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Onset of activity and time to response on individual CAPS-SX17 items in patients treated for posttraumatic stress disorder with venlafaxine XR: A pooled analysis

Onset of activity and time to response on individual CAPS-SX17 items in patients treated for posttraumatic stress disorder with venlafaxine XR: A pooled analysis
Onset of activity and time to response on individual CAPS-SX17 items in patients treated for posttraumatic stress disorder with venlafaxine XR: A pooled analysis
This pooled analysis of data from two randomized, placebo-controlled trials of venlafaxine extended release (ER) assessed onset of activity and time to response on the 17 symptoms of post-traumatic stress disorder (PTSD) listed in DSM-IV and measured by the 17-item Clinician-Administered PTSD Scale (CAPS-SX17). The intent-to-treat (ITT) population comprised 687 patients (placebo, n=347; venlafaxine ER, n=340). Significant (p<0.05) separation between venlafaxine ER and placebo was observed on most CAPS-SX17 items, with earliest onset of activity and response (week 2) on items 5 (physiological reactivity on exposure to cues) and 14 (irritability or anger outbursts), and (week 4) items 1 (intrusive recollections) and 4 (psychological distress at exposure to cues). Onset of activity and response occurred later (generally, weeks 6-8) on items 9 (diminished interest/participation in activities), 10 (detachment or estrangement), 11 (restricted range of affect), 12 (sense of foreshortened future), all associated with numbing, 15 (difficulty concentrating), 16 (hypervigilance), 17 (exaggerated startle response), associated with hyperarousal, and 6 (avoidance of thoughts/feelings or conversations). Significant differences between venlafaxine ER and placebo were largely absent throughout the treatment period and at the primary week-12 end-point for items 2 (distressing dreams), 7 (avoidance of activities, places or people), 8 (inability to recall important aspect of trauma) and 13 (difficulty falling/staying asleep). These results indicate that symptoms of physiological reactivity and psychological distress in response to cues, and irritability/anger outbursts show early and robust improvement with venlafaxine ER treatment, while symptoms of numbing and hyperarousal take longer. The early and persistent effect of venlafaxine ER over placebo on anger/irritability is noteworthy in view of the clinical significance of these symptoms in PTSD.
venlafaxine, pooled analysis, stress
367-367
Stein, D.J.
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Rothbaum, B.O.
6899f274-4948-49e3-8377-6be800f7cde3
Baldwin, D.S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Tan, X.W.
bb76be8f-1c59-4cdb-a8f6-b4bacf42c432
Ahmed, S.
8946ec30-34fd-4a8a-b3e9-89f326b57251
Musgnung, J.
f1de9630-0480-418b-8da6-b40ab16cd775
Pedersen, R.
5da51cec-d52d-471e-abf8-b00a1a700376
Davidson, J.
f1dbeede-aa1e-4f10-967b-3029c7c0d38d
Stein, D.J.
908f8238-f5e4-4ea1-9f19-9be45feea5b6
Rothbaum, B.O.
6899f274-4948-49e3-8377-6be800f7cde3
Baldwin, D.S.
1beaa192-0ef1-4914-897a-3a49fc2ed15e
Tan, X.W.
bb76be8f-1c59-4cdb-a8f6-b4bacf42c432
Ahmed, S.
8946ec30-34fd-4a8a-b3e9-89f326b57251
Musgnung, J.
f1de9630-0480-418b-8da6-b40ab16cd775
Pedersen, R.
5da51cec-d52d-471e-abf8-b00a1a700376
Davidson, J.
f1dbeede-aa1e-4f10-967b-3029c7c0d38d

Stein, D.J., Rothbaum, B.O., Baldwin, D.S., Tan, X.W., Ahmed, S., Musgnung, J., Pedersen, R. and Davidson, J. (2007) Onset of activity and time to response on individual CAPS-SX17 items in patients treated for posttraumatic stress disorder with venlafaxine XR: A pooled analysis. Depression and Anxiety, 24 (5), 367-367.

Record type: Article

Abstract

This pooled analysis of data from two randomized, placebo-controlled trials of venlafaxine extended release (ER) assessed onset of activity and time to response on the 17 symptoms of post-traumatic stress disorder (PTSD) listed in DSM-IV and measured by the 17-item Clinician-Administered PTSD Scale (CAPS-SX17). The intent-to-treat (ITT) population comprised 687 patients (placebo, n=347; venlafaxine ER, n=340). Significant (p<0.05) separation between venlafaxine ER and placebo was observed on most CAPS-SX17 items, with earliest onset of activity and response (week 2) on items 5 (physiological reactivity on exposure to cues) and 14 (irritability or anger outbursts), and (week 4) items 1 (intrusive recollections) and 4 (psychological distress at exposure to cues). Onset of activity and response occurred later (generally, weeks 6-8) on items 9 (diminished interest/participation in activities), 10 (detachment or estrangement), 11 (restricted range of affect), 12 (sense of foreshortened future), all associated with numbing, 15 (difficulty concentrating), 16 (hypervigilance), 17 (exaggerated startle response), associated with hyperarousal, and 6 (avoidance of thoughts/feelings or conversations). Significant differences between venlafaxine ER and placebo were largely absent throughout the treatment period and at the primary week-12 end-point for items 2 (distressing dreams), 7 (avoidance of activities, places or people), 8 (inability to recall important aspect of trauma) and 13 (difficulty falling/staying asleep). These results indicate that symptoms of physiological reactivity and psychological distress in response to cues, and irritability/anger outbursts show early and robust improvement with venlafaxine ER treatment, while symptoms of numbing and hyperarousal take longer. The early and persistent effect of venlafaxine ER over placebo on anger/irritability is noteworthy in view of the clinical significance of these symptoms in PTSD.

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Published date: 2007
Keywords: venlafaxine, pooled analysis, stress

Identifiers

Local EPrints ID: 62609
URI: http://eprints.soton.ac.uk/id/eprint/62609
PURE UUID: e79d06ba-0040-4a28-93de-14e4ea52b206
ORCID for D.S. Baldwin: ORCID iD orcid.org/0000-0003-3343-0907

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Date deposited: 10 Sep 2008
Last modified: 12 Dec 2021 02:52

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Contributors

Author: D.J. Stein
Author: B.O. Rothbaum
Author: D.S. Baldwin ORCID iD
Author: X.W. Tan
Author: S. Ahmed
Author: J. Musgnung
Author: R. Pedersen
Author: J. Davidson

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