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Common PTSD drug is no more effective than placebo
December 04, 2006Guanfacine, a medication commonly prescribed to alleviate symptoms of post-traumatic stress disorder, is no more effective than a placebo, according to a study led by researchers at the San Francisco VA Medical Center.
"There was no benefit at all, and there were several adverse side effects," says lead author Thomas Neylan, MD, medical director of the PTSD treatment program at SFVAMC. "People with symptoms of PTSD should probably stay away from this drug and others of its type."
The study appears in the December 1, 2006 issue of the American Journal of Psychiatry.
Guanfacine belongs to a class of medications known as alpha-2 agonists, which lower the brain's supply of the neurotransmitter norepinephrine. Neurotransmitters are chemicals that transmit electrical signals between nerve cells. They are responsible for many aspects of behavior.
"Norepinephrine is released in the brain during states of excited arousal, and PTSD is associated with that state - patients startle easily, have trouble sleeping, and are hypervigilant and anxious," explains Neylan, who is also an associate professor of psychiatry at the University of California, San Francisco.
Guanfacine and clonidine, another alpha-2 agonist, are commonly prescribed for PTSD symptoms. "There are at least 20 peer-reviewed articles published in the field of PTSD that recommend drugs which lower norepinephrine," Neylan says. "However, ours was the first randomized, controlled study of alpha-2 agonists for symptoms of PTSD."
The double-blind study compared the effects of guanfacine and an identical looking placebo pill on 63 male and female veterans at four VA medical centers in California and Hawaii. Twenty-nine participants were randomly assigned to take weekly doses of the drug, and 34 were assigned the placebo, for eight weeks.
At the end of the study, the effect of guanfacine on PTSD symptoms was "zero," and there were no differences between men and women or older versus younger veterans. In addition, the subjects who took guanfacine had significantly more somnolence, lightheadedness, and dry mouth than those who took placebo.
The study authors conclude, "These results do not support the use of alpha 2 agonists in veterans with chronic PTSD."
Neylan speculates that instead of lowering the overall level of norepinephrine, a more effective approach might be to inhibit the ability of brain cells to respond to the neurotransmitter. He notes that this is the action of prazosin, a blood pressure medication that has been found by other researchers to decrease the incidence of nightmares in combat veterans with PTSD.
University of California - San Francisco
Guanfacine belongs to a class of medications known as alpha-2 agonists, which lower the brain's supply of the neurotransmitter norepinephrine. Neurotransmitters are chemicals that transmit electrical signals between nerve cells. They are responsible for many aspects of behavior.
"Norepinephrine is released in the brain during states of excited arousal, and PTSD is associated with that state - patients startle easily, have trouble sleeping, and are hypervigilant and anxious," explains Neylan, who is also an associate professor of psychiatry at the University of California, San Francisco.
Guanfacine and clonidine, another alpha-2 agonist, are commonly prescribed for PTSD symptoms. "There are at least 20 peer-reviewed articles published in the field of PTSD that recommend drugs which lower norepinephrine," Neylan says. "However, ours was the first randomized, controlled study of alpha-2 agonists for symptoms of PTSD."
The double-blind study compared the effects of guanfacine and an identical looking placebo pill on 63 male and female veterans at four VA medical centers in California and Hawaii. Twenty-nine participants were randomly assigned to take weekly doses of the drug, and 34 were assigned the placebo, for eight weeks.
At the end of the study, the effect of guanfacine on PTSD symptoms was "zero," and there were no differences between men and women or older versus younger veterans. In addition, the subjects who took guanfacine had significantly more somnolence, lightheadedness, and dry mouth than those who took placebo.
The study authors conclude, "These results do not support the use of alpha 2 agonists in veterans with chronic PTSD."
Neylan speculates that instead of lowering the overall level of norepinephrine, a more effective approach might be to inhibit the ability of brain cells to respond to the neurotransmitter. He notes that this is the action of prazosin, a blood pressure medication that has been found by other researchers to decrease the incidence of nightmares in combat veterans with PTSD.
University of California - San Francisco
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Despite some benefit, drug ads can be harmful to your health
While the debate over prescription drug advertising persists, a new study released online in the American Journal of Public Health offers guidelines for improving drug ads in order to minimize potential harm and maximize benefits.
The narrow line between love and jealousy
A new study carried out at the University of Haifa has found that the hormone oxytocin, the "love hormone", which affects behaviors such as trust, empathy and generosity, also affects opposite behaviors, such as jealousy and gloating.
CSHL study shows that some malignant tumors can be shut down after all
Oncologists have had their hands tied because more than half of all human cancers have mutations that disable a protein called p53.
Does green tea prevent cancer? Evidence continues to brew, but questions remain
Although scientists are reluctant to officially endorse green tea as a cancer prevention method, evidence continues to grow about its protective effects, including results of a new study published in Cancer Prevention Research, a journal of the American Association for Cancer Research, which suggests some reduction in oral cancer.
Green tea shows promise as chemoprevention agent for oral cancer, M. D. Anderson study finds
Green tea extract has shown promise as cancer prevention agent for oral cancer in patients with a pre-malignant condition known as oral leukoplakia, according to researchers at The University of Texas M. D. Anderson Cancer Center.
Java and nighttime jobs don't mix: study
Night-shift workers should avoid drinking coffee if they wish to improve their sleep, according to research published in the journal Sleep Medicine.
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