THURSDAY, Oct. 6 (HealthDay News) -- New research suggests
certain long-term psychotherapies may do a better job than an
antidepressant in preventing post-traumatic stress disorder (PTSD)
following a traumatic event.
The Israeli research team also found that delaying treatment for
PTSD didn't seem to boost a person's risk of chronic symptoms. "A
delayed intervention is an acceptable option when early clinical
interventions cannot be provided," as might be the case during wars
or disasters, the study authors wrote.
The researchers, from Hadassah University Hospital in Jerusalem,
added that shorter-term treatment approaches that do not first
include patient assessment or diagnosis have
not been shown to prevent PTSD.
In the study, the team recruited 242 patients who had suffered
from a recent traumatic event (an average of about 10 days prior)
and then had experienced subsequent acute stress. The participants
received one of four treatments.
One group received prolonged exposure therapy, which involved
breath control training as they imagined the trauma they had
experienced. Another group went through cognitive training designed
to teach them how to reduce negative thoughts. A third group only
went through prolonged exposure therapy if they still showed signs
of stress disorder problems after five months. Two more groups took
either a placebo medication or the antidepressant Lexapro.
The researchers found that after nine months of follow-up,
between 21 percent and 23 percent of the participants in the groups
that got psychotherapy developed PTSD, while 42 percent and 47
percent of those who took the drug or placebo, respectively,
developed symptoms.
Keith A. Young, director of the Neuropsychiatry Research Program
at the Texas A&M Health Science Center, said in an interview
that he was surprised by the lack of response to Lexapro, although
he believes that may have something to do with doses that he
considered too low. More evidence is needed before mental health
workers should stop prescribing certain kinds of antidepressants
early after traumatic incidents, he said.
Young added that treatments such as prolonged exposure therapy
or cognitive training should be offered to as many people as
possible.
"In the end, it is likely that we will find that a combination of drugs and exposure therapies may be a good option for preventing PTSD," he said.
The study appeared online Oct. 3 in the
Archives of General Psychiatry. It received funding Lundbeck Pharmaceuticals, the manufacturer of Lexapro, the U.S. National Institute of Health and other sources.
More information
There's more on PTSD at the
U.S. National Library of Medicine.