Sertraline in the treatment of co-occurring alcohol dependence and posttraumatic stress disorder.
BACKGROUND
Posttraumatic stress disorder (PTSD) frequently co-occurs with alcohol use disorders. This study investigated the use of sertraline, a serotonin reuptake inhibitor, in treating co-occurring symptoms of alcohol dependence and PTSD.


METHODS
A total of 94 individuals with current alcohol dependence and PTSD were randomly assigned to receive sertraline (150 mg/day) or placebo for 12 weeks. Post hoc cluster analysis of baseline characteristics was used to define subgroups of participants.


RESULTS
There was a significant decrease in alcohol use during the trial in both the sertraline and the placebo groups. Cluster analysis revealed significant medication group by cluster interactions for alcohol-related outcomes. Sertraline-treated participants with less severe alcohol dependence and early-onset PTSD had significantly fewer drinks per drinking day (p < 0.001). For participants with more severe alcohol dependence and later onset PTSD, the placebo group had significantly greater decreases in drinks per drinking day (p < 0.01) and average number of drinks consumed per day (p < 0.05).


CONCLUSIONS
There may be subtypes of alcohol-dependent individuals who respond differently to serotonin reuptake inhibitor treatment. Further investigation of differential responders may lead to improvements in the pharmacological treatment of co-occurring alcohol dependence and PTSD.
Brady
Kathleen T
KT
The Medical University of South Carolina, Department of Psychiatry, Charleston, SC 29425, USA. bradyk@musc.edu
Sonne
Susan
S
Anton
Raymond F
RF
Randall
Carrie L
CL
Back
Sudie E
SE
Simpson
Kit
K
D000328:Adult; D000437:Alcoholism / Q000150:complications* / Q000188:drug therapy*; D016000:Cluster Analysis; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D020280:Sertraline / Q000627:therapeutic use*; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000188:drug therapy*; D016896:Treatment Outcome
D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline