Sertraline treatment of comorbid posttraumatic stress disorder and alcohol dependence.
BACKGROUND
Posttraumatic stress disorder (PTSD) often co-occurs with alcohol dependence, yet little is known about treatment of this comorbidity. The serotonin selective reuptake inhibitors have been shown preliminarily to be effective in decreasing symptoms of PTSD but have not been studied in individuals with comorbid alcohol dependence. This is of particular interest as the SSRIs also have a modest effect in decreasing alcohol consumption.


METHODS
In this preliminary trial, nine subjects with comorbid PTSD and alcohol dependence were treated in an open-label trial with sertraline for a 12-week period. Symptoms of PTSD and depression were monitored monthly with the Impact of Event Scale and the Hamilton Rating Scale for Depression (HAM-D). Alcohol consumption was monitored by a self-report instrument (Time-Line Follow-Back).


RESULTS
There were significant decreases in all three symptom clusters of PTSD measured by overall PTSD symptom scores (p < or = .001) and in HAM-D scores (p < or = .001) during the follow-up period. Days of abstinence increased and average number of drinks decreased during the follow-up period. Four subjects claimed total abstinence during the follow-up period.


CONCLUSIONS
While limited by small sample size and the open-label, nonblinded study design, this study suggests that sertraline may be useful in the treatment of PTSD complicated by alcoholism. The medication was well tolerated and subjects showed improvement in PTSD symptoms as well as decreased alcohol consumption. A controlled trial of sertraline in this population would be of interest.
Brady
K T
KT
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston 29425, USA.
Sonne
S C
SC
Roberts
J M
JM
D015057:1-Naphthylamine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D000428:Alcohol Drinking / Q000188:drug therapy; D000437:Alcoholism / Q000188:drug therapy* / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D020280:Sertraline; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome
D015057:1-Naphthylamine; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline