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Study Suggests Effective Treatment for Vets with Dual Diagnosis of PTSD and Alcohol Dependence

12/15/2011: Despite the relatively common diagnosis of Post Traumatic Stress Disorder (PTSD) and comorbid Alcohol Dependence (AD) among veterans, very little research into effective clinical therapies in these populations has been undertaken. As a result, the efficacy of medications that treat either PTSD or AD in comorbid populations is unclear.

Recent Yale-led research published in Neuropsychopharmacology suggests that despiramine, a norepinephrine uptake inhibitor, is as effective as current FDA-approved treatments for PTSD while achieving superior alcohol use outcomes.

Currently the only Food and Drug Administration (FDA) approved medications to treat PTSD are antidepressants that act on the neurotransmitter serotonin.

The study, of predominantly male veterans, compared the efficacy of paroxetine, a serotonin uptake inhibitor and FDA-approved medication for PTSD, with the norepinephrine uptake inhibitor desipramine. It also evaluated the adjunctive efficacy of the FDA-approved alcoholism medication, naltrexone, relative to placebo.

Ismene Petrakis, MD , Professor of Psychiatry at Yale School of Medicine and the lead author of the study remarked, "Until now there has been little data about effective treatments for patients suffering from both PTSD and alcoholism. As more Veterans return home from the wars in Iraq and Afghanistan, many of them with this dual diagnosis, it is important to evaluate the efficacy of alternative therapies. Our study suggests that the use of norepinephrine uptake inhibitors for the treatment of PTSD and Alcohol Dependence among male veterans is promising and that further exploration is warranted." Dr. Petrakis also serves as Chief of Psychiatry at the VA Connecticut Healthcare System.

Other Yale-affiliated authors on the study include Elizabeth Ralevski, Louis Trevisan, Ralitza Gueorguieva, Bruce Rounsaville, and John Krystal.

For more information:

Noradrenergic vs Serotonergic Antidepressant with or without Naltrexone for Veterans with PTSD and Comorbid Alcohol Dependence

Ismene Petrakis, MD