Manteghi Ali Akhoundpour, Hebrani Paria, Mortezania Mohammad, Haghighi Mehri Baghban, Javanbakht Arash
From the *Department of Psychiatry, Mashhad University of Medical Sciences, Mashhad, Iran; and †Department of Psychiatry, University of Michigan, Ann Arbor, MI.
J Clin Psychopharmacol. 2014 Apr;34(2):240-3. doi: 10.1097/JCP.0000000000000089.
Posttraumatic stress disorder (PTSD) is a chronic disabling illness, resulting from exposure to extreme traumatic event. Although different pharmacologic agents are suggested for treatment of PTSD, none have been completely effective in eliminating symptoms. The purpose of this study was to assess the use of baclofen as an add-on to citalopram in treatment of PTSD.
In this double-blind clinical trial, 40 Iranian combat veterans with PTSD were randomly assigned to 2 groups. The first group received a combination treatment of 20 to 60 mg/d citalopram and 40 mg/d baclofen, and the second group received 20 to 60 mg/d citalopram plus placebo. Symptom severity was assessed by Clinician-Administered PTSD Scale at the beginning of the study and after 2, 4, 6, and 8 weeks. Global Assessment of Functioning and Hamilton Rating Scale for Anxiety and Depression were also used at the same periods. Data were analyzed with independent t test and paired t test using SPSS software version 13 (IBM, Armonk, NY).
Twenty-three male patients (baclofen group, 13 patients; placebo group, 10 patients) completed the study. Dropout from the treatment was not caused by adverse effects of the new medications in any of the subjects. Baclofen group showed significantly larger improvement in Clinician-Administered PTSD Scale total (P = 0.040), hyperarousal (P = 0.020), and avoidance (0.020) scores, Global Assessment of Functioning score (0.001), depression (P = 0.000), and anxiety (P = 0.000) after 8 weeks of treatment. No intergroup difference was found in improvement of reexperience symptoms (P = 0.740).
Baclofen showed to be an effective add-on to selective serotonin reuptake inhibitors in treatment of PTSD for better symptom recovery and functional improvement.
创伤后应激障碍（PTSD）是一种因暴露于极端创伤事件而导致的慢性致残性疾病。尽管有不同的药物被建议用于治疗PTSD，但尚无一种能完全有效消除症状。本研究的目的是评估巴氯芬作为西酞普兰的附加药物用于治疗PTSD的效果。
在这项双盲临床试验中，40名患有PTSD的伊朗退伍军人被随机分为两组。第一组接受20至60毫克/天西酞普兰和40毫克/天巴氯芬的联合治疗，第二组接受20至60毫克/天西酞普兰加安慰剂治疗。在研究开始时以及2、4、6和8周后，通过临床医生管理的PTSD量表评估症状严重程度。在同一时期还使用了功能总体评估量表以及汉密尔顿焦虑和抑郁评定量表。使用SPSS软件版本13（IBM，阿蒙克，纽约）通过独立t检验和配对t检验对数据进行分析。
23名男性患者（巴氯芬组13名患者；安慰剂组10名患者）完成了研究。在任何受试者中，治疗中断均不是由新药物的不良反应引起的。治疗8周后，巴氯芬组在临床医生管理的PTSD量表总分（P = 0.040）、过度警觉（P = 0.020）和回避（0.020）得分、功能总体评估得分（0.001）、抑郁（P = 0.000）和焦虑（P = 0.000）方面显示出显著更大的改善。在重新体验症状的改善方面未发现组间差异（P = 0.740）。
巴氯芬显示出作为选择性5-羟色胺再摄取抑制剂的附加药物在治疗PTSD方面有效，可实现更好的症状恢复和功能改善。
