Antidepressants in the acute treatment of post-traumatic stress disorder in adults: a systematic review and meta-analysis.

Autor:	Guidetti C; Department of Psychiatry, Clinical Trials Network and Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.; Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's hopsital, IRCCS, Rome, Italy., Feeney A; Department of Psychiatry, Clinical Trials Network and Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Hock RS; Department of Psychiatry, Clinical Trials Network and Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Iovieno N; Department of Psychiatry, Clinical Trials Network and Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Hernández Ortiz JM; Department of Psychiatry, Clinical Trials Network and Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Fava M; Department of Psychiatry, Clinical Trials Network and Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Papakostas GI; Department of Psychiatry, Clinical Trials Network and Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	International clinical psychopharmacology [Int Clin Psychopharmacol] 2024 Jun 14. Date of Electronic Publication: 2024 Jun 14.
DOI:	10.1097/YIC.0000000000000554
Abstrakt:	Currently, there are few pharmacotherapy options for clinicians treating post-traumatic stress disorder (PTSD), and antidepressants are usually the medication of choice. This meta-analysis aimed to review the efficacy of antidepressants in the acute treatment of PTSD in adults while investigating the contribution of study design and placebo response to the findings of these studies. Randomized, double-blind, placebo-controlled clinical trials that compared antidepressants with placebo for acute treatment of PTSD were selected. Standardized mean difference (SMD) in change in Clinician-Administered PTSD Scale scores were pooled after examining for heterogeneity. A random-effects meta-analysis was performed. Twenty-nine antidepressant-placebo comparisons, involving 4575 subjects, were analyzed. The SMD among all studies was 0.25, a small to medium effect size, lower than that in studies of antidepressants in adult major depressive disorder. The SMDs for low and high mean placebo responses, were 0.27 and 0.22, respectively. The overall SMD for paroxetine studies was in the moderate range (0.43) and that for sertraline studies was in the small range (0.12). Our findings suggest that antidepressants have modest efficacy in alleviating PTSD symptoms. Patient-level meta-analyses are required to further explore the potential clinical relevance of sertraline for PTSD. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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