title: Effects of Pharmacotherapy on Combat-Related PTSD, Anxiety, and Depression: A Systematic Review and Meta-Regression Analysis.
abstract: OBJECTIVE
  To estimate the effect of pharmacotherapy on PTSD, anxiety, and depression among combat veterans; to determine whether the effects varied according to patient and intervention characteristics; and to examine differential effects of pharmacotherapy on outcomes.
  
  
  METHODS
  Google Scholar, PILOTS, PsycINFO, PubMed, and Web of Science databases were searched through November 2014. Searches resulted in eighteen double-blind, placebo controlled trials of 773 combat veterans diagnosed with PTSD and included only validated pre- and post-intervention PTSD and anxiety or depression measures. Authors extracted data on effect sizes, moderators, and study quality. Hedges' d effect sizes were computed and random effects models estimated sampling error and population variance. The Johnson-Neyman procedure identified the critical points in significant interactions to define regions of significance.
  
  
  RESULTS
  Pharmacotherapy significantly reduced (Δ, 95%CI) PTSD (0.38, 0.23-0.52), anxiety (0.42, 0.30-0.54), and depressive symptoms (0.52, 0.35-0.70). The effects of SSRIs and tricyclic antidepressants on PTSD were greater than other medications independent of treatment duration. The effect of SSRIs and tricyclic antidepressants were greater than other medications up to 5.2 and 13.6 weeks for anxiety and depression, respectively. The magnitude of the effect of pharmacotherapy on concurrently-measured PTSD, anxiety, and depression did not significantly differ.
  
  
  CONCLUSIONS
  Pharmacotherapy reduced PTSD, anxiety, and depressive symptoms in combat veterans. The effects of SSRIs and tricyclic antidepressants were greater for PTSD and occurred quicker for anxiety and depression than other medications.
authors.affiliation: Office of the Director, Clinical Center, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Puetz
authors.affiliation: College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, United States of America; School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona, United States of America; Phoenix VA Health Care System, Phoenix, Arizona, United States of America.
authors.forename: Shawn D
authors.initials: SD
authors.lastname: Youngstedt
authors.affiliation: Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Herring
mesh_terms: D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D001007:Anxiety / Q000175:diagnosis / Q000188:drug therapy*; D003130:Combat Disorders / Q000175:diagnosis / Q000188:drug therapy*; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000188:drug therapy*; D014728:Veterans
chemical_list: D000929:Antidepressive Agents, Tricyclic