Introduction: Posttraumatic stress disorder (PTSD) is an incapacitating clinical syndrome characterized by intrusive recollections, emotional numbing and withdrawal, cue-related responses, and psychological and physiological hyperarousal. In the treatment of PTSD pharmacotherapy must be supported with psychotherapy to increase the success of treatment. In this study we aimed to evaluate the effect of venlafaxine-mirtazapine combination in the PTSD patients, who did not respond to antidepressant treatment at adequate dose for an adequate duration.
Material and Methods: The hospital records of the patients who were diagnosed with PTSD according to DSM-IV diagnostic criteria and did not respond to adequate doses of an antidepressant treatment for adequate duration were examined retrospectively. Data of the patients (n=28), whose treatment were venlafaxine- mirtazapine combination, were obtained. These data were IES-R, Hamilton Anxiety scale and Hamilton Depression Scale scores.
Results: IES-R score, Hamilton Anxiety, Hamilton depression scores of 28 patients who were diagnosed with PTSD were evaluated. A significant decrease in IES-R total, IES-R avoidance, Hamilton Anxiety and Hamilton depression scores (p> 0.05) with adequate dose and duration of venlafaxine-mirtazapine treatment were detected. The same change was not accompanied in IES-R hyperarousal and IES-R intrusive test scores.
Conclusion: Post-traumatic stress disorder treatment takes longer and sometimes becomes chronic. According to the results of this study, venlafaxine- mirtazapine combination can be used in the treatment of PTSD patients who did not respond to antidepressant treatment at adequate doses for an adequate duration.
References:
1. McDougall SJ, Widdop RE, Lawrence AJ (2004) Medial prefrontal cortical integration of psychological stress in rats. Eur J Neurosci; 20: 2430-2440.
2. Radley JJ, Rocher AB, Janssen WG, Hof PR, McEwen BS, Morrison JH (2005) Reversibility of apical dendritic retraction in the rat medial prefrontal cortex following repeated stress. Exp Neurol; [Epub ahead of print].
3. Kylyço?lu A. Stress and effects of brain: A review. New Symposium Journal; July 2007, Volume 45, Yssue 3 Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S175