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1. van der Kolk, B. A., Hopper, J., & Spinazzola, J. (2004, November). Biological changes in arousal and cortisol following PTSD treatment. Symposium conducted (M. Olff, Chair) at the 20th annual meeting of the International Society of Traumatic Stress Studies, New Orleans, LA.

Language: English

Format: Conference

Abstract:
Effects of treatment of PTSD on psychobiological measures: It is well known that PTSD is associated with changes in several biological systems. However little research has been done on whether it is possible to “reset” these biological systems with effective psychotherapy of pharmacological therapy. This symposium will present data on neuroendocrine and neuroimaging outcome measures.
Biological changes in arousal and cortisol following PTSD treatment: This presentation will discuss the results of a controlled treatment outcome study comparing EMDR, fluoxetine and pill placebo and demonstrate how effective treatment resulted in changes in memory processes, utilizing the Traumatic Memory Inventrory. In the EMDR condition, but not fluoxetine, the change in traumatic memory towards an integrated narrative was linearly correlated with physiological arousal in response to script driven imagery. This presentation will also present the relationship between clinical improvement in the three conditions and change in the cortisol response to a dexamethasone challenge.

Keywords: Fluoxetine  Pill Placebo  Posttraumatic Stress Disorder  PSTD  Symposium  

Accuracy Verified: Yes


2. Splete, H. (2005, January). Clinical Psychiatry news’ top stories of 2004: Development on antidepressant labeling, psychologist prescribing could affect the specialty. Clinical Psychiatry News, 33(1), 14.

Language: English

Format: Newspaper

Abstract:
Biologic and psychosocial treatments of posttraumatic stress disorder were equally effective in their first direct comparison ("Psychotherapy May Offer More Benefits for PTST," June 2004, p. 20). In addition, psychotherapy patients were more likely to remit or even become asymptomatic, according to the study of 88 adults randomized to fluoxetine, placebo, or an exposure therapy method known as eye movement desensitization reprocessing (EMDR). Patients in the EMDR group ininally responded to the treatment with psychophysiologic arousal and appeared to relive the trauma. But they ultimately improved significantly more than did the placebo group and continued to improve at 2 and 6 months' follow-up, when the fluoxetine group remained stable.

Keywords: Efficacy  

Accuracy Verified: Yes


3. Hopper, J., Spinazzola, J., Blaustein, M., Yehuda, R., van der Kolk, B. A., & Simpson, W. (2003, October-November). Differential biological outcomes of EMDR and fluoxetine for PTSD. In B. A. van der Kolk (Chair), Treatment outcome studies of PTSD. Symposium conducted at the 19th annual meeting of the International Society for Traumatic Stress Studies, Chicago, IL.

Language: English

Format: Conference

Abstract:
Treatment Outcome Studies of PTSD: This symposium presents three large carefully controlled treatment outcome studies using four different treatment modalities (CBT, EMDR, psychopharmacology and Cognitive Processing) and presents data on comparative efficacy, treatment responsiveness and resistance, effects on comorbidity, quality of life, and biological changes that accompany symptom improvement.

Differential Biological Outcomes of EMDR and Fluoxetine for PTSD: Two major developments in PTSD research have been the development of effective treatments and the delineation of pathophysiology. While major gains have been made in both of these areas, they have occurred in parallel. There is a need for investigations of possible differential effects of different treatment modalities on biological aspects of PTSD. In this randomized controlled trial (N = 105), we compared the exposure treatment Eye Movement Desensitization and Reprocessing, the serotonergic reuptake inhibitor fluoxetine, and pill placebo for their effects on both PTSD symptoms and biological parameters. The outcome measures were severity of reexperiencing, avoidant/numbing, and hyperarousal symptoms; psychophysiological reactivity to script-driven imagery; basal salivary cortisol and dexamethasone suppression test (DST). At pre-treatment, post-treatment and 3-month follow-up, saliva samples were acquired at 8 a.m., 11 p.m. (immediately followed by dexamethasone) and 8 a.m.. Participants also underwent a script-driven imagery protocol utilizing four 30s scripts, each followed by a 60s script imaging period and 2 minute recovery periods (fixed order: neutral, trauma, neutral, trauma). Preliminary analyses partially support hypothesizes concerning differential efficacies of pharmacological and psychological treatments on different symptom clusters and biological markers of the disorder, at post-treatment and 3- month follow-up. Potential implications for treatment and future research will be discussed.

Keywords: Fluoxetine  Posttraumatic Stress Disorder  PTSD  Symposium  

Accuracy Verified: Yes


4. Corrigan, F. M., & Jennett, J. (2004, August). Ephedra alkaloids and brief relapse in EMDR-treated obsessive compulsive disorder. Acta Psychiatrica Scandinavica, 110(2), 158. doi:10.1111/j.1600-0047.2004.00368.x.

Language: English

Format: Journal

Abstract:
Letter to the editor commenting on an article by E. Ernst (see record 2003-05653-002). We report the case of a patient who was effectively treated for severe obsessive compulsive disorder but relapsed briefly following ingestion of herbal products containing ephedra alkaloids that she bought to facilitate weight loss. The patient was a 29-year-old woman with a 10-year history of obsessive compulsive disorder who was referred for Eye Movement Desensitisation and Reprocessing (EMDR) when her condition had not responded to cognitive behavior therapy nor to various medications including Fluoxetine, Paroxetine, Clomipramine and Amitriptyline. Her score on the Dissociative Experiences Scale was low and there was nothing in the clinical history to suggest major dissociative disorder, so after preparation with mindfulness, relaxation and safe place imagery she proceeded to treatment with EMDR. Nine months later she reported a relapse into increased anxiety with a partial return to compulsive thoughts and behaviours after she had obtained a herbal health product sold to promote weight loss. (PsycINFO Database Record (c) 2008 APA, all rights reserved)

Keywords: Comment  Desensitization  Ephedra  Letter  Luvoxamine  Obsessive Compulsive Disorder  OCD  Plant Preparations  Relapse  Reply  Review  Serotonin Uptake Inhibitors  

Accuracy Verified: Yes


5. Klingler, O. J. (2010). Eye movement desensitization and reprocessing (EMDR) in der behandlung der posttraumatischen belastungsstörung (PTSD): Seine irksamkeit im vergleich zu alternativen verfahren [Eye movement desensitization and reprocessing (EMDR) in the treatment of post traumatic stress disorder (PTSD): Its effectiveness compared to alternative methods]. Grin, 34.

Language: German

Format: Book

Abstract:
Hintergrund: Untersuchungen zur Wirksamkeit des EMDR in der Behandlung der Posttraumatischen Belastungsstörung liefern uneinheitliche Ergebnisse und keine ausreichende Grundlagen für Behandlungsentscheidungen. Fragestellung: Welche Entscheidungsgrundlagen liefert ein „entscheidungsorientiertes Modell der besten Vergleiche“, nach dem nur jene direkten Vergleiche mit anderen aktiven Behandlungsverfahren berücksichtigt werden, die besonderen methodischen Kriterien entsprechen? Methoden: Zusammenfassende Auswertung von randomisierten Vergleichen des EMDR mit alternativen Behandlungsverfahren bezüglich der Zielvariablen Remissionen, Schweregrad der Symptomatik, allgemeines Wohlbefinden und Completer. Ergebnisse: EMDR führt zu günstigeren Ergebnissen im Vergleich zu Placebo und ver-haltenstherapeutischer Exposition und zu keinen ungünstigeren Ergebnissen als Fluoxetine, Entspannungsverfahren und „unvollständiges“ EMDR ohne Augenbewegungen. Schlussfolgerungen: Bei Anwendung des entscheidungs-orientierten Modells der besten Vergleiche legen die vorliegenden Ergebnisse nahe, bei der Posttraumatischen Belastungsstörung EMDR vorläufig als die Behandlungsmethode der Wahl anzusehen.
[Background: Studies on the effectiveness of EMDR in the treatment of posttraumatic stress disorder deliver inconsistent results and insufficient basis for treatment decisions. Question: What are the bases for decision provides a "decision-oriented model of the best comparisons" are taken into account according to which only those direct comparisons with other active treatments that meet specific methodological criteria? Methods: Summary analysis of randomized comparisons of EMDR with alternative treatment methods in relation to the target variable remission, severity of symptoms, general well-being and Completer. Results: EMDR leads to better results compared to placebo and behavioral therapeutic exposure and no less favorable results than fluoxetine, relaxation techniques and "incomplete" EMDR without eye movements. Conclusions: Application of decision-oriented model of the best comparisons suggest the results presented at the post-traumatic stress disorder EMDR provisionally be regarded as the treatment of choice.]

Background: Studies on the effectiveness of EMDR in the treatment of posttraumatic stress disorder deliver inconsistent results and insufficient basis for treatment decisions. Question: What are the bases for decision provides a "decision-oriented model of the best comparisons" are taken into account according to which only those direct comparisons with other active treatments that meet specific methodological criteria? Methods: Summary analysis of randomized comparisons of EMDR with alternative treatment methods in relation to the target variable remission, severity of symptoms, general well-being and Completer. Results: EMDR leads to better results compared to placebo and behavioral therapeutic exposure and no less favorable results than fluoxetine, relaxation techniques and "incomplete" EMDR without eye movements. Conclusions: Application of decision-oriented model of the best comparisons suggest the results presented at the post-traumatic stress disorder EMDR provisionally be regarded as the treatment of choice.
[Background: Studies on the effectiveness of EMDR in the treatment of post traumatic stress disorder deliver inconsistent results and insufficient basis for treatment decisions. Question: What are the bases for decision provides a "decision-oriented model of the best comparisons" are taken into account according to Which only those direct comparisons with other active treatments that meet specific methodological criteria? Methods: Summary analysis of randomized comparisons of EMDR with alternative treatment methods in relation to the target variable remission, severity of symptoms, general well-being and Completer. Results: EMDR leads to better results compared to placebo and behavioral therapeutic exposure and no less Favorable results than fluoxetine, relaxation techniques and "incomplete" EMDR without eye movements. Conclusions: Application of decision-oriented model of the best comparisons suggest the results presented at the post-traumatic stress disorder EMDR provisionally be regarded as the treatment of choice].

Keywords: Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes


6. Staff. (2007, March 17). Fluoxetine lags behind EMDR in PTSD. Inpharma Weekly, 1(1579), 12-21.

Language: English

Format: Magazine

Abstract:
No abstract available.

Keywords: Fluoxetine  Posttraumatic Stress Disorder  PTSD  Therapeutic Use  Treatment  

Accuracy Verified: Yes


7. van der Kolk, B. A., Spinazolla, J., & Hopper, J. (2000, November). Fluoxetine vs. prozac in PTSD: Preliminary analysis of psychological and psychophysiological changes following effective treatment. In B. A. van der Kolk (Chair), Current Research on EMDR. Symposium conducted at the annual meeting of the International Society for the Study of Traumatic Stress, San Antonio, TX.

Language: English

Format: Conference

Keywords: Fluxotine  Posttraumatic Stress Disorder  Prozac  PTSD  Research  Symposium  

Accuracy Verified: Yes


8. Cahill, P. C., Pontoski, K., & D’Olio, C. M. (2005, September). Posttraumatic stress disorder and acute stress disorder II: Considerations for treatment and prevention. Psychiatry, 2(9), 34-46.

Language: English

Format: Journal

Abstract:
Posttraumatic stress disorder is a common and often chronic and disabling anxiety disorder that can develop after exposure to highly stressful events characterized by actual or threatened harm to the self or others. This is the second of two invited articles summarizing the nature and treatment of PTSD and the associated condition of acute stress disorder (ASD). The present article reviews evidence for the efficacy of psychological and pharmacological treatments for PTSD and ASD. In summary, cognitive behavior therapy (CBT) has been found efficacious in the treatment of chronic PTSD as well as the treatment of ASD/prevention of PTSD. The selective serotonin reuptake inhibitors, sertraline, paroxetine, and fluoxetine, have been found efficacious in the treatment of chronic PTSD, with sertraline and paroxetine receiving the FDA indication for this condition. There is less evidence for efficacious medications in the treatment of ASD/prevention of PTSD. At present, hydrocortisone and propranolol show the greatest promise. Limitations of these treatments, including dropout and a significant number of patients showing no or only partial response, are discussed as well as issues related to selecting among efficacious treatments.

Keywords: ASD  Acute Stress Disorder  Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes


9. Alley, A., Spinazzola, J., Blaustein, M., & van der Kolk, B. A. (2005, November). Pretreatment attrition in a PTSD comparative treatment outcome study. Poster presented at the 21st annual meeting of the International Society for Traumatic Stress Studies, Toronto, ON.

Language: English

Format: Conference

Abstract:
Treatment attrition represents a considerable problem for effective delivery of care for PTSD. While treatment attrition during the course of treatment is well researched, little is known about the factors that affect sample selection before the beginning of a study. Previous research on other Axis I disorders indicates that patients may refuse participation more often because of study medication than because of psychosocial treatment. The present study examines traits and predictors of pretreatment attrition from a study of PTSD that compared treatment outcomes for fluoxetine versus EMDR. Potential study participants were screened over the telephone for study eligibility. During the telephone screen, a total of 394 people met study eligibility requirements but declined participation (59% of total eligible participants). While a variety of factors were cited for declining study participation, consistent with previous research, refusal of study medication emerged as the pre-dominant reason for pretreatment attrition (49%). Results are discussed in terms of how treatment preferences and other pretreatment attrition factors may impact the external validity of comparative treatment outcome studies. Clinical implications discussed include the potential for pretreatment attrition factors to interfere with trauma survivors’ ability to seek and obtain effective treatment

Keywords: Comparative Treatment Outcome Study  Poster  Pretreatment Attrition  Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes


10. van der Kolk, B. A., Spinazzola, J., Blaustein, M. E., Hopper, J. W., Hopper, E. K., Korn, D. L., & Simpson, W. B. (2007, January). A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder: Treatment effects and long-term maintenance. Journal of Clinical Psychiatry, 68(1), 37-46.

Language: English

Format: Journal

Abstract:
Objective: The relative short-term efficacy and long-term benefits of pharmacologic versus psychotherapeutic interventions have not been studied for PTSD. This study compared the efficacy of a selective serotonin reuptake inhibitor (SSRI), fluoxetine, with a psychotherapeutic treatment, eye movement desensitization and reprocessing (EMDR), and pill placebo and measured maintenance of treatment gains at 6-month follow-up. Method: 88 PTSD subjects diagnosed according to DSM-IV criteria were randomly assigned to EMDR, fluoxetine, or pill placebo. They received 8 weeks of treatment and were assessed by blind raters posttreatment and at 6-month follow-up. The primary outcome measure was the Clinician-Administered PTSD Scale, DSM-IV version, and the secondary outcome measure was the Beck Depression Inventory-II. The study ran from July 2000 through July 2003. Results: The psychotherapy intervention was more successful than pharmacotherapy in achieving sustained reductions in PTSD and depression symptoms, but this benefit accrued primarily for adult-onset trauma survivors. At 6-month follow-up, 75.0% of adult-onset versus 33.3% of child-onset trauma subjects receiving EMDR achieved asymptomatic end-state functioning compared with none in the fluoxetine group. For most childhood-onset trauma patients, neither treatment produced complete symptom remission. Conclusions: This study supports the efficacy of brief EMDR treatment to produce substantial and sustained reduction of PTSD and depression in most victims of adult-onset trauma. It suggests a role for SSRIs as a reliable first-line intervention to achieve moderate symptom relief for adult victims of childhood-onset trauma. Future research should assess the impact of lengthier intervention, combination treatments, and treatment sequencing on the resolution of PTSD in adults with childhood-onset trauma. [Author Abstract]

Keywords: Adults  Depressive Disorders  Empirical Study  Posttraumatic Stress Disorder  PTSD  Quantitative Study  Random Clinical Trial  RCT  Selective Serotonin Reuptake Inhibitors  Stressors  Survivors  Treatment Effectiveness  

Accuracy Verified: Yes


11. Bisson, J. L. (2007, November). Review: Eye movement desensitisation and reprocessing reduces PTSD symptoms compared with fluoxetine at six months post-treatment. Evidence-based Mental Health, 10(4), 118. doi:10.1136/ebmh.10.4.118.

Language: English

Format: Journal

Abstract:
Is eye movement desensitisation and reprocessing more effective than fluoxetine in people with post-traumatic stress disorder? van der Kolk BA, Spinazzola J, Blaustein ME, et al. A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder: treatment effects and long-term maintenance. J Clin Psychiatry 2007; 68:37–46.

Keywords: Fluoxetine  Desensitization  Mental Illness  Posttraumatic Stress Disorder  PTSD  Treatment  

Accuracy Verified: Yes


12. Hopper, E., Simpson, W., Blaustein, M., & Spinazzola, J. (2004, November). Self-perception of symptom change in the treatment of PTSD. Presentation at the 20th annual meeting of the International Society of Traumatic Stress Studies, New Orleans, LA.

Language: English

Format: Conference

Abstract:
The current study examined client self-perception of change in posttraumatic stress symptoms during and after treatment in three treatment conditions: psychopharmacology (fluoxetine), an exposure-based psychotherapeutic treatment (EMDR), and a pill placebo. Subjects were 88 patients with mixed-trauma exposure and primarily chronic trauma response. Subjects completed the Davidson Trauma Scale (DTS) prior to beginning treatment, during the treatment phase, and during follow-up. In all conditions, selfreported symptoms of posttraumatic stress decreased during the treatment phase. After treatment, average DTS score for subjects in the therapy condition continued to decrease, while mean score for subjects who received pharmacological treatment increased slightly. Two months after termination of treatment, the average DTS score was 21 for the EMDR condition and 43 for the fluoxetine condition. Results revealed that subjects perceived themselves as improving steadily during the course of treatment, regardless of treatment condition. These results support the idea that there are non-specific factors in therapy (perhaps including factors such as instillation of hope, treatment expectations, and empathy) that lead to self-perceived improvement in symptoms. However, maintenance of perceived gains did appear to favor exposure-based therapy as a treatment for posttraumatic stress disorder.

Keywords: Posttraumatic Stress Disorder  PSTD  Self-Perception  Symptom Change  

Accuracy Verified: Yes


13. Greenwald, R., Stain, M., Allen, R., Azubuike, A., & Borgen, R. (2004, November). Trauma-informed treatment for incarcerated youth: A controlled study. Presentation at the 20th annual meeting of the International Society for Traumatic Stress Studies, New Orleans, LA .

Language: English

Format: Conference

Abstract:
The current study examined client self-perception of change in posttraumatic stress symptoms during and after treatment in three treatment conditions: psychopharmacology (fluoxetine), an exposure-based psychotherapeutic treatment (EMDR), and a pill placebo. Subjects were 88 patients with mixed-trauma exposure and primarily chronic trauma response. Subjects completed the Davidson Trauma Scale (DTS) prior to beginning treatment, during the treatment phase, and during follow-up. In all conditions, selfreported symptoms of posttraumatic stress decreased during the treatment phase. After treatment, average DTS score for subjects in the therapy condition continued to decrease, while mean score for subjects who received pharmacological treatment increased slightly. Two months after termination of treatment, the average DTS score was 21 for the EMDR condition and 43 for the fluoxetine condition. Results revealed that subjects perceived themselves as improving steadily during the course of treatment, regardless of treatment condition. These results support the idea that there are non-specific factors in therapy (perhaps including factors such as instillation of hope, treatment expectations, and empathy) that lead to self-perceived improvement in symptoms. However, maintenance of perceived gains did appear to favor exposure-based therapy as a treatment for posttraumatic stress disorder.

Keywords: Incareration  Trauma  Youth  

Accuracy Verified: Yes


14. van der Kolk, B. A., Hopper, J., & Spinazzola, J. (2004, November). Treatment integration of traumatic memories vs. suppression of distress. Presentation at the 20th annual meeting of the International Society of Traumatic Stress Studies, New Orleans, LA .

Language: English

Format: Conference

Abstract:
This presentation will review a series of three studies that investigated the quality of traumatic memories in three subject populations, using the Traumatic Memory Inventory (TMI- van der Kolk & Fisler, 1996): 1) victims of interpersonal trauma, 2) victims of motor vehicle accidents, and 3) patients who experienced awareness during anesthesia. We then will present the results of the Memory component study from a large treatment outcome study comparing EMDR and fluoxetine for PTSD which showed that, following effective treatment with EMDR, the fragmentation of memory imprints was resolved, while treatment with fluoxetine did not alter the quality of traumatic memories, but suppressed subjective distress.

Keywords: Awareness During Anesthesia  Fluoxetine  Motor Vehicle Accidents  Traumatic Memory Inventory  

Accuracy Verified: Yes


15. van der Kolk, B. A., Hopper, J., Spinazzola, J., Blaustein, M., Hopper, E., & Simpson, W. (2003, October/November). Treatment outcome of fluoxetine vs. EMDR in PTSD. Symposium conducted (B. A. van der Kolk, Chair) at the 19th annual meeting of the International Society for Traumatic Stress Studies, Chicago, IL.

Language: English

Format: Conference

Abstract:
Treatment Outcome Studies of PTSD: This symposium presents three large carefully controlled treatment outcome studies using four different treatment modalities (CBT, EMDR, psychopharmacology and Cognitive Processing) and presents data on comparative efficacy, treatment responsiveness and resistance, effects on comorbidity, quality of life, and biological changes that accompany symptom improvement.

Treatment outcome of fluoxetine vs. EMDR in PTSD: This NIMH funded study compared the efficacy of two widely different treatment approaches for treating patients with PTSD: fluoxetine, which acts directly on biological systems (N=30), and Eye Movement Desensitization and Reprocessing (EMDR) (N=30). There also was a pill placebo control group (N=30). We assessed subjects with a multi-modal biological and psychological assessment, in order to determine whether treatment efficacy is associated with changes: 1) social adjustment, 2) psychophysiological reactivity to personalized trauma scripts (heart rate and skin conductance), and 3) basal salivary cortisol. We also tracked the stability of symptom change for nine months following the cessation of active treatment. Preliminary results suggest that at the end of 8 weeks of treatment, there is a 30% improvement in the pill placebo condition, while both active treatments demonstrate additional symptom improvement, with EMDR being most effective for the treatment of acute PTSD, and Prozac for subjects with prolonged childhood histories of trauma. Clinically significant improvement in CAPS scores is accompanied by an increase in basal cortisol and improvement in social and occupational functioning. We will also present data on the differential rates of symptom change in the different PTSD symptom clusters between the two treatment groups during the nine months of follow- up after cessation of the acute treatment phase.

Keywords: Fluoxetine  Posttraumatic Stress Disorder  PTSD  Symposium  

Accuracy Verified: Yes