Nefazodone in post-traumatic stress disorder: results from six open-label trials

Nefazodone, an antidepressant which blocks serotonin (5-HT)(2) receptors an d 5-HT reuptake, was evaluated in the treatment of post-traumatic stress di sorder (PTSD) in six open-label studies involving both civilians and combat veterans. Our objective was to report this available pooled data to charac terize the response of this drug in PTSD. Specifically, we looked at respon se rates using three different criteria, the effect of nefazodone on each P TSD cluster and individual symptoms and, lastly, variables that might predi ct response. One hundred and five outpatients with chronic PTSD were treate d with nefazodone titrated up to 600 mg/day, 92 of whom were entered in an intent to treat analysis. We used the percentage drop in score between base line and endpoint on main scale as a common measure to evaluate outcome. Th e response criterion of a drop in score of at least 30%, 40% and 50% reveal ed response rates of 46, 36 and 26%, respectively. Nefazodone showed a broa d spectrum of action on PTSD symptoms. This profile might make nefazodone a useful drug to treat PTSD. Predictors of response include age, sex and tra uma type. Double blind, placebo-controlled clinical trials in PTSD are in p rogress to assess the utility of nefazodone as a treatment in this disorder . Int clin Psychopharmacol 14:61-68 (C) 1999 Lippincott Williams & Wilkins.