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Widely-used stress disorder drug not effective: US study
by Rebecca Vesely, Dec 1, 2006
A drug prescribed to treat symptoms of post-traumatic stress disorder (PTSD) is ineffective and causes troubling side effects, according to a US study > released. Guanfacine, a medication used for decades to treat high blood pressure, has previously been shown anecdotally to help with symptoms of PTSD. "It's effectiveness turned out to be zero," said lead study author Dr. Thomas Neylan, medical director of the PTSD treatment program at the San Francisco VA Medical Center.
Guanfacine is one of a handful of drugs used to treat war veterans suffering PTSD symptoms that include flashbacks, emotional numbness, sleep problems, hypervigilance caused by the horrors they endured in battle zones. The drug belongs to a class of medications called alpha-2 agonists, which lower the brain's supply of the neurotransmitter norepinephrine, which is released in the brain during states of excitement. Researchers thought it would help PTSD because the disorder is associated with states in which patients startle easily and experience anxiety. About 20 peer-reviewed studies recommend guanfacine and clonidine, a similar medication, to treat the disorder, Neylan said.
In this first randomized, controlled trial of guanfacine, 63 male and female veterans at four VA medical centers in California and Hawaii with long-standing chronic PTSD participated. About half were given weekly doses of guanfacine during the course of two months week and half received a placebo. At the end of the trial, not only did those who received guanfacine get no relief from PTSD, but they experienced more side effects than the placebo group, including sleepiness, lightheadedness and dry mouth. The findings were published in the American Journal of Psychiatry on Friday. Neylans said the study made him suspect that "clonidine would be somewhat disappointing too" because it works in a similar way to guanfacine. Funding for the study was provided by the US Department of Veterans Affairs.
An estimated 10 to 15 percent of war veterans experience PTSD, including those returning from Iraq and Afganistan. Treatment options today include psychotherapy and the antidepressants Zoloft and Paxil. Another common blood pressure medication called propranolol has shown promise in treating PTSD, but is controversial because it can weaken or alter memories. Researchers at the University of Lille, France, published a study in 2003 indicating that patients given propranolol just after a traumatic event, such as a car crash, later experienced half as many symptoms associated with PTSD. But more research is needed because not everyone responds to every treatment, said William Schlenger, principal scientist with the research group Abt Associates and a PTSD specialist.
Schlenger noted that the subjects of the guanfacine study had long-term PTSD. "It's not surprising the new intervention didn't work," he said.
"What is it about their PTSD that makes it resistant? That it is a very difficult question."
NB: In no way do we recommend Paxil, Zoloft or other SSRI drugs because of the very serious side effects, the Leaflady.