSD for the combined groups. Discriminant analyses indicated that systolic blood pressure best classified patients with
PTSD (75% sensitivity) and control subjects (100% specificity), with a stepwise discriminant analysis showing that combined physiologic variables correctly classified 75% of patients with
PTSD and 100% of control subjects. After 10 weeks of
fluvoxamine treatment (100-300 mg/day), patients'
PTSD, depression, and physiologic reactivity improved significantly. Medicated patients with
PTSD could not be distinguished statistically from untreated control subjects in any physiologic measure. This dampening of autonomic reactivity after
drug treatment corroborates subjective measures of improvement, validating the reported efficacy of
fluvoxamine in this open trial.