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Predictors of response to prolonged exposure, sertraline, and their combination for the treatment of military PTSD

The Journal of Clinical Psychiatry Jun 19, 2021

Rauch SAM, Kim HM, Lederman S, et al. - Researchers aimed at determining the predictors of posttraumatic stress disorder (PTSD) treatment response in a clinical trial comparing (1) prolonged exposure plus placebo (PE + PLB), (2) PE + sertraline (PE + SERT), and (3) sertraline + enhanced medication management (SERT + EMM). Recruitment of 196 veterans with combat-related PTSD (DSM-IV-TR) of at least 3 months’ duration was done between 2012 and 2016 from 4 sites in the 24-week PROlonGed ExpoSure and Sertraline (PROGrESS) clinical trial (assessments at weeks 0 [intake], 6, 12, 24, 36, and 52). Across treatment conditions, (1) greater week 24 PTSD symptom improvement was observed in correlation with longer time since trauma (TST), (2) smaller symptom improvement was observed in correlation with higher baseline pain severity, suggesting a common neuropathologic substrate, and (3) greater improvement was recorded in Hispanic patients vs non-Hispanic patients. Alcohol use was not identified to impede the effectiveness of pharmacotherapy for PTSD.

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