OPEN TRIAL OF NEFAZODONE FOR COMBAT-RELATED POSTTRAUMATIC-STRESS-DISORDER

Background: Because of its ability to block 5-MT2 receptors postsynapt ically and inhibit 5-HT reuptake presynaptically and/or its enhancemen t of sleep quality, nefazodone may be useful for symptom management in posttraumatic stress disorder (PTSD) patients. Method: Ten patients w ith combat-related DSM-IV posttraumatic stress disorder (PTSD) entered an open-label 12-week trial of nefazodone with a C-week follow-up, be ginning with 100 mg/day and increasing as necessary to achieve a maxim al response or until reaching a maximum dosage of 600 mg/day. Results: Nefazodone was well tolerated, and no significant changes in sexual f unction were reported. Based on Clinical Global Impressions-Improvemen t scores, all 10 patients were rated as much improved. All PTSD sympto ms (except self-reported PTSD reexperiencing symptoms), sleep, and cli nician-rated depression significantly improved at week 12. At follow-u p, significant changes were maintained, and self-reported PTSD reexper iencing symptoms had also significantly improved. Effect sizes for all changed symptoms were moderate to large at week 12 and at followup. S elf-reported and clinician-rated anger significantly improved. Self-re ported depression failed to improve. Improvement in social and occupat ional functioning was minimal. Conclusion: These preliminary data sugg est that nefazodone may be effective in reducing the 3 primary PTSD sy mptom clusters and may be particularly helpful in improving sleep and decreasing anger.