Sertraline in the Treatment of Co-occurring Alcohol Dependence and Posttraumatic Stress Disorder

Authors

  • Kathleen T. Brady,

    Corresponding author
    1. From The Medical University of South Carolina, Department of Psychiatry, Charleston, South Carolina
      Reprint requests: Dr. Kathleen T. Brady, Medical University of South Carolina, Clinical Neuroscience Division, 67 President Street, PO Box 250861, Charleston, SC 29425; Fax: 843-792-4817; E-mail: bradyk@musc.edu.
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  • Susan Sonne,

    1. From The Medical University of South Carolina, Department of Psychiatry, Charleston, South Carolina
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  • Raymond F. Anton,

    1. From The Medical University of South Carolina, Department of Psychiatry, Charleston, South Carolina
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  • Carrie L. Randall,

    1. From The Medical University of South Carolina, Department of Psychiatry, Charleston, South Carolina
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  • Sudie E. Back,

    1. From The Medical University of South Carolina, Department of Psychiatry, Charleston, South Carolina
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  • Kit Simpson

    1. From The Medical University of South Carolina, Department of Psychiatry, Charleston, South Carolina
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  • This work was supported by National Institute on Alcohol Abuse and Alcoholism Grant P50 AA 10751.

Reprint requests: Dr. Kathleen T. Brady, Medical University of South Carolina, Clinical Neuroscience Division, 67 President Street, PO Box 250861, Charleston, SC 29425; Fax: 843-792-4817; E-mail: bradyk@musc.edu.

Abstract

Background:

Posttraumatic stress disorder (PTSD) frequently co-occurs with alcohol use disorders. This study investigated the use of sertraline, a serotonin reuptake inhibitor, in treating co-occurring symptoms of alcohol dependence and PTSD.

Methods:

A total of 94 individuals with current alcohol dependence and PTSD were randomly assigned to receive sertraline (150 mg/day) or placebo for 12 weeks. Post hoc cluster analysis of baseline characteristics was used to define subgroups of participants.

Results:

There was a significant decrease in alcohol use during the trial in both the sertraline and the placebo groups. Cluster analysis revealed significant medication group by cluster interactions for alcohol-related outcomes. Sertraline-treated participants with less severe alcohol dependence and early-onset PTSD had significantly fewer drinks per drinking day (p < 0.001). For participants with more severe alcohol dependence and later onset PTSD, the placebo group had significantly greater decreases in drinks per drinking day (p < 0.01) and average number of drinks consumed per day (p < 0.05).

Conclusions:

There may be subtypes of alcohol-dependent individuals who respond differently to serotonin reuptake inhibitor treatment. Further investigation of differential responders may lead to improvements in the pharmacological treatment of co-occurring alcohol dependence and PTSD.

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