Department of Psychiatry, Yale University School of Medicine, West Haven, CT 06516, USA.
Pharmacopsychiatry. 2010 Mar;43(2):45-9. doi: 10.1055/s-0029-1237694. Epub 2009 Dec 15.
Although there is evidence that selective serotonin reuptake inhibitors provide some benefit in the treatment of post-traumatic stress disorder (PTSD), most meta-analytical reviews have concluded that effect sizes are small and, moreover, that there may be relatively little benefit for some populations (e. g., combat veterans with co-morbid major depression, MDD). This study aimed to evaluate the effectiveness and tolerability of the dual reuptake inhibitor duloxetine in the treatment of PTSD and co-morbid MDD.
Twenty-one treatment refractory, male, combat-related patients with PTSD and co-morbid MDD were enrolled in a naturalistic study and twenty completed the trial. Duloxetine was given between 60 and 120 mg daily over 8 weeks.
Duloxetine led to a significant improvement of PTSD-characteristic symptoms as well as co-morbid MDD. Duloxetine effectively reduced nightmares, which is important because decreasing nightmares has been associated with improved sleep in PTSD.
The results of this naturalistic study suggest that duloxetine is an effective and well-tolerated treatment for patients with PTSD and co-morbid MDD. These initial results need to be extended to the study of women with PTSD.
虽然有证据表明选择性 5-羟色胺再摄取抑制剂（SSRIs）在治疗创伤后应激障碍（PTSD）方面有一定益处，但大多数荟萃分析综述的结论是，其疗效较小，而且对于某些人群（例如，伴有共病重度抑郁症的战斗老兵）可能相对益处较小。本研究旨在评估双重再摄取抑制剂度洛西汀治疗 PTSD 合并共病 MDD 的疗效和耐受性。
21 名治疗抵抗的男性战斗相关 PTSD 合并共病 MDD 患者入组一项自然研究，其中 20 名患者完成了试验。度洛西汀在 8 周内每天给予 60-120mg。
度洛西汀显著改善了 PTSD 特征性症状和共病 MDD。度洛西汀有效减少了梦魇，这很重要，因为减少梦魇与 PTSD 中改善睡眠有关。
这项自然研究的结果表明，度洛西汀是治疗 PTSD 合并共病 MDD 患者的一种有效且耐受性良好的治疗方法。这些初步结果需要扩展到 PTSD 女性患者的研究中。
