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Abstract:
Although selective serotonin reuptake inhibitors (SSRIs) are routinely prescribed for acute stress disorder and early PTSD and recommended in the VA-DoD best practice guidelines, the efficacy of SSRIs as an early intervention for PTSD in service members returning from war-zone duty has still not been determined. Consequently, this study was designed to conduct a controlled trial of fluoxetine as an early intervention for recently redeployed soldiers, as well as to develop methodologies for understanding the multiple risk factors that may predict outcome. Fluoxetine was selected as the psychopharmacologic agent for this study because it is well tolerated, it has a very favorable cost-benefit advantage as a generic drug, and the fact that it is the only SSRI with at least preliminary studies demonstrating its efficacy in recent-onset, war-related PTSD. Studies focusing on targeting chronic combat-related PTSD with SSRIs have shown mixed results with some small open-label studies suggesting efficacy, while two controlled trials with Vietnam veterans were negative. In a recent study of survivors of war violence in Europe, Israel, and South Africa, fluoxetine was shown to significantly reduce PTSD symptoms. Because in all prior trials there is considerable variability of response to fluoxetine, we plan to examine several predictors of efficacy. We argue that the efficacy of SSRIs for recently redeployed soldiers at risk for chronic PTSD is moderated by multiple personal, deployment, and environmental factors. It is expected that not all subjects will respond to fluoxetine. For those that do not respond to fluoxetine alone, augmentation with either buspirone or buproprion will be offered based on their reasonable tolerability, low cost and the recent findings documenting their utility as adjunctive treatments for depression.
| Limitations: |
 APPROVED FOR PUBLIC RELEASE |
| Description: |
Annual rept. 1 Jul 2010-30 Jun 2011 |
| Pages: |
49 |
| Report Date: |
Jul 2011 |
| Contract Number: |
W81XWH-07-1-0283 |
| Report Number: |
A651455 |
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