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. 2022 Mar 2;3(3):CD002795.
doi: 10.1002/14651858.CD002795.pub3.

Pharmacotherapy for post traumatic stress disorder (PTSD)

Taryn Williams  1 , Nicole J Phillips  1 , Dan J Stein  1 , Jonathan C Ipser  1
Affiliations

Pharmacotherapy for post traumatic stress disorder (PTSD)

Taryn Williams et al. Cochrane Database Syst Rev. .

Abstract

Background: Posttraumatic stress disorder (PTSD) is a prevalent and disabling disorder. Evidence that PTSD is characterised by specific psychobiological dysfunctions has contributed to a growing interest in the use of medication in its treatment.

Objectives: To assess the effects of medication for reducing PTSD symptoms in adults with PTSD.

Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL; Issue 11, November 2020); MEDLINE (1946-), Embase (1974-), PsycINFO (1967-) and PTSDPubs (all available years) either directly or via the Cochrane Common Mental Disorders Controlled Trials Register (CCMDCTR). We also searched international trial registers. The date of the latest search was 13 November 2020.

Selection criteria: All randomised controlled trials (RCTs) of pharmacotherapy for adults with PTSD.

Data collection and analysis: Three review authors (TW, JI, and NP) independently assessed RCTs for inclusion in the review, collated trial data, and assessed trial quality. We contacted investigators to obtain missing data. We stratified summary statistics by medication class, and by medication agent for all medications. We calculated dichotomous and continuous measures using a random-effects model, and assessed heterogeneity.

Main results: We include 66 RCTs in the review (range: 13 days to 28 weeks; 7442 participants; age range 18 to 85 years) and 54 in the meta-analysis. For the primary outcome of treatment response, we found evidence of beneficial effect for selective serotonin reuptake inhibitors (SSRIs) compared with placebo (risk ratio (RR) 0.66, 95% confidence interval (CI) 0.59 to 0.74; 8 studies, 1078 participants), which improved PTSD symptoms in 58% of SSRI participants compared with 35% of placebo participants, based on moderate-certainty evidence. For this outcome we also found evidence of beneficial effect for the noradrenergic and specific serotonergic antidepressant (NaSSA) mirtazapine: (RR 0.45, 95% CI 0.22 to 0.94; 1 study, 26 participants) in 65% of people on mirtazapine compared with 22% of placebo participants, and for the tricyclic antidepressant (TCA) amitriptyline (RR 0.60, 95% CI 0.38 to 0.96; 1 study, 40 participants) in 50% of amitriptyline participants compared with 17% of placebo participants, which improved PTSD symptoms. These outcomes are based on low-certainty evidence. There was however no evidence of beneficial effect for the number of participants who improved with the antipsychotics (RR 0.51, 95% CI 0.16 to 1.67; 2 studies, 43 participants) compared to placebo, based on very low-certainty evidence. For the outcome of treatment withdrawal, we found evidence of a harm for the individual SSRI agents compared with placebo (RR 1.41, 95% CI 1.07 to 1.87; 14 studies, 2399 participants). Withdrawals were also higher for the separate SSRI paroxetine group compared to the placebo group (RR 1.55, 95% CI 1.05 to 2.29; 5 studies, 1101 participants). Nonetheless, the absolute proportion of individuals dropping out from treatment due to adverse events in the SSRI groups was low (9%), based on moderate-certainty evidence. For the rest of the medications compared to placebo, we did not find evidence of harm for individuals dropping out from treatment due to adverse events.

Authors' conclusions: The findings of this review support the conclusion that SSRIs improve PTSD symptoms; they are first-line agents for the pharmacotherapy of PTSD, based on moderate-certainty evidence. The NaSSA mirtazapine and the TCA amitriptyline may also improve PTSD symptoms, but this is based on low-certainty evidence. In addition, we found no evidence of benefit for the number of participants who improved following treatment with the antipsychotic group compared to placebo, based on very low-certainty evidence. There remain important gaps in the evidence base, and a continued need for more effective agents in the management of PTSD.

PubMed Disclaimer

Conflict of interest statement

Taryn Williams: declares no conflicts of interest outside of her funding from the Medical Research Council of South Africa, SAMRC Unit on Risk & Resilience in Mental Disorders.

Nicole Phillips: receives funding from the Neuroscience Institute’s Fellowship Programme 2021.

Dan J Stein: has received research grants and/or consultancy honoraria from Discovery Vitality, Johnson & Johnson, Lundbeck, Sanofi, Servier, Takeda, and Vistagen.

Jonathan Ipser: none known.

Figures

1
1
Study flow diagram.
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
3
3
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
4
4
Funnel plot of comparison: 13 Comparison 13: SSRIs versus placebo, outcome: 13.1 Clinical Global Impressions scale improvement item (CGI‐I). Note: The left side favours the SSRI arm and the right side favours the placebo arm.
5
5
Funnel plot of comparison: 15 Comparison 13: SSRIs versus placebo, outcome: 15.5 Clinically Administered PTSD Scale (CAPS): reduction of PTSD symptoms. Note: The left side favours the SSRI arm and the right side favours the placebo arm.
1.1
1.1. Analysis
Comparison 1: Alpha‐blockers versus placebo, Outcome 1: Dropout rate due to treatment‐emergent adverse effects
1.2
1.2. Analysis
Comparison 1: Alpha‐blockers versus placebo, Outcome 2: Clinically Administered PTSD Scale (CAPS): reduction of PTSD symptoms
1.3
1.3. Analysis
Comparison 1: Alpha‐blockers versus placebo, Outcome 3: Self‐rated scales
1.4
1.4. Analysis
Comparison 1: Alpha‐blockers versus placebo, Outcome 4: Depression scale (typically Hamilton Depression)
1.5
1.5. Analysis
Comparison 1: Alpha‐blockers versus placebo, Outcome 5: Dropout rate due to any cause
2.1
2.1. Analysis
Comparison 2: Anticonvulsants versus placebo, Outcome 1: Clinical Global Impressions Scale Improvement Item (CGI‐I)
2.2
2.2. Analysis
Comparison 2: Anticonvulsants versus placebo, Outcome 2: Dropout rate due to treatment emergent adverse effects
2.3
2.3. Analysis
Comparison 2: Anticonvulsants versus placebo, Outcome 3: Clinically Administered PTSD Scale (CAPS): reduction of PTSD symptoms
2.4
2.4. Analysis
Comparison 2: Anticonvulsants versus placebo, Outcome 4: Symptom severity: Other measures
2.5
2.5. Analysis
Comparison 2: Anticonvulsants versus placebo, Outcome 5: Self‐rated scales
2.6
2.6. Analysis
Comparison 2: Anticonvulsants versus placebo, Outcome 6: Depression scale (typically Hamilton Depression)
2.7
2.7. Analysis
Comparison 2: Anticonvulsants versus placebo, Outcome 7: Anxiety ‐ Hamilton Anxiety Scale
2.8
2.8. Analysis
Comparison 2: Anticonvulsants versus placebo, Outcome 8: Anxiety ‐ Other scales
2.9
2.9. Analysis
Comparison 2: Anticonvulsants versus placebo, Outcome 9: Sheehan Disability Scale
2.10
2.10. Analysis
Comparison 2: Anticonvulsants versus placebo, Outcome 10: Dropout rate due to any cause
3.1
3.1. Analysis
Comparison 3: Antipsychotics versus placebo, Outcome 1: Clinical Global Impressions Scale Improvement Item (CGI‐I)
3.2
3.2. Analysis
Comparison 3: Antipsychotics versus placebo, Outcome 2: Drop‐out rate due to treatment emergent adverse effects
3.3
3.3. Analysis
Comparison 3: Antipsychotics versus placebo, Outcome 3: Clinically Administered PTSD Scale (CAPS): reduction of PTSD symptoms
3.4
3.4. Analysis
Comparison 3: Antipsychotics versus placebo, Outcome 4: Symptom severity: Other measures
3.5
3.5. Analysis
Comparison 3: Antipsychotics versus placebo, Outcome 5: Self‐rated scales
3.6
3.6. Analysis
Comparison 3: Antipsychotics versus placebo, Outcome 6: Depression Scale (typically Hamilton Depression)
3.7
3.7. Analysis
Comparison 3: Antipsychotics versus placebo, Outcome 7: Anxiety ‐ Hamilton Anxiety Scale
3.8
3.8. Analysis
Comparison 3: Antipsychotics versus placebo, Outcome 8: Sheehan Disability Scale
3.9
3.9. Analysis
Comparison 3: Antipsychotics versus placebo, Outcome 9: Drop‐out rate due to any cause
4.1
4.1. Analysis
Comparison 4: Benzodiazepines versus placebo, Outcome 1: Drop‐out rate due to treatment emergent adverse effects
4.2
4.2. Analysis
Comparison 4: Benzodiazepines versus placebo, Outcome 2: Drop‐out rate due to any cause
5.1
5.1. Analysis
Comparison 5: Dopamine beta‐hydroxylase inhibitors versus placebo, Outcome 1: Drop‐out rate due to treatment emergent adverse effects
5.2
5.2. Analysis
Comparison 5: Dopamine beta‐hydroxylase inhibitors versus placebo, Outcome 2: Clinically Administered PTSD Scale (CAPS): reduction of PTSD symptoms
5.3
5.3. Analysis
Comparison 5: Dopamine beta‐hydroxylase inhibitors versus placebo, Outcome 3: Drop‐out rate due to any cause
6.1
6.1. Analysis
Comparison 6: Ganaxolone versus placebo, Outcome 1: Drop‐out rate due to treatment emergent adverse effects
6.2
6.2. Analysis
Comparison 6: Ganaxolone versus placebo, Outcome 2: Clinically Administered PTSD Scale (CAPS): reduction of PTSD symptoms
6.3
6.3. Analysis
Comparison 6: Ganaxolone versus placebo, Outcome 3: Symptom severity: Other measures
6.4
6.4. Analysis
Comparison 6: Ganaxolone versus placebo, Outcome 4: Self‐rated scales
6.5
6.5. Analysis
Comparison 6: Ganaxolone versus placebo, Outcome 5: Drop‐out rate due to any cause
7.1
7.1. Analysis
Comparison 7: GR205171 versus placebo, Outcome 1: Clinical Global Impressions Scale Improvement Item (CGI‐I)
7.2
7.2. Analysis
Comparison 7: GR205171 versus placebo, Outcome 2: Drop‐out rate due to treatment emergent adverse effects
7.3
7.3. Analysis
Comparison 7: GR205171 versus placebo, Outcome 3: Clinically Administered PTSD Scale (CAPS): reduction of PTSD symptoms
7.4
7.4. Analysis
Comparison 7: GR205171 versus placebo, Outcome 4: Drop‐out rate due to any cause
8.1
8.1. Analysis
Comparison 8: GSK561679 versus placebo, Outcome 1: Clinical Global Impressions Scale Improvement Item (CGI‐I)
9.1
9.1. Analysis
Comparison 9: Hypnotics versus placebo, Outcome 1: Clinically Administered PTSD Scale (CAPS): reduction of PTSD symptoms
9.2
9.2. Analysis
Comparison 9: Hypnotics versus placebo, Outcome 2: Symptom severity: Other measures
9.3
9.3. Analysis
Comparison 9: Hypnotics versus placebo, Outcome 3: Depression Scale (typically Hamilton Depression)
9.4
9.4. Analysis
Comparison 9: Hypnotics versus placebo, Outcome 4: Drop‐out rate due to any cause
10.1
10.1. Analysis
Comparison 10: MAOIs versus placebo, Outcome 1: Drop‐out rate due to treatment emergent adverse effects
10.2
10.2. Analysis
Comparison 10: MAOIs versus placebo, Outcome 2: Self‐rated scales
10.3
10.3. Analysis
Comparison 10: MAOIs versus placebo, Outcome 3: Depression Scale (typically Hamilton Depression)
10.4
10.4. Analysis
Comparison 10: MAOIs versus placebo, Outcome 4: Anxiety ‐ Other scales
10.5
10.5. Analysis
Comparison 10: MAOIs versus placebo, Outcome 5: Drop‐out rate due to any cause
11.1
11.1. Analysis
Comparison 11: NaSSAs versus placebo, Outcome 1: Clinical Global Impressions Scale Improvement Item (CGI‐I)
11.2
11.2. Analysis
Comparison 11: NaSSAs versus placebo, Outcome 2: Drop‐out rate due to treatment emergent adverse effects
11.3
11.3. Analysis
Comparison 11: NaSSAs versus placebo, Outcome 3: Clinically Administered PTSD Scale (CAPS): reduction of PTSD symptoms
11.4
11.4. Analysis
Comparison 11: NaSSAs versus placebo, Outcome 4: Symptom severity: Other measures
11.5
11.5. Analysis
Comparison 11: NaSSAs versus placebo, Outcome 5: Self‐rated scales
11.6
11.6. Analysis
Comparison 11: NaSSAs versus placebo, Outcome 6: Depression Scale (typically Hamilton Depression)
11.7
11.7. Analysis
Comparison 11: NaSSAs versus placebo, Outcome 7: Anxiety ‐ Other scales
11.8
11.8. Analysis
Comparison 11: NaSSAs versus placebo, Outcome 8: Drop‐out rate due to any cause
12.1
12.1. Analysis
Comparison 12: NK‐1 receptor antagonists versus placebo, Outcome 1: Drop‐out rate due to any cause
13.1
13.1. Analysis
Comparison 13: RIMAs versus placebo, Outcome 1: Clinical Global Impressions Scale Improvement Item (CGI‐I)
13.2
13.2. Analysis
Comparison 13: RIMAs versus placebo, Outcome 2: Drop‐out rate due to treatment emergent adverse effects
13.3
13.3. Analysis
Comparison 13: RIMAs versus placebo, Outcome 3: Clinically Administered PTSD Scale (CAPS): reduction of PTSD symptoms
13.4
13.4. Analysis
Comparison 13: RIMAs versus placebo, Outcome 4: Drop‐out rate due to any cause
14.1
14.1. Analysis
Comparison 14: SARIs versus placebo, Outcome 1: Drop‐out rate due to treatment emergent adverse effects
14.2
14.2. Analysis
Comparison 14: SARIs versus placebo, Outcome 2: Clinically Administered PTSD Scale (CAPS): reduction of PTSD symptoms
14.3
14.3. Analysis
Comparison 14: SARIs versus placebo, Outcome 3: Drop‐out rate due to any cause
15.1
15.1. Analysis
Comparison 15: SNRIs versus placebo, Outcome 1: Drop‐out rate due to treatment emergent adverse effects
15.2
15.2. Analysis
Comparison 15: SNRIs versus placebo, Outcome 2: Clinically Administered PTSD Scale (CAPS): reduction of PTSD symptoms
15.3
15.3. Analysis
Comparison 15: SNRIs versus placebo, Outcome 3: Symptom severity: Other measures
15.4
15.4. Analysis
Comparison 15: SNRIs versus placebo, Outcome 4: Self‐rated scales
15.5
15.5. Analysis
Comparison 15: SNRIs versus placebo, Outcome 5: Depression Scale (typically Hamilton Depression)
15.6
15.6. Analysis
Comparison 15: SNRIs versus placebo, Outcome 6: Sheehan Disability Scale
15.7
15.7. Analysis
Comparison 15: SNRIs versus placebo, Outcome 7: Drop‐out rate due to any cause
16.1
16.1. Analysis
Comparison 16: SSRIs versus placebo, Outcome 1: Clinical Global Impressions Scale Improvement Item (CGI‐I)
16.2
16.2. Analysis
Comparison 16: SSRIs versus placebo, Outcome 2: CGI: Individual SSRI agents
16.3
16.3. Analysis
Comparison 16: SSRIs versus placebo, Outcome 3: Drop‐out rate due to treatment emergent adverse effects
16.4
16.4. Analysis
Comparison 16: SSRIs versus placebo, Outcome 4: Drop‐out rate due to treatment emergent adverse effects: Individual SSRI agents
16.5
16.5. Analysis
Comparison 16: SSRIs versus placebo, Outcome 5: Clinically Administered PTSD Scale (CAPS): reduction of PTSD symptoms
16.6
16.6. Analysis
Comparison 16: SSRIs versus placebo, Outcome 6: CAPS: Individual SSRI agents
16.7
16.7. Analysis
Comparison 16: SSRIs versus placebo, Outcome 7: Symptom severity: Other measures
16.8
16.8. Analysis
Comparison 16: SSRIs versus placebo, Outcome 8: Self‐rated scales
16.9
16.9. Analysis
Comparison 16: SSRIs versus placebo, Outcome 9: Depression Scale (typically Hamilton Depression)
16.10
16.10. Analysis
Comparison 16: SSRIs versus placebo, Outcome 10: Anxiety ‐ Hamilton Anxiety Scale
16.11
16.11. Analysis
Comparison 16: SSRIs versus placebo, Outcome 11: Sheehan Disability Scale
16.12
16.12. Analysis
Comparison 16: SSRIs versus placebo, Outcome 12: Drop‐out rate due to any cause
16.13
16.13. Analysis
Comparison 16: SSRIs versus placebo, Outcome 13: Continuation trials
17.1
17.1. Analysis
Comparison 17: TCAs versus placebo, Outcome 1: Clinical Global Impressions Scale Improvement Item (CGI‐I)
17.2
17.2. Analysis
Comparison 17: TCAs versus placebo, Outcome 2: Drop‐out rate due to treatment emergent adverse effects
17.3
17.3. Analysis
Comparison 17: TCAs versus placebo, Outcome 3: Self‐rated scales
17.4
17.4. Analysis
Comparison 17: TCAs versus placebo, Outcome 4: Depression Scale (typically Hamilton Depression)
17.5
17.5. Analysis
Comparison 17: TCAs versus placebo, Outcome 5: Anxiety ‐ Hamilton Anxiety Scale
17.6
17.6. Analysis
Comparison 17: TCAs versus placebo, Outcome 6: Anxiety ‐ Other scales
17.7
17.7. Analysis
Comparison 17: TCAs versus placebo, Outcome 7: Drop‐out rate due to any cause
18.1
18.1. Analysis
Comparison 18: Total effect of medication versus placebo, Outcome 1: Clinical Global Impressions ‐ Improvement (CGI‐I) or similar) scale: no. of responders
18.2
18.2. Analysis
Comparison 18: Total effect of medication versus placebo, Outcome 2: Drop‐out rate due to treatment emergent adverse effects
18.3
18.3. Analysis
Comparison 18: Total effect of medication versus placebo, Outcome 3: Clinically Administered PTSD Scale (CAPS): CAPS Total
18.4
18.4. Analysis
Comparison 18: Total effect of medication versus placebo, Outcome 4: Drop‐out rate due to any cause
19.1
19.1. Analysis
Comparison 19: Head‐to‐head comparisons, Outcome 1: Drop‐out rate due to treatment emergent adverse effects
19.2
19.2. Analysis
Comparison 19: Head‐to‐head comparisons, Outcome 2: Clinician administered scales: Symptom severity
19.3
19.3. Analysis
Comparison 19: Head‐to‐head comparisons, Outcome 3: Comorbid symptoms: Depression
19.4
19.4. Analysis
Comparison 19: Head‐to‐head comparisons, Outcome 4: Comorbid symptoms: Anxiety (Hamilton Anxiety Scale)
20.1
20.1. Analysis
Comparison 20: Subgroup analyses ‐ Methodological criteria, Outcome 1: Single versus multi‐centre trials (CGI‐I: No. of responders)
20.2
20.2. Analysis
Comparison 20: Subgroup analyses ‐ Methodological criteria, Outcome 2: Single versus multi‐centre trials (CAPS: Total score)
20.3
20.3. Analysis
Comparison 20: Subgroup analyses ‐ Methodological criteria, Outcome 3: Industry versus non‐industry funded trials (CGI‐I: No. of responders)
20.4
20.4. Analysis
Comparison 20: Subgroup analyses ‐ Methodological criteria, Outcome 4: Industry versus non‐industry funded trials (CAPS: Total score)
21.1
21.1. Analysis
Comparison 21: Subgroup analyses ‐ Clinical criteria, Outcome 1: Inclusion of major depression vs. non‐inclusion: (CGI‐I: No. of responders)
21.2
21.2. Analysis
Comparison 21: Subgroup analyses ‐ Clinical criteria, Outcome 2: Inclusion of major depression vs. non‐inclusion: (CAPS: Total score)
21.3
21.3. Analysis
Comparison 21: Subgroup analyses ‐ Clinical criteria, Outcome 3: Inclusion of war veterans versus non‐inclusion: (CGI‐I: No. of responders)
21.4
21.4. Analysis
Comparison 21: Subgroup analyses ‐ Clinical criteria, Outcome 4: Inclusion of war veterans versus non‐inclusion: (CAPS: Total score)
22.1
22.1. Analysis
Comparison 22: Sensitivity analyses, Outcome 1: Clinical Global Impressions Scale Improvement Item (CGI‐I): non‐response
22.2
22.2. Analysis
Comparison 22: Sensitivity analyses, Outcome 2: "Worst case" loss to follow up analysis
22.3
22.3. Analysis
Comparison 22: Sensitivity analyses, Outcome 3: "Best case" loss to follow up analysis
See this image and copyright information in PMC

Update of

Comment in

References

References to studies included in this review

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Davidson 2001b {published data only}
    1. Davidson J, Londborg P, Pearlstein T, Rothbaum B, Brady K, Farfel G.Double-blind, randomized, 28-week continuation study of sertraline and placebo in posttraumatic stress disorder. International Journal of Neuropsychopharmacology 2000;3(Suppl 1):292.
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Davidson 2003 {published data only}
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    1. Davis LL, Jewell ME, Ambrose S, Farley J, English B, Bartolucci A, et al.A placebo-controlled study of nefazodone for the treatment of chronic posttraumatic stress disorder: a preliminary study. Journal of Clinical Psychopharmacology 2004;24(3):291-7. [DOI: 10.1097/01.jcp.0000125685.82219.1a] - DOI - PubMed
Davis 2008 {published data only}
    1. Davis LL, Davidson JR, Ward C, Bartolucci A, Bowden CL, Petty F.Divalproex in the treatment of posttraumatic tress disorder: a randomized, double-blind, placebo-controlled trial in a veteran population. Journal of Clinical Psychopharmacology 2008;28(21):84–8. [DOI: 10.1097/jcp.0b013e318160f83b] - DOI - PubMed
Davis 2020 {published data only}
    1. Davis LL, Pilkinton P, Lin C, Parker P, Estes S, Bartolucci A.A randomized, placebo-controlled trial of mirtazapine for the treatment of posttraumatic stress disorder in v eterans. Journal of Clinical Psychiatry 2020;81(6):e1-8. [DOI: 10.4088/JCP.20m13267] - DOI - PubMed
Dowd 2020 {published data only}
    1. Dowd SM, Zalta AK, Burgess HJ, Adkins EC, Valdespino-Hayden Z, Pollack MH.Double-blind randomized controlled study of the efficacy, safety and tolerability of eszopiclone vs placebo for the treatment of patients with post-traumatic stress disorder and insomnia. World Journal of Psychiatry 2020;10(3):21-8. [DOI: 10.5498/wjp.v10.i3.21] - DOI - PMC - PubMed
Dunlop 2017 {published data only}
    1. Dunlop BW, Binder EB, Iosifescu D, Mathew SJ, Neylan TC, Pape JC, et al.Corticotropin-releasing factor receptor 1 antagonism Is ineffective for women with posttraumatic stress disorder. Biological Psychiatry 2017;82(12):866–74. [DOI: ] - PMC - PubMed
Feder 2014 {published data only}
    1. Feder A, Parides MK, Murrough JW, Perez AM, Morgan JE, Saxena S, et al.Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder. A randomized clinical trial. JAMA Psychiatry 2014;71(6):681-8. [DOI: 10.1001/jamapsychiatry.2014.62] - DOI - PubMed
Friedman 2007 {published data only}
    1. Eli Lilly.Unpublished data. Appendix 14 of 2nd consultation draft for the NICE (2005) PTSD guidelines.
    1. Friedman MJ, Marmar CR, Baker DG, Sikes CR, Farfel GM.Randomised, double-blind comparison of sertraline and placebo for posttraumatic stress disorder in a Department of Veterans Affairs setting. Journal of Clinical Psychiatry 2007;68(5):711-20. - PubMed
GSK 29060 627 {published data only}
    1. GSK 29060 627.A 12-week, double-blind, placebo-controlled, parallel group study to assess the efficacy and tolerability of paroxetine in patients suffering from posttraumatic stress disorder (PTSD). https://www.gsk-studyregister.com/en/trial-details/?id=29060/648.
Hamner 2008 {published data only}
    1. Hamner MB, Faldowski RA, Robert S, Ulmer HG, Horner MD, Lorberbaum JP.A preliminary controlled trial of divalproex in posttraumatic stress disorder. Annals of Clinical Psychiatry 2008;21(2):89-94. - PubMed
Hertzberg 1999 {published data only}
    1. Hertzberg MA, Butterfield MI, Feldman ME, Beckham JC, Sutherland SM, Connor KM, et al.A preliminary study of lamotrigine for the treatment of posttraumatic stress disorder. Biological Psychiatry 1999;45(9):1226-9. - PubMed
Hertzberg 2000 {published data only}
    1. Hertzberg MA, Feldman ME, Beckham JC, Kudler HS, Davidson JR.Lack of efficacy for fluoxetine in PTSD: a placebo controlled trial in combat veterans. Annals of Clinical Psychiatry 2000;12(2):101-5. - PubMed
Kaplan 1996 {published data only}
    1. Kaplan Z, Amir M, Swartz M, Levine J.Inositol treatment of posttraumatic stress disorder. Anxiety 1996;2(1):51–2. [DOI: 10.1002/(SICI)1522-7154(1996)2:1<51::AID-ANXI8>3.0.CO;2-G] - DOI - PubMed
Katz 1994 {published data only}
    1. Connor KM, Hidalgo RB, Crockett B, Malik M, Katz RJ, Davidson JR.Predictors of treatment response in patients with posttraumatic stress disorder. Progress in Neuro-Psychopharmacology and Biological Psychiatry 2001;25(2):337–45. - PubMed
    1. Katz RJ, Lott MH, Arbus P, Crocq L, Herlobsen P, Lingjaerde O, et al.Pharmacotherapy of post-traumatic stress disorder with a novel psychotropic. Anxiety 1994;1(4):169–74. [DOI: https://doi.org/10.1002/anxi.3070010404 ] - PubMed
Kosten 1991 {published data only}
    1. Kosten TR, Frank JB, Dan E, McDougle CJ, Giller EL Jr.Pharmacotherapy for posttraumatic stress disorder using phenelzine or imipramine. Journal of Nervous and Mental Disease 1991;179(6):366–70. - PubMed
Li 2017 {published data only}
    1. Li W, Ma Y-B, Yang Q, Li BL, Meng Q-G, Zhang Y.Effect and safety of sertraline for treat posttraumatic stress disorder: a multicenter randomised controlled study. International Journal of Psychiatry in Clinical Practice 2017;21(2):151-5. [DOI: 10.1080/13651501.2017.1291838] - DOI - PubMed
Marshall 2001 {published data only}
    1. Food and Drugs Administration (FDA).Paxil (paroxetine) [NDA 20-031/S-029 Paxil (Paroxetine hydrochloride) tablets; GlaxoSmithKline; Post-traumatic Stress Disorder]. www.accessdata.fda.gov/drugsatfda_docs/nda/2001/20-031S029.pdf (accessed 26 November 2021).
    1. GlaxoSmithKline.A 12 week, double-blind, fixed dose comparison of 20 and 40 mg daily of paroxetine and placebo in Patients suffering from Posttraumatic Stress Disorder (PTSD). GSK - clinical study register [www.gsk-clinicalstudyregister.com]:Study ID: PAR 29060 651 (BRL-02960).
    1. Marshall RD, Beebe KL, Oldham M, Zaninelli R.Efficacy and safety of paroxetine treatment for chronic PTSD: A fixed-dose, placebo-controlled study. American Journal of Psychiatry 2001;158(12):1982-8. - PubMed
Marshall 2007 {published data only}
    1. Marshall R, Blanco C, Lewis-Fernandez R, Simpson B, Lin SH, Garcia W, et al.Randomized controlled trial of paroxetine in adults with chronic PTSD. In: 18th Annual Meeting, International Society for Traumatic Stress Studies, November 7 - 10, Baltimore, MD. 2002.
    1. Marshall RD, Lewis-Fernandez R, Blanco C, Simpson HB, Lin S, Garcia W, et al.A controlled trial of paroxetine for chronic PTSD, dissociation and interpersonal problems in mostly minority adults. Draft manuscript 2004. - PubMed
    1. Marshall RD, Lewis-Fernandez R, Blanco C, Simpson HB, Lin S-H, Vermes D, et al.A controlled trial of paroxetine for chronic PTSD, dissociation, and interpersonal problems in mostly minority adults. Depression and Anxiety 2007;24(2):77–84. [DOI: 10.1002/da] - DOI - PubMed
Martenyi 2002a {published data only}
    1. Martenyi F, Brown EB, Zhang H, Prakash A, Koke SC.Fluoxetine versus placebo in posttraumatic stress disorder. Journal of Clinical Psychiatry 2002;63(3):199-206. - PubMed
Martenyi 2002b {published data only}
    1. Martenyi F, Brown EB, Zhang H, Koke SC, Prakash A.Fluoxetine v. placebo in prevention of relapse in post-traumatic stress disorder. British Journal of Psychiatry 2002;181:315-20. - PubMed
Martenyi 2007 {published data only}
    1. Martenyi F, Brown EB, Caldwell CB.Failed efficacy of fluoxetine in the treatment of posttraumatic stress disorder: results of a fixed-dose, placebo-controlled study. Journal of Clinical Psychopharmacology 2007;27(2):166–70. [DOI: 10.1097/JCP.0b013e31803308ce] - DOI - PubMed
Mathew 2011 {published data only}
    1. Mathew SJ, Vythilingam M, Murrougha JW, Zarate CA, Federa A, Luckenbaugh DA, et al.A selective neurokinin-1 receptor antagonist in chronic PTSD: a randomized, double-blind, placebo-controlled, proof-of-concept trial. European Neuropsychopharmacology 2011;21(3):221–9. - PMC - PubMed
McCall 2018 {published data only}
    1. McCall WV, Youssef N, Branch F, Nolla T, McCloud L, Moraczewski J, et al.A randomized controlled trial (RCT) of prazosin versus placebo for suicidal posttraumatic stress disorder (PTSD) patients with nightmares-a pilot study. Sleep 2018;41(Supplement 1):A351-2. [DOI: 10.1097/JCP.0000000000000968] - DOI - PubMed
McRae 2004 {published data only}
    1. McRae AL, Brady KT, Mellman TA, Sonn SC, Killeen TK, Timmerman MA, et al.Comparison of nefazodone and sertraline for the treatment of posttraumatic stress disorder. Depression and Anxiety 2004;19(3):190–6. [DOI: 10.1002/da.20008] - DOI - PubMed
NCT00659230 {published data only}
    1. NCT00659230.Nepicastat for Posttraumatic Stress Disorder (PTSD) in OIF/OEF Veterans (Nepicastat). clinicaltrials.gov/ct2/show/NCT00659230 (first received 06 May 2008).
NCT01000493 {published data only}
    1. NCT01000493.Orvepitant (GW823296) in adult Post Traumatic Stress Disorder. clinicaltrials.gov/ct2/show/NCT01000493 (first received 23 October 2009).
NCT01681849 {published data only}
    1. NCT01681849.Neural circuits in women with abuse and Posttraumatic Stress Disorder. clinicaltrials.gov/ct2/show/NCT01681849 (first received 10 September 2012).
Padala 2006 {published data only}
    1. Padala PR, Madison J, Monnahan M, Marcil W, Price P, Ramaswamy S, et al.Risperidone monotherapy for post-traumatic stress disorder related to sexual assault and domestic abuse in women. International Clinical Psychopharmacology 2006;21(5):275–80. - PubMed
Panahi 2011 {published data only}
    1. Panahi Y, Moghaddam BR, Sahebkar A, Nazari MA, Beiraghdar F, Karami G, et al.A randomized, double-blind, placebo-controlled trial on the efficacy and tolerability of sertraline in Iranian veterans with post-traumatic stress disorder. Psychological Medicine 2011;41(10):2159–66. [DOI: 10.1017/S0033291711000201] - DOI - PubMed
Pfizer588 {unpublished data only}
    1. Food and Drug Administration (FDA).Review and evaluation of clinical data [Pfizer NDA application: Sertraline (Zoloft) for PTSD]. www.accessdata.fda.gov/drugsatfda_docs/nda/99/19-839S026_Zoloft_Clinr_P1... 1999;(accessed 28 November 2021).
    1. Pfizer.Unpublished data. Appendix 14 of 2nd consultation draft for the NICE (2005) PTSD guidelines.
Pfizer589 {unpublished data only}
    1. Food and Drug Adminstration (FDA).Review and evaluation of clinical data [Pfizer NDA application: Sertraline (Zoloft) for PTSD]. www.accessdata.fda.gov/drugsatfda_docs/nda/99/19-839S026_Zoloft_Clinr_P1... 1999;(accessed 28 November 2021).
    1. Friedman MJ, Marmar CR, Baker DG, Sikes CR, Farfel GM.Randomized, double-blind comparison of sertraline and placebo for posttraumatic stress disorder in a Department of Veterans Affairs setting. Journal of Clinical Psychiatry 2007;68(5):711-20. - PubMed
    1. Pfizer.Unpublished data. Appendix 14 of 2nd consultation draft for the NICE (2005) PTSD guidelines.
Raskind 2018 {published data only}
    1. Raskind MA, Peskind ER, Chow B, Harris C, Davis-Karim A, Holmes HA, et al.Trial of prazosin for post-traumatic stress disorder in military veterans. New England Journal of Medicine 2018;378(6):507-17. [DOI: 10.1056/NEJMoa1507598] - DOI - PubMed
Rasmusson 2017 {published data only}
    1. Rasmusson AM, Marx CE, Jain S, Farfel GM, Tsai J, Sun X, et al.A randomized controlled trial of ganaxolone in posttraumatic stress disorder. Psychopharmacology 2017;234(15):2245–57. [DOI: 10.1007/s00213-017-4649-y] - DOI - PubMed
Reich 2004 {published data only}
    1. Reich DB, Winternitz S, Hennen J, Watts T, Stanculescu C.A preliminary study of risperidone in the treatment of posttraumatic stress disorder related to childhood abuse in women. Journal of Clinical Psychiatry 2004;65(12):1601-5. - PubMed
Reist 1989 {published data only}
    1. Reist C, Kauffmann CD, Chicz Demet A, Chen CC, Demet EM.REM latency, dexamethasone suppression test, and thyroid releasing hormone stimulation test in posttraumatic stress disorder. Progress in Neuropsychopharmacology and Biological Psychiatry 1995;19(3):433-43. - PubMed
    1. Reist C, Kauffmann CD, Haier RJ, Sangdahl C, DeMet EM, Chicz-DeMet A, et al.A controlled trial of desipramine in 18 men with posttraumatic stress disorder. American Journal of Psychiatry 1989;146(4):513-6. - PubMed
Saygin 2002 {published data only}
    1. Saygin MZ, Sungur MZ, Sabol EU, Cetinkaya P.Nefazodone versus sertraline in treatment of posttraumatic stress disorder. Bulletin of Clinical Psychopharmacology 2002;12(1):1-5.
Shestatzky 1988 {published data only}
    1. Shestatzky M, Greenberg D, Lerer B.A controlled trial of phenelzine in posttraumatic stress disorder. Psychiatric Research 1988;24(2):149-55. - PubMed
SKB627 {unpublished data only}
    1. Food and Drug Administration (FDA).NDA 20-031/S-029 Paxil (paroxetine hydrochloride) tablets; GlaxoSmithKline; Post-traumatic Stress Disorder. www.accessdata.fda.gov/drugsatfda_docs/nda/2001/20-031S029.pdf;(accessed 28 November 2021).
    1. GlaxoSmithKline.A 12-week, double-blind, placebo-controlled, parallel group study to assess the efficacy and tolerability of paroxetine in patients suffering from posttraumatic stress disorder (PTSD). GSK - clinical study register [www.gsk-clinicalstudyregister.com]:Study ID: 29060/627.
    1. SmithKline Beecham.Unpublished data. Appendix 14 of 2nd consultation draft for the NICE (2005) PTSD guidelines.
    1. Stein DJ, Davidson J, Seedat S, Beebe K.Paroxetine in the treatment of post-traumatic stress disorder: pooled analysis of placebo-controlled studies. Expert Opinion on Pharmacotherapy 2003;4(10):1829-38. - PubMed
SKB650 {published data only}
    1. SmithKline Beecham.Unpublished data. Appendix 14 of 2nd consultation draft for the NICE (2005) PTSD guidelines.
Smajkic 2001 {published data only}
    1. Smajkic A, Weine S, Djuric-Bijedic Z, Boskailo E, Lewis J, Pavkovic I.Sertraline, paroxetine, and venlafaxine in refugee posttraumatic stress disorder with depression symptoms. Journal of Traumatic Stress 2001;14(3):445-52. - PubMed
Spivak 2006 {published data only}
    1. Spivak B, Strous RD, Shaked G, Shabash E, Kotler M, Weizman A.Reboxetine versus fluvoxamine in the treatment of motor vehicle accident-related posttraumatic stress disorder: a double-blind, fixed-dosage, controlled trial. Journal of Clinical Psychopharmacology 2006;26(2):152–6. [DOI: 10.1097/01.jcp.0000203195.65710.f0] - DOI - PubMed
Tucker 2001 {published data only}
    1. GlaxoSmithKline.A 12-week, double-blind, placebo-controlled, parallel group study to assess the efficacy and tolerability of paroxetine in patients suffering from posttraumatic stress disorder (PTSD). GSK - Clinical Study Register [www.gsk-clinicalstudyregister.com] 2000:Study ID:GSK 29060/648.
    1. Tucker P, Zaninelli R, Yehuda R, Ruggiero L, Dillingham K, Pitts CD.Paroxetine in the treatment of chronic posttraumatic stress disorder: results of a placebo-controlled, flexible-dosage trial. Journal of Clinical Psychiatry 2001;62(11):860-8. - PubMed
Tucker 2003 {published data only}
    1. Tucker P, Potter-Kimball R, Wyatt DB, Parker DE, Burgin C, Jones DE, et al.Can physiologic assessment and side effects tease out differences in PTSD trials? A double-blind comparison of citalopram, sertraline, and placebo. General Psychopharmacology 2003;37(3):135-49. - PubMed
Tucker 2007 {published data only}
    1. Tucker P, Trautman RP, Wyatt DB, Thompson J, Wu SC, Capece JA, et al.Efficacy and safety of topiramate monotherapy in civilian posttraumatic stress disorder: a randomized, double-blind, placebo-controlled study. Journal of Clinical Psychiatry 2007;68(2):201-6. - PubMed
Van der Kolk 1994 {published data only}
    1. Van der Kolk BA, Dreyfuss D, Michaels M, Shera D, Berkowitz R, Fisler R, et al.Fluoxetine treatment in posttraumatic stress disorder. Journal of Clinical Psychiatry 1994;55(12):517-22. - PubMed
Van der Kolk 2007 {published and unpublished data}
    1. Van der Kolk, Spinazzola J, Blaustein M, Hopper J, Hopper E, Korn D, et al.A randomized clinical trial of EMDR, fluoxetine and pill placebo in the treatment of PTSD: treatment effects and long-term maintenance. Draft manuscript 2004. - PubMed
    1. Van der Kolk BA, Spinazzola J, Blaustein ME, Hopper JW, Hopper EK, Korn DL, et al.A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder: treatment effects and long-term maintenance. Journal of Clinical Psychiatry 2007;68(1):37-46. - PubMed
Villarreal 2016 {published data only}
    1. Villarreal G, Hamner MB, Cañive JM, Robert S, Calais LA, Durklaski V, et al.Efficacy of quetiapine monotherapy in posttraumatic stress disorder: a randomized, placebo-controlled trial. American Journal of Psychiatry 2016;173(12):1205-12. [DOI: 10.1176/appi.ajp.2016.15070967] - DOI - PubMed
Yeh 2011 {published data only}
    1. Yeh MS, Mari JJ, Costa MC, Andreoli SB, Bressan RA, Mello MF.A double-blind randomized controlled trial to study the efficacy of topiramate in a civilian sample of PTSD. CNS Neuroscience and Therapeutics 2011;17(5):305–10. [DOI: 10.1111/j.1755-5949.2010.00188.x] - DOI - PMC - PubMed
Zohar 2002 {published data only}
    1. Amital D, Zohar J, Kotler M, Bleich A, Miodovnik H, Nevo A, et al.A placebo-controlled study of sertraline in posttraumatic stress disorder. International Journal of Neuropsychopharmacology 2000;3(Suppl 1):269.
    1. Amital D, Zohar J, Kotler M, Bleich A, Miodovnik H, Nevo A, et al.A placebo-controlled trial pilot study of sertraline in PTSD. In: Annual Meeting of the American Psychiatric Association. American Psychiatric Association, 1999:157.
    1. Zohar J, Amital D, Miodownik C, Kotler M, Bleich A, Lane RM.Double-blind placebo-controlled pilot study of sertraline in military veterans with posttraumatic stress disorder. Journal of Clinical Psychopharmacology 2002;22(2):190-5. - PubMed

References to studies excluded from this review

Aerni 2004 {published data only}
    1. Aerni A, Traber R, Hock C, Roozendaal B, Schelling G, Papassotiropoulos A, et al.Low-dose cortisol for symptoms of posttraumatic stress disorder. American Journal of Psychiatry 2004;161(8):1488-90. - PubMed
Angelidis 2019 {published data only}
    1. Angelidis A, Kyrgiou A, Van der Wee N, Van der Does W, Putman P.P.3.26 Effects of hydrocortisone on cognitive performance and threat-interference under acute stress in highly anxious females. European Neuropsychopharmacology 2019;29(Supplement 2):S698-9. [DOI: ]
Back 2016 {published data only}
    1. Back SE, McCauley JL, Korte KJ, Gros DF, Leavitt V, Gray KM, et al.A double-blind, randomized, controlled pilot trial of N-Acetylcysteine in veterans with posttraumatic stress disorder and substance use disorders. Journal of Clinical Psychiatry 2016;77(11):e1439-46. [DOI: 10.4088/JCP.15m10239] - DOI - PMC - PubMed
Back 2018 {published data only}
    1. Back SE, Flanagan JC, Jones JL, Augur I, Peterson AL, Young-McCaughan S, et al.Doxazosin for the treatment of co-occurring PTSD and alcohol use disorder: design and methodology of a randomized controlled trial in military veterans. Contemporary Clinical Trials 2018;73:8-15. [DOI: 10.1016/j.cct.2018.08.009] - DOI - PMC - PubMed
Bartzokis 2005 {published data only}
    1. Bartzokis G, Lu PH, Turner J, Mintz J, Saunders CS.Adjunctive risperidone in the treatment of chronic combat-related posttraumatic stress disorder. Biological Psychiatry 2005;57(5):474-9. - PubMed
Batki 2014 {published data only}
    1. Batki SL, Pennington DL, Lasher B, Neylan TC, Metzler T, Waldrop A, et al.Topiramate treatment of alcohol use disorder in veterans with PTSD: a randomized controlled pilot trial. Alcoholism: Clinical and Experimental Research 2014;38(8):2169–77. [DOI: ] - PMC - PubMed
Boroughs 2018 {published data only}
    1. Boroughs MS, Ehlinger PP, Batchelder AW, Safren SA, O'Cleirigh C.Posttraumatic stress symptoms and emerging adult sexual minority men: implications for assessment and treatment of childhood sexual abuse. Journal of Traumatic Stress 2018;31(5):665-75. [DOI: 10.1002/jts.22335] - DOI - PMC - PubMed
Borrelli 2019 {published data only}
    1. Borrelli J Jr, Starr A, Downs DL, North CS.Prospective study of the effectiveness of paroxetine on the onset of posttraumatic stress disorder, depression, and health and functional outcomes after trauma. Journal of Orthopaedic Trauma 2019;33(2):e58-e63. [DOI: ] - PubMed
Bountress 2018 {published data only}
    1. Bountress KE, Badour C, Flanagan J, Gilmore AK, Back SE.Treatment of co-occurring posttraumatic stress disorder and substance use: does order of onset influence outcomes? Psychological Trauma: Theory, Research, Practice and Policy 2018;10(6):662-5. [DOI: 10.1037/tra0000309] - DOI - PMC - PubMed
Brady 2005 {published data only}
    1. Brady KT, Sonne S, Anton RF, Randall CL, Back SE, Simpson K.Sertraline in the treatment of co-occurring alcohol dependence and posttraumatic stress disorder. Alcoholism: Clinical and Experimental Research 2005;29(3):395–401. [DOI: 10.1097/01.ALC.0000156129.98265.57] - DOI - PubMed
Bremner 1997 {published data only}
    1. Bremner JD, Innis RB, Ng CK, Staib LH, Salomon RM, Bronen RA, et al.Positron emission tomography measurement of cerebral metabolic correlates of yohimbine administration in combat-related posttraumatic stress disorder. Archives of General Psychiatry 1997;54(3):246-54. - PubMed
Brunet 2018 {published data only}
    1. Brunet A, Saumier D, Liu A, Streiner DL, Tremblay J, Pitman RK.Reduction of PTSD symptoms with pre-reactivation propranolol therapy: a randomized controlled trial. American Journal of Psychiatry 2018;175(5):427-33. [DOI: 10.1176/appi.ajp.2017.17050481] - DOI - PubMed
Buhmann 2018 {published data only}
    1. Buhmann CB, Nordentoft M, Ekstroem M, Carlsson J, Mortensen EL.Long-term treatment effect of trauma-affected refugees with flexible cognitive behavioural therapy and antidepressants. Psychiatry Research 2018;264:217-23. [DOI: 10.1016/j.psychres.2018.03.069] - DOI - PubMed
Coupland 1997 {published data only}
    1. Coupland NJ, Lillywhite A, Bell CE, Potokar JP, Nutt DJ.A pilot controlled study of the effects of flumazenil in posttraumatic stress disorder. Biological Psychiatry 1997;41(9):988-90. - PubMed
Eftekhari 2004 {unpublished data only}
    1. Eftekhari A, Miller H, Zoellner L, Feeny N.Prolonged exposure vs. sertraline: Secondary outcomes in PTSD treatment. In: 20th Annual Meeting, International Society for Traumatic Stress Studies, November 14 - November 18, New Orleans, LA. 2004.
Feder 2021 {published data only}
    1. Feder A, Costi S, Rutter SB, Collins AB, Govindarajulu U, Jha MK, et al.A randomized controlled trial of repeated ketamine administration for chronic posttraumatic stress disorder. American Journal of Psychiatry 2021;178(2):193–202. [DOI: 10.1176/appi.ajp.2020.20050596] - DOI - PubMed
Flanagan 2018 {published data only}
    1. Flanagan JC, Hand A, Jarnecke AM, Moran-Santa Maria MM, Brady KT, Joseph JE.Effects of oxytocin on working memory and executive control system connectivity in posttraumatic stress disorder. Experimental and Clinical Psychopharmacology 2018;26(4):391-402. [DOI: 10.1037/pha0000197] - DOI - PMC - PubMed
Flanagan 2019 {published data only}
    1. Flanagan JC, Allan NP, Calhoun CD, Badour CL, Moran-Santa Maria M, Brady KT, et al.Effects of oxytocin on stress reactivity and craving in veterans with co-occurring PTSD and alcohol use disorder. Experimental and Clinical Psychopharmacology 2019;27(1):45-54. [DOI: ] - PMC - PubMed
Frank 1988 {published data only}
    1. Frank JB, Kosten TR, Giller EL Jr, Dan E.A randomized clinical trial of phenelzine and imipramine for post-traumatic stress disorder. American Journal of Psychiatry 1988;145(10):1289-91. - PubMed
Frijling 2017 {published data only}
    1. Frijling JL.Preventing PTSD with oxytocin: effects of oxytocin administration on fear neurocircuitry and PTSD symptom development in recently trauma-exposed individuals. European Journal of Psychotraumatology 2017;8(1):1302652. [DOI: ] - PMC - PubMed
Frommberger 1998 {published data only}
    1. Frommberger U, Nyberg E, Richter H, Stieglitz RD, Berger M.Paroxetine vs. cognitive-behavioral therapy in the treatment of depression in PTSD patients. In: XXIst Collegium Internationale Neuro psychopharmacologicum, Glasgow, Scotland. 12th 16th July. 1998.
Gelpin 1996 {published data only}
    1. Gelpin E, Bonne O, Peri T, Brandes D, Shalev AY.Treatment of recent trauma survivors with benzodiazepines: a prospective study. Journal of Clinical Psychiatry 1996;57(9):390-4. - PubMed
Graham 2018 {published data only}
    1. Graham B, Garcia NM, Burton MS, Cooper AA, Roy-Byrne PP, Mavissakalian MR.High expectancy and early response produce optimal effects in sertraline treatment for post-traumatic stress disorder. British Journal of Psychiatry 2018;213(6):704-8. [DOI: ] - PMC - PubMed
Hamner 1997 {published data only}
    1. Hamner M, Ulmer H, Horne D.Buspirone potentiation of antidepressants in the treatment of PTSD. Depression and Anxiety 1997;5(3):137-9. - PubMed
Hamner 1999 {published data only}
    1. Hamner MB, Ulmer HG, Horne DF, George MS, Arana GW.Procaine administration and behavioral responsivity in post-traumatic stress disorder: a pilot study of tolerability. Human Psychopharmacology 1999;14(2):105-11.
Hamner 2003 {published data only}
    1. Hamner MB, Faldowski RA, Ulmer HG, Frueh BC, Huber MG, Arana GW.Adjunctive risperidone treatment in post-traumatic stress disorder: a preliminary controlled trial of effects on comorbid psychotic symptoms. International Clinical Psychopharmacology 2003;18(1):1-8. - PubMed
Heresco‐Levy 2002 {published data only}
    1. Heresco-Levy U, Kremer I, Javitt DC, Goichman R, Reshef A, Blanaru M, et al.Pilot-controlled trial of D-cycloserine for the treatment of post-traumatic stress disorder. International Journal of Neuropsychopharmacology 2002;5(4):301-7. - PubMed
Inslicht 2018 {published data only}
    1. Inslicht S, Niles A, Metzler T, Milad M, Orr SP, Marmar C, et al.Randomized controlled trial of hydrocortisone and D-cycloserine on fear extinction in PTSD. Biological Psychiatry 2018;83(9 Supplement 1):S352.
Jacobs‐Rebhun 2000 {published data only}
    1. Jacobs-Rebhun S, Schnurr PP, Friedman MJ, Peck R, Brophy M, Fuller D.Posttraumatic stress disorder and sleep difficulty. American Journal of Psychiatry 2000;157(9):1525-6. - PubMed
Kanter 2001 {published data only}
    1. Kanter ED, Wilkinson CW, Radant AD, Petrie EC, Dobie DJ, McFall ME, et al.Glucocorticoid feedback sensitivity and adrenocortical responsiveness in posttraumatic stress disorder. Biological Psychiatry 2001;50(4):238-45. - PubMed
Kellner 2000 {published data only}
    1. Kellner M, Wiedemann K, Yassouridis A, Levengood R, Guo LS, Holsboer F, et al.Behavioral and endocrine response to cholecystokinin tetrapeptide in patients with posttraumatic stress disorder. Biological Psychiatry 2000;47(2):107-11. - PubMed
Le 2018 {published data only}
    1. Le QA, Doctor JN, Zoellner LA, Feeny NC.Effects of treatment, choice, and preference on health-related quality-of-life outcomes in patients with posttraumatic stress disorder (PTSD). Quality of Life Research 2018;27(6):1555-62. [DOI: ] - PubMed
Mello 2009 {published data only}
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Monnelly 2003 {published data only}
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Morgan 1995 {published data only}
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Naylor 2013 {published data only}
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    1. NCT00557622.Clinical evaluation of BRL29060A (paroxetine hydrochloride hydrate) in posttraumatic stress disorder (PTSD). clinicaltrials.gov/ct2/show/record/ NCT00557622 (first received 14 November 2007).
NCT00648375 {published data only}
    1. NCT00648375.Effectiveness of propranolol for treating people with post-traumatic stress disorder. clinicaltrials.gov/ct2/show/record/NCT00648375 (first received 01 April 2008).
NCT00706173 {published data only}
    1. NCT00706173.Trial of hydrocortisone for post-traumatic stress disorder (PTSD). clinicaltrials.gov/ct2/show/record/NCT00706173 (first received 27 June 2008).
NCT01325168 {published data only}
    1. NCT01325168.The effect of intranasal oxytocin on emphatic abilities in patients with post traumatic stress disorder (PTSD). clinicaltrials.gov/ct2/show/record/NCT01325168 (first received 29 March 2011).
NCT01449955 {published data only}
    1. NCT01449955.Rapamycin as a means of interference with reconsolidation of posttraumatic stress disorder-related traumatic memory. clinicaltrials.gov/ct2/show/record/NCT01449955 (first received 10 October 2011).
NCT01477762 {published data only}
    1. NCT01477762.Cortisol suppression and startle responses in posttraumatic stress disorder (PTSD) (CSS). clinicaltrials.gov/ct2/show/record/NCT01477762 (first received 18 April 2017).
NCT01664260 {published data only}
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Neylan 2006 {published data only}
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References to studies awaiting assessment

Davis 2003 {published data only}
    1. Davis L, Petty F.GABAergic modulation in PTSD and treatment with anticonvulsants. In: In: 19th Annual Meeting, International Society for Traumatic Stress Studies, October 29 - November 1, Chicago, IL. 2003.
Nagy 1996 {unpublished data only}
    1. Nagy LM, Southwick SM, Charney DS.Placebo-controlled trial of fluoxetine in PTSD. In: International Society for Traumatic Stress Studies 12th Annual Meeting, San Francisco, CA, November 11. 1996.
NCT00413296 {published data only}
    1. NCT00413296.Levetiracetam in post-traumatic stress disorder (PTSD). clinicaltrials.gov/ct2/show/record/NCT00413296 (first received 19 December 2006).
NCT00672776 {published data only}
    1. NCT00672776.Effects of Paxil CR on neural circuits in posttraumatic stress disorder (PTSD). clinicaltrials.gov/ct2/show/record/NCT00672776 (first received 06 May 2008).
NCT01517711 {published data only}
    1. NCT01517711.Tramadol Extended-Release (ER) for posttraumatic stress disorder (PTSD). clinicaltrials.gov/ct2/show/record/NCT01517711 (first received 25 January 2012).
NCT02637895 {published data only}
    1. NCT02637895.Vortioxetine for posttraumatic stress disorder. clinicaltrials.gov/ct2/show/record/NCT02637895 (first received 22 December 2015).
NCT02709018 {published data only}
    1. NCT02709018.A controlled trial of losartan in posttraumatic stress disorder (LOSe-PTSD). clinicaltrials.gov/ct2/show/record/NCT02709018 (first received 15 March 2016).
NCT02933606 {published data only}
    1. NCT02933606.Phase II study of BNC210 in PTSD (RESTORE). clinicaltrials.gov/ct2/show/record/NCT02933606 (first received 14 October 2016).

References to ongoing studies

NCT01221792 {published data only}
    1. NCT01221792.Carvedilol versus placebo for treatment in post traumatic stress disorder (PTSD). clinicaltrials.gov/ct2/show/record/NCT01221792 (first received 15 October 2010).

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