Treatment of Posttraumatic Stress Disorder With Venlafaxine Extended Release

Davidson, Jonathan; Baldwin, David S.; Stein, Dan J.; Kuper, Enrique; Benattia, I.; Ahmed, Saeed; Pedersen, Ron; Musgnung, Jeff

doi:10.1001/archpsyc.63.10.1158

Cited by 196 publications

(123 citation statements)

References 32 publications

(49 reference statements)

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“…A recent review of PTSD pharmacotherapy indicated that the largest and greatest number of trials showing efficacy have been with the SSRIs (Ipser and Stein, 2012). Venlafaxine, an SNRI, has had positive results in two trials with more than 800 participants with non-combat related PTSD (Davidson, Baldwin, et al, 2006;Davidson, Rothbaum, et al, 2006). PTSD practice guidelines from the Society for Traumatic Stress Studies and the American Psychiatric Association echo the recommendations of the VA/DoD CPG (American Psychiatric Association, 2004;Benedek et al, 2009;Foa, Keane and Friedman, 1999).…”

Section: Research Evidencementioning

confidence: 99%

Quality of Care for PTSD and Depression in the Military Health System: Phase I Report

Hepner¹,

Sloss²,

Roth³

et al. 2016

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This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited. Permission is given to duplicate this document for personal use only, as long as it is unaltered and complete. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial use. For information on reprint and linking permissions, please visit www.rand.org/pubs/permissions.html.The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. RAND is nonprofit, nonpartisan, and committed to the public interest.RAND's publications do not necessarily reflect the opinions of its research clients and sponsors. For more information on this publication, visit www.rand.org/t/RR978 Support RANDPublished by the RAND Corporation, Santa Monica, Calif. © Copyright 2016 RAND CorporationR® is a registered trademark. Cover: U.S. Air Force photo by Senior Airman Tabatha Zarrella iii PrefaceThe U.S. Department of Defense (DoD) strives to maintain a physically and psychologically healthy, mission-ready force, and the care provided by the Military Health System (MHS) is critical to meeting this goal. Given the rates of posttraumatic stress disorder (PTSD) and depression among U.S. service members, attention has been directed to ensuring the quality and availability of programs and services targeting these and other psychological health (PH) conditions. Understanding the current quality of care for PTSD and depression is an important step toward future efforts to improve care across the MHS.To help determine whether the service members with PTSD and/or depression are receiving evidence-based care and whether there are disparities in care quality by branch of service, geographic region, and service member characteristics (e.g., gender, age, pay grade, race/ethnicity, deployment history), DoD's Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) asked the RAND Corporation to conduct a review of the administrative data and medical records of service members diagnosed with PTSD and/or depression and to recommend areas on which the MHS could focus its efforts to continuously improve the quality of care provided to all service members.This report should be of interest to MHS personnel who provide care for service members with PTSD and/or depression. It should also be useful to those responsible for monitoring the quality of that care and developing evidence-based quality measures to improve care for service members and individuals with PTSD or depression in other health systems.This research was sponsored by DCoE and conducted within the Forces and Resources Policy Center of the RAND National Defense Research Institute, a federally funded research and development center sponsored by the Office of ...

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Section: Research Evidencementioning

confidence: 99%

Quality of Care for PTSD and Depression in the Military Health System: Phase I Report

Hepner¹,

Sloss²,

Roth³

et al. 2016

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“…Based on the proposed network model of LC-NE changes in the pathophysiology of anxiety and depression, findings from the preclinical studies and treatment efficacy studies suggest that blocking or attenuating the hyperactive NE system resulting from acute and repeated traumatic stress would be beneficial (e.g., the use of a1 antagonist, b blocker, with benzodiazepine as an adjunct medication to turn down hyperactivity of the NE system). [114] In contrast, in treating chronic stress-induced anxious depression, a facilitation of NE and/or 5-HT functioning (e.g., the use of NRI and SNRI) would be beneficial to normalize NE hypoactivity and this is not associated with exacerbation of anxiety symptoms (Fig. 3).…”

Section: Treatment Implications Of Ne System Dysregulationmentioning

confidence: 99%

Current perspectives of the roles of the central norepinephrine system in anxiety and depression

et al. 2010

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Norepinephrine (NE) is a major monoamine neurotransmitter that has widespread effects across multiple brain areas to regulate arousal and stress responses. The underlying function of the NE cortical system is to balance vigilance/scanning behavior with focused attention on novel environmental stimuli and the state of arousal. The central NE system is involved intrinsically with the stress response system, and dysregulation within the NE system has been implicated in the pathogenesis of anxiety and depressive disorders. Central NE activity paradoxically has either anxiogenic or anxiolytic effects, depending on whether the time course of the stress is acute or chronic, whether the stress is predictable or unpredictable, and which underlying brain regions are affected. Under conditions of chronic stress, NE system activity dysregulation of the hypothalamic-pituitary-adrenal system may turn a homeostatic stress response into a pathological stress response. Data suggest that the NE interplay with the serotonin system may exert neurobiological normalization of the pathophysiological state of anxious depression. Accordingly, pharmacological interventions targeting the NE system can result in anxiolytic, rather than anxiogenic, outcomes when used to treat patients with anxiety and depression. Depression and Anxiety 27:339-350, 2010. r r

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“…Venlafaxine is recommended by the VA/DOD CPG [12] as a first-line treatment for PTSD. Venlafaxine's effectiveness for the treatment of PTSD was demonstrated in a large (N = 329) multinational RCT (Davidson et al [90]). Sleep quality measures were not reported in this study.…”

Section: Antidepressant Agentsmentioning

confidence: 99%

Treatment of sleep disturbances in posttraumatic stress disorder: A review

Schoenfeld

DeViva²,

Manber³

2012

JRRD

218

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Abstract-Sleep disturbances are among the most commonly reported posttraumatic stress disorder (PTSD) symptoms. It is essential to conduct a careful assessment of the presenting sleep disturbance to select the optimal available treatment. Cognitivebehavioral therapies (CBTs) are at least as effective as pharmacologic treatment in the short-term and more enduring in their beneficial effects. Cognitive-behavioral treatment for insomnia and imagery rehearsal therapy have been developed to specifically treat insomnia and nightmares and offer promise for more effective relief of these very distressing symptoms. Pharmacotherapy continues to be an important treatment choice for PTSD sleep disturbances as an adjunct to CBT, when CBT is ineffective or not available, or when the patient declines CBT. Great need exists for more investigation into the effectiveness of specific pharmacologic agents for PTSD sleep disturbances and the dissemination of the findings to prescribers. The studies of prazosin and the findings of its effectiveness for PTSD sleep disturbance are examples of studies of pharmacologic agents needed in this area. Despite the progress made in developing more specific treatments for sleep disturbances in PTSD, insomnia and nightmares may not fully resolve.

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Treatment of Posttraumatic Stress Disorder With Venlafaxine Extended Release

Abstract: In this study, venlafaxine ER was effective and well tolerated in short-term and continuation treatment of patients with posttraumatic stress disorder.

Cited by 196 publications

References 32 publications

Quality of Care for PTSD and Depression in the Military Health System: Phase I Report

Quality of Care for PTSD and Depression in the Military Health System: Phase I Report

Current perspectives of the roles of the central norepinephrine system in anxiety and depression

Treatment of sleep disturbances in posttraumatic stress disorder: A review

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