Open trial of nefazodone for combat-related posttraumatic stress disorder.

Because of its ability to block 5-HT2 receptors postsynaptically and inhibit 5-HT reuptake presynaptically and/or its enhancement of sleep quality, nefazodone may be useful for symptom management in posttraumatic stress disorder (PTSD) patients.
Ten patients with combat-related DSM-IV posttraumatic stress disorder (PTSD) entered an open-label 12-week trial of nefazodone with a 4-week follow-up, beginning with 100 mg/day and increasing as necessary to achieve a maximal response or until reaching a maximum dosage of 600 mg/day.
Nefazodone was well tolerated, and no significant changes in sexual function were reported. Based on Clinical Global Impressions-Improvement scores, all 10 patients were rated as much improved. All PTSD symptoms (except self-reported PTSD reexperiencing symptoms), sleep, and clinician-rated depression significantly improved at week 12. At follow-up, significant changes were maintained, and self-reported PTSD reexperiencing symptoms had also significantly improved. Effect sizes for all changed symptoms were moderate to large at week 12 and at follow-up. Self-reported and clinician-rated anger significantly improved. Self-reported depression failed to improve. Improvement in social and occupational functioning was minimal.
These preliminary data suggest that nefazodone may be effective in reducing the 3 primary PTSD symptom clusters and may be particularly helpful in improving sleep and decreasing anger.
AuthorsM A Hertzberg, M E Feldman, J C Beckham, S D Moore, J R Davidson
JournalThe Journal of clinical psychiatry (J Clin Psychiatry) Vol. 59 Issue 9 Pg. 460-4 (Sep 1998) ISSN: 0160-6689 [Print] UNITED STATES
PMID9771816 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Antidepressive Agents, Second-Generation
  • Triazoles
  • nefazodone
  • Adult
  • Ambulatory Care
  • Anger (drug effects)
  • Antidepressive Agents, Second-Generation (administration & dosage, adverse effects, therapeutic use)
  • Combat Disorders (diagnosis, drug therapy, psychology)
  • Depressive Disorder (diagnosis, drug therapy, psychology)
  • Drug Administration Schedule
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Personality Inventory
  • Psychiatric Status Rating Scales
  • Sleep (drug effects)
  • Sleep Initiation and Maintenance Disorders (drug therapy, psychology)
  • Treatment Outcome
  • Triazoles (administration & dosage, adverse effects, therapeutic use)

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