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Value of Most Post-Traumatic Stress Treatments 'Uncertain'
Date:10/18/2007

uld avoid seeking care because care doesn't work -- that's not at all the message of this report," said report co-author Matchar, who is also a professor of medicine at Duke. "It would be a mistake to receive this as a guideline -- it is not a guideline."

The Veterans Administration does have PTSD clinical practice guidelines in place, and they were last revised in 2004, Berg said. Any changes in those guidelines would not only affect veterans suffering from the condition, but a much wider population of patients. According to the experts, seven percent of Americans -- about 20 million people -- can expect to experience some form of PTSD during their lifetime.

In their review of the data, the IOM researchers pored through 53 trials investigating the effectiveness of medications against PTSD, including anticonvulsants, selective serotonin reuptake inhibitors (SSRIs) antidepressants (which include drugs such as Celexa, Paxil, Prozac and Zoloft), monoamine oxidase inhibitors, and certain antipsychotics.

They also looked at 37 studies that focused on the use of psychotherapies against PTSD. Those approaches included exposure therapy, cognitive therapy, coping skills training, and hypnosis.

Only studies involving exposure psychotherapy provided enough quality evidence to support the claim that it can ease PTSD, the researchers said.

All of the other pharmaceutical or behavioral treatments failed to reach that threshold, leaving the IOM team uncertain as to whether or not the therapies might be effective.

Much of that uncertainty was due to a preponderance of poorly conducted or incomplete trials, the experts said.

For example, many studies had participant dropout rates between 20 percent and 50 percent, making it nearly impossible for researchers to draw reliable conclusions.

In other cases, investigators weren't "blinded" as to which patients were getting a particular treatment or not, al
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