A controlled trial of desipramine in 18 men with posttraumatic stress disorder

Reist, Christopher; Kauffmann, Curtis D.; Haier, Richard J.; Sangdahl, Christopher; DeMet, Edward M.; Chicz-DeMet, Aleksandra; Nelson, James N.

doi:10.1176/ajp.146.4.513

Cited by 163 publications

(8 citation statements)

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“…Data with desipramine are mixed, with one RCT showing significant benefit, which were comparable to paroxetine [970], and the other showing improvements in depression only [995]. While RCTs with the TCAs suggest some benefit with these agents, it appears to be limited.…”

Section: Posttraumatic Stress Disordermentioning

confidence: 99%

Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

et al. 2014

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BackgroundAnxiety and related disorders are among the most common mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated.MethodsThese guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process. Data on the epidemiology, diagnosis, and treatment (psychological and pharmacological) were obtained through MEDLINE, PsycINFO, and manual searches (1980–2012). Treatment strategies were rated on strength of evidence, and a clinical recommendation for each intervention was made, based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines.ResultsThese guidelines are presented in 10 sections, including an introduction, principles of diagnosis and management, six sections (Sections 3 through 8) on the specific anxiety-related disorders (panic disorder, agoraphobia, specific phobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder), and two additional sections on special populations (children/adolescents, pregnant/lactating women, and the elderly) and clinical issues in patients with comorbid conditions.ConclusionsAnxiety and related disorders are very common in clinical practice, and frequently comorbid with other psychiatric and medical conditions. Optimal management requires a good understanding of the efficacy and side effect profiles of pharmacological and psychological treatments.

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Section: Posttraumatic Stress Disordermentioning

confidence: 99%

Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

et al. 2014

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“…Tricyclic antidepressants, which block presynaptic reuptake of serotonin and NE, such as amitriptyline (J. Davidson et al, 1990), imipramine (Kosten, Frank, Dan, McDougle, & Giller, 1991) have demonstrated to be superior to placebo for the treatment of PTSD; although there was also a negative RCT with desipramine (Reist et al, 1989). In another study, paroxetine did not show statistical superiority to desipramine, but desipramine was superior to paroxetine with respect to study retention and alcohol use outcomes (Petrakis et al, 2012).…”

Section: Monoaminergic Systemmentioning

confidence: 99%

Posttraumatic stress disorder: An integrated overview of the neurobiological rationale for pharmacology.

Kelmendi¹,

Adams²,

Southwick³

et al. 2017

Clinical Psychology: Science and Practice

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Thirty years of research on the biology of posttraumatic stress disorder now provides a foundation for hypotheses related to the mechanisms underlying the pharmacotherapy of this disorder. Only two medications, sertraline and paroxetine, are approved by the U.S. Food and Drug Administration for the treatment of PTSD. While these medications are somewhat effective, other treatment mechanisms must be explored to address the unmet need for effective treatment. This article provides a concise summary of advances in our understanding of the neurobiology of PTSD that suggest novel approaches to pharmacotherapy.

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“…This then left 154 full-text articles which were read and 39 were removed as not meeting the inclusion criteria. A total of 115 studies were included for our series of pharmacological reviews ( Figure 1 ); with 49 studies (Baker et al, 1995 ; Brady et al, 2000 , 2005 ; Braun, Greenberg, Dasberg, & Lerer, 1991 ; Butterfield et al, 2001 ; Carey, Suliman, Ganesan, Seedat, & Stein, 2012 ; Connor, Sutherland, Tupler, Malik, & Davidson, 1999 ; Davidson, 2004 ; Davidson et al, 2006 ; Davidson, Brady, Mellman, Stein, & Pollack, 2007 ; Davidson et al, 2005 , 1990 ; Davidson, Rothbaum, & Tucker, 2006 ; Davidson, Rothbaum, van der Kolk, Sikes, & Farfel, 2001 ; Davidson et al, 2003 ; Davis et al, 2008 , 2004 ; Dunlop et al, 2017 ; Feder et al, 2014 ; Friedman, Marmar, Baker, Sikes, & Farfel, 2007 ; Hertzberg et al, 1999 ; Hertzberg, Feldman, Beckham, Kudler, & Davidson, 2000 ; Katz et al, 1994 ; Kosten, Frank, Dan, McDougle, & Giller, 1991 ; Kwako et al, 2015 ; Li et al, 2017 ; Marshall, Beebe, Oldham, & Zaninelli, 2001 ; Marshall et al, 2007 ; Martenyi, Brown, & Caldwell, 2007 ; Martenyi, Brown, Zhang, Prakash, & Koke, 2002 ; Matthew et al, 2011 ; Padala et al, 2006 ; Panahi et al, 2011 ; Pfizer588 – sertraline ; Rasmusson et al, 2017 ; Reist et al, 1989 ; Shalev et al, 2011 ; Shestatzky, Greenberg, & Lerer, 1988 ; SKB627, Bryson, Lawrinson, GJ, & KM, unpublished ; SKB650, Bryson, KE, & Jeffery, unpublished ; Sonne et al, 2006 ; Tucker et al, 2003 , 2007 , 2001 ; van der Kolk et al, 1994 , 2007 ; Villarreal et al, 2016 ; Yeh...…”

Section: Resultsmentioning

confidence: 99%

Pharmacological therapy for post-traumatic stress disorder: a systematic review and meta-analysis of monotherapy, augmentation and head-to-head approaches

Hoskins

Bridges

Sinnerton

et al. 2021

European Journal of Psychotraumatology

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Background: Pharmacological approaches are widely used for post-traumatic stress disorder (PTSD) despite uncertainty over efficacy. Objectives: To determine the efficacy of all pharmacological approaches, including monotherapy, augmentation and head-to-head approaches (drug versus drug, drug versus psychotherapy), in reducing PTSD symptom severity. Method: A systematic review and meta-analysis of randomised controlled trials were undertaken; 115 studies were included. Results: Selective serotonin reuptake inhibitors (SSRIs) were found to be statistically superior to placebo in reduction of PTSD symptoms but the effect size was small (standardised mean difference −0.28, 95% CI −0.39 to −0.17). For individual monotherapy agents compared to placebo in two or more studies, we found small statistically significant evidence for the antidepressants fluoxetine, paroxetine, sertraline, venlafaxine and the antipsychotic quetiapine. For pharmacological augmentation, we found small statistically significant evidence for prazosin and risperidone. Conclusions: Some medications have a small positive effect on reducing PTSD symptom severity and can be considered as potential monotherapy treatments; these include fluoxetine, paroxetine, sertraline, venlafaxine and quetiapine. Two medications, prazosin and risperidone, also have a small positive effect when used to augment pharmacological monotherapy. There was no evidence of superiority for one intervention over another in the small number of head-to-head comparison studies. Tratamiento farmacologico para el trastorno de estres postraumatico: una revision sistematica y metanalisis de monoterapia, potenciacion y abordajes comparativos Antecedentes: Los abordajes farmacológicos se usan ampliamente para el trastorno de estrés postraumático (TEPT) a pesar de su eficacia incierta. Objetivos: Determinar la eficacia de todos los abordajes farmacológicos, incluyendo monoterapia, potenciación y abordajes comparativos (droga versus droga, droga versus psicoterapia), en la reducción de la severidad de los síntomas de TEPT. Método: Se llevó a cabo una revisión sistemática y metanálisis de estudios controlados aleatorizados; se incluyeron 115 estudios. Resultados: Se encontró que los inhibidores selectivos de la recaptación de serotonina (ISRSs) fueron estadísticamente superiores a placebo en la reducción de los síntomas de TEPT, pero el tamaño de efecto fue pequeño (diferencia media estandarizada −0.28, IC 95% −0.39 a −0.17). Para agentes en monoterapia individuales comparados con placebo en dos o más estudios, encontramos para los antidepresivos fluoxetina, paroxetina, sertralina, venlafaxina y el antipsicótico quetiapina una evidencia estadísticamente significativa pequeña. Para la potenciación farmacológica, encontramos para prazosina y risperidona, evidencia estadísticamente significativa pequeña. Conclusiones: Algunos medicamentos tienen un efecto positivo pequeño en la reducción de la severidad de los síntomas de TEPT y pueden ser considerados como potenciales tratamientos en monoterap...

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A controlled trial of desipramine in 18 men with posttraumatic stress disorder

Cited by 163 publications

References 10 publications

Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

Posttraumatic stress disorder: An integrated overview of the neurobiological rationale for pharmacology.

Pharmacological therapy for post-traumatic stress disorder: a systematic review and meta-analysis of monotherapy, augmentation and head-to-head approaches

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