Abstract
Background: Chronic Post Traumatic Stress Disorder (PTSD) represents a significant and frequent cause of long term disability amongst war veterans. Available estimates suggest that up to 15% of Vietnam War veterans still suffer from PTSD, now some 25 years since the end of the war. This condition has proved relatively refractory, with most forms of treatment showing modest benefits only, once subject to rigorous examination. The pharmacotherapy of Chronic PTSD. Trials of a range of agents including antidepressant medications such as the tricyclics and serotonin specific uptake inhibitors have shown modest and variable benefits beyond treating comorbid depression. It is possible that newer antidepressant medications may prove to have a clearer role in the treatment of PTSD. In the case of Venlafaxine, the combined serotonergic and noradrenergic properties of the compound may result in greater efficacy in chronic PTSD, with particularly action in a broader range of the symptomatology seen in this disorder.
Objective: We aimed to conduct a preliminary examination of the efficacy and tolerability of the serotonin-noradrenaline re-uptake inhibitor in the treatment of Chronic PTSD in war veterans.
Method: We conducted an open label 12 week trial of the use of the serotonin-noradrenaline reuptake inhibitor Venlafaxine in a group of Vietnam Veterans with PTSD. PTSD was diagnosed according to DSMIIIR criteria utilising the Clinician Assisted PTSD Scale (CAPS). Patients were commenced on a dose of 37.5 mg bd of Venlafaxine and the dose increased to a maximum of 375 mg per day depending on response.
Efficacy was monitored by utilising the Clinic Global Impression (CGI), the Montgomery and Asberg Depression Rating Scale (MADRS) and the Impact of Event Scale (IES).
Results: The study has been completed with recruitment of 33 participants, 24 of whom completed the study period. Data is currently undergoing analysis, but initial review suggests that Venlafaxine will be of at least equivalent efficacy to other antidepressant medication utilised in the treatment of PTSD. It is now appropriate that further examination of Venlafaxine's use in this condition be undertaken utilising larger sample size and placebocontrolled double blind methodology take place.