Predicting response to amitriptyline in posttraumatic stress disorder.
OBJECTIVE
This study evaluated the relation between baseline clinical phenomena and response to amitriptyline in patients with posttraumatic stress disorder (PTSD).


METHODS
Data were obtained from an 8-week placebo-controlled, double-blind study of combat veterans. Bivariate and multivariate statistics were used to evaluate the relations between the following variables and outcome: age, depression, anxiety, severity of PTSD symptoms, personality, psychiatric comorbidity, level of exposure to trauma, and individual symptoms of depression, anxiety, and traumatic stress. Outcome measures were scores on the Clinical Global Impression scale, Hamilton Rating Scale for Depression, Hamilton Rating Scale for Anxiety, and Impact of Event Scale.


RESULTS
Drug response was related to lower baseline levels of depression, neuroticism, combat intensity, anxious mood, impaired concentration, somatic symptoms, feelings of guilt, and one intrusion and four avoidance symptoms of PTSD.


CONCLUSIONS
The results demonstrate that response to amitriptyline is related to measures of depression, anxiety, PTSD, personality, and intensity of combat trauma. Similar relationships were not observed in the placebo group, suggesting a specific relationship to the drug.
Davidson
J R
JR
Department of Psychiatry, Duke University Medical Center, Durham, NC 27710.
Kudler
H S
HS
Saunders
W B
WB
Erickson
L
L
Smith
R D
RD
Stein
R M
RM
Lipper
S
S
Hammett
E B
EB
Mahorney
S L
SL
Cavenar
J O
JO
D000639:Amitriptyline / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D004311:Double-Blind Method; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011336:Probability; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome
D010919:Placebos; D000639:Amitriptyline