scholarly journals Comparative efficacy and acceptability of pharmacological treatments for post-traumatic stress disorder in adults: a network meta-analysis

2017 ◽  
Vol 48 (12) ◽  
pp. 1975-1984 ◽  
Author(s):  
Andrea Cipriani ◽  
Taryn Williams ◽  
Adriani Nikolakopoulou ◽  
Georgia Salanti ◽  
Anna Chaimani ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Meta Analysis ◽  
Dropout Rate ◽  
Pharmacological Intervention ◽  
Cochrane Central Register ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Better Than

AbstractBackgroundGuidelines about post-traumatic stress disorder (PTSD) recommend broad categories of drugs, but uncertainty remains about what pharmacological treatment to select among all available compounds.MethodsCochrane Central Register of Controlled Trials register, MEDLINE, PsycINFO, National PTSD Center Pilots database, PubMed, trial registries, and databases of pharmaceutical companies were searched until February 2016 for double-blind randomised trials comparing any pharmacological intervention or placebo as oral therapy in adults with PTSD. Initially, we performed standard pairwise meta-analyses using a random effects model. We then carried out a network meta-analysis. The main outcome measures were mean change on a standardised scale and all-cause dropout rate. Acute treatment was defined as 8-week follow up.ResultsDesipramine, fluoxetine, paroxetine, phenelzine, risperidone, sertraline, and venlafaxine were more effective than placebo; phenelzine was better than many other active treatments and was the only drug, which was significantly better than placebo in terms of dropouts (odds ratio 7.50, 95% CI 1.72–32.80). Mirtazapine yielded a relatively high rank for efficacy, but the respective value for acceptability was not among the best treatments. Divalproex had overall the worst ranking.ConclusionsThe efficacy and acceptability hierarchies generated by our study were robust against many sources of bias. The differences between drugs and placebo were small, with the only exception of phenelzine. Considering the small amount of available data, these results are probably not robust enough to suggest phenelzine as a drug of choice. However, findings from this review reinforce the idea that phenelzine should be prioritised in future trials in PTSD.

scholarly journals Pharmacotherapy for post-traumatic stress disorder: Systematic review and meta-analysis

2015 ◽  
Vol 206 (2) ◽  
pp. 93-100 ◽  
Author(s):  
Mathew Hoskins ◽  
Jennifer Pearce ◽  
Andrew Bethell ◽  
Liliya Dankova ◽  
Corrado Barbui ◽  
...  
Keyword(s):  
Systematic Review ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Stress Disorder ◽  
Positive Impact ◽  
Meta Analysis ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Post Traumatic

BackgroundPharmacological treatment is widely used for post-traumatic stress disorder (PTSD) despite questions over its efficacy.AimsTo determine the efficacy of all types of pharmacotherapy, as monotherapy, in reducing symptoms of PTSD, and to assess acceptability.MethodA systematic review and meta-analysis of randomised controlled trials was undertaken; 51 studies were included.ResultsSelective serotonin reuptake inhibitors were found to be statistically superior to placebo in reduction of PTSD symptoms but the effect size was small (standardised mean difference −0.23, 95% CI −0.33 to −0.12). For individual pharmacological agents compared with placebo in two or more trials, we found small statistically significant evidence of efficacy for fluoxetine, paroxetine and venlafaxine.ConclusionsSome drugs have a small positive impact on PTSD symptoms and are acceptable. Fluoxetine, paroxetine and venlafaxine may be considered as potential treatments for the disorder. For most drugs there is inadequate evidence regarding efficacy for PTSD, pointing to the need for more research in this area.

scholarly journals Prevalence of suicidality, depression, post-traumatic stress disorder, and anxiety among female sex workers: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Juan Manuel Millan-Alanis ◽  
Farid Carranza-Navarro ◽  
Humberto de León-Gutiérrez ◽  
Paloma C. Leyva-Camacho ◽  
Andrea Fernanda Guerrero-Medrano ◽  
...  
Keyword(s):  
Systematic Review ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Stress Disorder ◽  
Meta Analysis ◽  
Post Traumatic Stress ◽  
Female Sex ◽  
Post Traumatic

The Prevalence of Post-Traumatic Stress Disorder in Birth Parents in Child Protection Services: Systematic Review and Meta-analysis

2021 ◽  
pp. 152483802110484
Author(s):  
Aino Suomi ◽  
Annalese Bolton ◽  
Dave Pasalich
Keyword(s):  
Mental Health ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Child Protection ◽  
Stress Disorder ◽  
Meta Analysis ◽  
Post Traumatic Stress ◽  
Birth Parents ◽  
Child Protection Services ◽  
Post Traumatic

Background Birth parents of children in the statutory child protection system have disproportionally high rates of trauma exposure and mental health problems, however, little is known about the extent to which this population display symptoms of Post-Traumatic Stress Disorder (PTSD) or Complex PTSD. This study provides a systematic review and meta-analysis of the PTSD rates in parent samples involved in the child protection services. Method Articles were identified by searching PSYCINFO, Medline, CINAHL, and PILOTS. The search included terminology pertaining to parents, trauma, and child protective services and we included all peer-reviewed articles that reported a valid measure of PTSD and child protection service involvement. Results Fifteen studies were included in the review with a combined prevalence estimate for PTSD based on 11 studies ( n = 4871) was 26.0% (95% CI 20.0–32.0%) for mothers, and estimate based on three studies ( n = 2606) was 13.0% (95% CI 7.0%–18.0%) for fathers and 23.0% (95% CI 17.0–29.0) for all parents based on 7848 responses. Four studies that did not report prevalence rates, reported sample mean scores for PTSD that were consistently higher than in general population. Factors associated with parents’ PTSD symptoms included mental health co-morbidities, victimization of physical and sexual violence, and perpetration of child abuse. Conclusion There are high rates of PTSD in parents involved in the protective system, thus more targeted efforts are needed to identify and adequately address trauma symptoms of parents as part of child protection interventions.

The Association between COMT Val158Met Polymorphism and the Post-Traumatic Stress Disorder Risk: A Meta-Analysis

2021 ◽  
pp. 1-14
Author(s):  
Mi Su ◽  
Yongyan Song
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Large Scale ◽  
Stress Disorder ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Post Traumatic Stress ◽  
Val158met Polymorphism ◽  
Post Traumatic ◽  
The Impact

<b><i>Background:</i></b> Genetic factors were suggested to have influence on the development of post-traumatic stress disorder (PTSD). The possible association between catechol-O-methyltransferase (<i>COMT</i>) Val158Met polymorphism and PTSD has been evaluated in several studies. But the results were still controversial. Therefore, we conduct this meta-analysis to address these issues. <b><i>Methods:</i></b> The PubMed, EMBASE, Cochrane Library, and Web of Science databases were searched for eligible studies. The pooled odds ratio (OR) with 95% confidence interval (CI) was calculated to estimate the association between <i>COMT</i> Val158Met polymorphism and PTSD. <b><i>Results:</i></b> Five articles including 6 studies with 893 cases and 968 controls were finally included in the present meta-analysis. The pooled analyses did not demonstrate a significant association between the <i>COMT</i> Val158Met polymorphism and PTSD in any of the selected genetic models: allele model (OR = 1.13, 95% CI: 0.97–1.31), dominant model (OR = 1.17, 95% CI: 0.93–1.46), recessive model (OR = 1.44, 95% CI: 0.78–2.66), and additive model (OR = 1.54, 95% CI: 0.85–2.80). Subgroup analyses suggested that the Hardy-Weinberg equilibrium status of genotype distributions could influence the relationship of <i>COMT</i> Val158Met polymorphism and PTSD. <b><i>Conclusions:</i></b> The present meta-analysis suggested that the <i>COMT</i> Val158Met polymorphism may not be associated with the PTSD risk. Further large-scale and population-representative studies are warranted to evaluate the impact of the <i>COMT</i> Val158Met polymorphism on the risk of PTSD.

A randomized clinical trial to assess the efficacy of trial-based cognitive therapy compared to prolonged exposure for post-traumatic stress disorder: preliminary findings

CNS Spectrums ◽  
2020 ◽  
pp. 1-8
Author(s):  
Érica Panzani Duran ◽  
Felipe Corchs ◽  
Andrea Vianna ◽  
Álvaro Cabral Araújo ◽  
Natália Del Real ◽  
...  
Keyword(s):  
Cognitive Therapy ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Dropout Rate ◽  
Dysfunctional Attitudes ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Secondary Outcomes

Abstract Background. Post-traumatic stress disorder (PTSD) is a prevalent mental health condition that is often associated with psychiatric comorbidities and changes in quality of life. Prolonged exposure therapy (PE) is considered the gold standard psychological treatment for PTSD, but treatment resistance and relapse rates are high. Trial-based cognitive therapy (TBCT) is an effective treatment for depression and social anxiety disorder, and its structure seems particularly promising for PTSD. Therefore, we evaluated the efficacy of TBCT compared to PE in patients with PTSD. Methods. Ninety-five patients (77.6% females) who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria for PTSD were randomly assigned to receive either TBCT (n = 44) or PE (n = 51). Patients were evaluated before and after treatment, and at follow-up 3 months after treatment. The primary outcome was improvement in PTSD symptoms as assessed by the Davidson Trauma Scale (DTS). Secondary outcomes were depression, anxiety, and dysfunctional attitudes assessed by the Beck Depression/Anxiety Inventories and Dysfunctional Attitudes Scale, as well as the dropout rate. Results. A significant reduction in DTS scores was observed in both arms, but no significant difference between treatments. Regarding the secondary outcomes, we found significant differences in depressive symptoms in favor of TBCT, and the dropout rate was lower in the TBCT group than the PE group. Conclusion. Our preliminary results suggest that TBCT may be an effective alternative for treating PTSD. Further research is needed to better understand its role and the mechanisms of change in the treatment of this disorder.

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