- Patients with posttraumatic stress disorder (PTSD) improved with either sertraline (Zoloft) or prolonged exposure therapy in this doubly randomized preference trial.
- Prolonged exposure achieved better results by some measures.
- Patients had greater benefits when receiving their preferred treatment.
Why this matters
- This is the largest randomized trial directly comparing cognitive behavioral therapy with a selective serotonin reuptake inhibitor in people with PTSD.
- Preference trial (PTSD, n=200).
- Choice of treatment, n=97.
- No choice of treatment, n=103.
- Choice of treatment (prolonged exposure, n=61; sertraline, n=36).
- No choice of treatment (prolonged exposure, n=55; sertraline, n=48).
- Funding: National Institute of Mental Health; others.
- Prolonged exposure (psychotherapy sessions, 10 weekly 90-120-minute sessions) was preferred over sertraline treatment:
- 61% vs 39%; number needed to treat (NNT), 4.5 (P<.01>
- Symptoms declined at a slower rate with sertraline (group differences were moderate); declines over time for the whole cohort were significant:
- PTSD severity: P<.001>
- depression: P=.02;
- state anxiety: P<.001 and>
- Sheehan Disability Scale: P=.006.
- No placebo group.
Coauthored with Chitra Ravi, MPharm