Am J Psychiatry 1993; 150:1024-1029
Copyright © 1993 by American Psychiatric Association
Predicting response to amitriptyline in posttraumatic stress disorder
JR Davidson, HS Kudler, WB Saunders, L Erickson, RD Smith, RM Stein, S Lipper, EB Hammett, SL Mahorney and JO Cavenar Jr
Department of Psychiatry, Duke University Medical Center, Durham, NC 27710.
OBJECTIVE: This study evaluated the relation between baseline clinical
phenomena and response to amitriptyline in patients with posttraumatic
stress disorder (PTSD). METHOD: Data were obtained from an 8-week
placebo-controlled, double-blind study of combat veterans. Bivariate and
multivariate statistics were used to evaluate the relations between the
following variables and outcome: age, depression, anxiety, severity of PTSD
symptoms, personality, psychiatric comorbidity, level of exposure to
trauma, and individual symptoms of depression, anxiety, and traumatic
stress. Outcome measures were scores on the Clinical Global Impression
scale, Hamilton Rating Scale for Depression, Hamilton Rating Scale for
Anxiety, and Impact of Event Scale. RESULTS: Drug response was related to
lower baseline levels of depression, neuroticism, combat intensity, anxious
mood, impaired concentration, somatic symptoms, feelings of guilt, and one
intrusion and four avoidance symptoms of PTSD. CONCLUSIONS: The results
demonstrate that response to amitriptyline is related to measures of
depression, anxiety, PTSD, personality, and intensity of combat trauma.
Similar relationships were not observed in the placebo group, suggesting a
specific relationship to the drug.
