TABLE 3-1 Alpha-Adrenergic Blockers

Study

Populationa

Arm (N)

Handling of Dropouts and % Completed Tx by Arm

PTSD Outcome Measure

Raskind et al., 2007c

Male, combat

Total (34)d

LOCFe

CAPS-Total

Prazosin (17)

90.0%

PL (17)

92.5%

Raskind et al., 2003

Male, combat

Total (10)f

LOCF

CAPS-Total

Prazosin (5)

100%g

PL (5)

100%

Crossover Study

 

 

 

 

aIn the population column, male alone or female alone denotes that at least 80% of the study population was male or female. If only one trauma type is listed, at least 80% of the study population reported that type of trauma.

bPTSD outcome measure change data were obtained either directly from the study, when provided, or by subtracting data reported at treatment completion (not follow-up data) from baseline data (before treatment began). Average baseline score when reported or when baseline scores for all arms are nearly the same; otherwise, baseline scores listed individually in order of arm.

cStudy focus was sleep and nightmares.

Conclusion: The committee concludes that the evidence is inadequate to determine the efficacy of anticonvulsants in the treatment of PTSD.

Exclusion Notes

Several open-label trials with anticonvulsants have been completed (Berlant, 2004; Berlant and van Kammen, 2002; Clark et al., 1999; Lipper et al., 1986), none of which were included. The committee identified one maintenance study (Connor et al., 2006) on tiagabine that was not included in its assessment of efficacy. This study was an open-label discontinuation study with 29 patients in the open-label portion following 18 responders who were randomized to either treatment or placebo. Patients in the maintenance phase who were randomized to tiagabine generally maintained the benefits obtained during the open-label portion although there was a 40 percent dropout rate compared to a 12.5 percent dropout rate in the placebo group. See Table 3-2 for a summary of the three included clinical trials.



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