engleski

The Treatment of Acute Posttraumatic Stress Disorder with Fluoxetine

The aims of study were: - to establish, the efficacy, tolerance and the safety of fluoxetine in patients with acute PTSD according DSM IV - to compare improvement of patients treated with cognitive-behavior therapy (CBT) alone, with patients treated with CBT and fluoxetine - to compare efficacy of fluoxetine with efficacy before the treatment. The study included two groups of subjects ; the first comprehended patients with CBT alone and the second patients with CBT and Fluoxetine (combined therapy). Medication was provided in capsules ; the initial dose was 20 mg/d with further option to increase the dose to maximum dose 60 mg/d. In both groups, patients were allowed to take sedative in the evening, in the case of sleep disturbances (Fluzepam a 1.5 or 30 mg). The included patients were refugees, displaced persons and war participants. The patients were of either sex, aged 18-60, of different education and socioeconomic status. In the moment they entered the study, symptoms of acute PTSD should have lasted at least 8 weeks and they had to be in former treatment (before the wash- out period). Patients haven't entered the study if they've had another psychiatric diagnosis except alcoholism. The examination lasted for 12 weeks and during that period we did the psychological assessment and noted the eventual side- effects. The following scales were applied: HAMAS, HMDS, GCI, Civilian Mississippi PTSD and Side-effects Scale. The efficacy of the earlier medication was self-rated by patients and therapists did the psychological assessment. The results showed improvement in both groups, psychological state was statistically better at the end of 12th week compared to the state entering the study. However, patients with combined treatment (CBT plus fluoxetine) had statistically significant score decrement on the rating-scales. Comparing former and present therapy, the results depend on the type and dose of former therapy.

Posttraumatic Stress Disorder; Cognitive-behavior therapy; Fluoxetine

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