Researchers Assess What Works Best to Prevent PTSD

New research suggests certain long-term psychotherapies may do a better job than an antidepressant in preventing post-traumatic stress disorder (PTSD) following a traumatic event.

The Israeli research team also found that delaying treatment for PTSD didn't seem to boost a person's risk of chronic symptoms. "A delayed intervention is an acceptable option when early clinical interventions cannot be provided," as might be the case during wars or disasters, the study authors wrote.

The researchers, from Hadassah University Hospital in Jerusalem, added that shorter-term treatment approaches that do not first include patient assessment or diagnosis have not been shown to prevent PTSD.

In the study, the team recruited 242 patients who had suffered from a recent traumatic event (an average of about 10 days prior) and then had experienced subsequent acute stress. The participants received one of four treatments.

One group received prolonged exposure therapy, which involved breath control training as they imagined the trauma they had experienced. Another group went through cognitive training designed to teach them how to reduce negative thoughts. A third group only went through prolonged exposure therapy if they still showed signs of stress disorder problems after five months. Two more groups took either a placebo medication or the antidepressant Lexapro.

The researchers found that after nine months of follow-up, between 21 percent and 23 percent of the participants in the groups that got psychotherapy developed PTSD, while 42 percent and 47 percent of those who took the drug or placebo, respectively, developed symptoms.

Keith A. Young, director of the Neuropsychiatry Research Program at the Texas A&M Health Science Center, said in an interview that he was surprised by the lack of response to Lexapro, although he believes that may have something to do with doses that he considered too low. More evidence is needed before mental health workers should stop prescribing certain kinds of antidepressants early after traumatic incidents, he said.

Young added that treatments such as prolonged exposure therapy or cognitive training should be offered to as many people as possible.

"In the end, it is likely that we will find that a combination of drugs and exposure therapies may be a good option for preventing PTSD," he said.