title: Prescription Stimulants and PTSD Among U.S. Military Service Members.
abstract: Posttraumatic stress disorder (PTSD) is a prevalent condition among military service members and civilians who have experienced traumatic events. Stimulant use has been postulated to increase the risk of incident PTSD; however, research in this area is lacking. In this study, the association between receipt of prescription stimulants and PTSD was examined in a secondary analysis among active duty U.S. military members (n = 25,971), participating in the Millennium Cohort Study, who completed a baseline (2001-2003) and two follow-up surveys (between 2004-2008). Prescription stimulant data were obtained from the military Pharmacy Data Transaction Service. PTSD was assessed using the PTSD Checklist-Civilian Version and incident PTSD was defined as meeting the criteria at follow-up among those who did not have a history of PTSD at baseline. Overall, 1,215 (4.7%) persons developed new-onset PTSD during follow-up. Receipt of prescription stimulants were significantly associated with incident PTSD, hazard ratio = 5.09, 95% confidence interval [3.05, 8.50], after adjusting for sociodemographic factors, military characteristics, attention-deficit/hyperactivity disorder, baseline mental and physical health status, deployment experiences, and physical/sexual trauma. Findings suggested that prescription stimulants are associated with incident PTSD among military personnel; these data may inform the underlying pathogenesis of and preventive strategies for PTSD.
authors.affiliation: Deployment Health Research Department, Naval Health Research Center, San Diego, California, USA.
authors.forename: Nancy F
authors.initials: NF
authors.lastname: Crum-Cianflone
authors.affiliation: Deployment Health Research Department, Naval Health Research Center, San Diego, California, USA.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Frasco
authors.affiliation: Deployment Health Research Department, Naval Health Research Center, San Diego, California, USA.|The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA.
authors.forename: Richard F
authors.initials: RF
authors.lastname: Armenta
authors.affiliation: Deployment Health Research Department, Naval Health Research Center, San Diego, California, USA.|The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Phillips
authors.affiliation: Deployment Health Research Department, Naval Health Research Center, San Diego, California, USA.
authors.forename: Jaime
authors.initials: J
authors.lastname: Horton
authors.affiliation: Occupational Medicine Department, Naval Hospital Camp Pendleton, Camp Pendleton, California, USA.
authors.forename: Margaret A K
authors.initials: MA
authors.lastname: Ryan
authors.affiliation: Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors.forename: Dale W
authors.initials: DW
authors.lastname: Russell
authors.affiliation: Deployment Health Research Department, Naval Health Research Center, San Diego, California, USA.|The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: LeardMann
mesh_terms: D055826:Afghan Campaign 2001-; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology; D000697:Central Nervous System Stimulants / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D054542:Iraq War, 2003-2011; D008297:Male; D008889:Military Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D055553:Prescription Drugs / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D016016:Proportional Hazards Models; D017678:Sex Distribution; D013313:Stress Disorders, Post-Traumatic / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology*; D014481:United States
chemical_list: D000697:Central Nervous System Stimulants; D055553:Prescription Drugs