Improvement of anger at one week predicts the effects of sertraline and placebo in PTSD.

Journal Article

In previous work we demonstrated an early, robust and sustained effect for sertraline vs placebo on irritability and anger in subjects with PTSD. In this report, we explore the same dataset to assess whether a clinician might usefully predict ultimate response to sertraline, on the basis of its effect upon anger after one week. Three hundred and eighteen subjects were assessed. Outcome was measured by whether or not the score was reduced by at least 50% from baseline. Ordinary least squares regression was used to estimate the effects of change in anger at one week. Logistic regression was applied to estimate the effects on odds of a 50% drop in score. Cut points were developed for one-week change scores on anger for sertraline and placebo. The best cut point was selected as predictive of non-response, i.e. a cue suggesting that treatment switch would be in order. An increase in anger of 30% at one-week best predicted the likelihood of not responding to treatment in both the drug and placebo groups. Twenty-five percent of all non-responders were incorrectly identified, while only 7% of all improvers were incorrectly categorized as non-responders using this cutoff. Our findings imply that, for patients similar to those in this study, an increase in anger after one week of treatment might be one factor to consider when making a decision about continuation of the medication.

Full Text

Duke Authors

Cited Authors

  • Davidson, J; Landerman, LR; Clary, CM

Published Date

  • September 2004

Published In

Volume / Issue

  • 38 / 5

Start / End Page

  • 497 - 502

PubMed ID

  • 15380400

Electronic International Standard Serial Number (EISSN)

  • 1879-1379

International Standard Serial Number (ISSN)

  • 0022-3956

Digital Object Identifier (DOI)

  • 10.1016/j.jpsychires.2004.01.005

Language

  • eng