A controlled trial of paroxetine for chronic PTSD, dissociation, and interpersonal problems in mostly minority adults
Open accessAbstract
This study evaluated the efficacy of paroxetine for symptoms and associated features of chronic posttraumatic stress disorder (PTSD), interpersonal problems, and dissociative symptoms in an urban population of mostly minority adults. Adult outpatients with a primary DSM-IV diagnosis of chronic PTSD received 1 week of single-blind placebo (N = 70). Those not rated as significantly improved were then randomly assigned to placebo (N = 27) or paroxetine (N = 25) for 10 weeks, with a flexible dosage design (maximum 60 mg by week 7). Significantly more patients treated with paroxetine were rated as responders (14/21, 66.7%) on the Clinical Global Impression-Improvement Scale (CGI-I) compared to patients treated with placebo (6/22, 27.3%). Mixed effects models showed greater reductions on the Clinician-Administered PTSD Scale (CAPS) total score (primary plus associated features of PTSD) in the paroxetine versus placebo groups. Paroxetine was also superior to placebo on reduction of dissociative symptoms [Dissociative Experiences Scale (DES) score] and reduction in self-reported interpersonal problems [Inventory of Interpersonal Problems (IIP) score]. In a 12-week maintenance phase, paroxetine response continued to improve, but placebo response did not. Paroxetine was well tolerated and superior to placebo in ameliorating the symptoms of chronic PTSD, associated features of PTSD, dissociative symptoms, and interpersonal problems in the first trial conducted primarily in minority adults.
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Only two medications have performed better than placebo for treatment of dissociative symptoms in randomized controlled trials: naloxone and paroxetine.
“Only two medications have performed better than placebo for treatment of dissociative symptoms in RCTs: the opioid antagonist naloxone and the SSRI paroxetine.”
From Treatment of dissociative identity disorder: leveraging neurobiology to optimize success (2024) · cites this paper as [127]
The Abstract and Dissociative Experiences Scale results (page not available) report that paroxetine outperformed placebo on dissociative symptoms in a randomized trial of adults with chronic PTSD. The paper does not establish that naloxone did so, or that these were the only two medications with such results; searches for naloxone and the two-medication claim found no supporting passage. (LLM, conf=0.88)
Experimental — accuracy not yet measuredParoxetine effectively reduced dissociative symptoms in PTSD in a randomized controlled trial.
“One RCT demonstrated effective reduction of dissociative symptoms in PTSD using a selective serotonin reuptake inhibitor (SSRI), paroxetine [127].”
From Treatment of dissociative identity disorder: leveraging neurobiology to optimize success (2024) · cites this paper as [127]
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References 50 · Cited by 98
- Authors
- Marshall, R. D., Lewis-Fernandez, R., Blanco, C., Simpson, H. B., Lin, S.-H., Vermes, D., Garcia, W., Schneier, F., Neria, Y., Sanchez-Lacay, A., & Liebowitz, M. R.
- Affiliations
- New York State Psychiatric Institute (US)
- Corresponding author
- Marshall, Randall D.
- Venue
- Depression and Anxiety
- Publisher
- Hindawi Limited
- Published
- 2007
- Volume
- 24
- Issue
- 2
- Pages
- 77-84
- ISSN
- 1091-4269 (ISSN-L)
- 1520-6394
- OpenAlex
- W2029676726
- Cited by
- 98
- References
- 50
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 10 · 2023: 2 · 2022: 5 · 2021: 3 · 2020: 7 · 2019: 3 · 2018: 4 · 2017: 3 · 2016: 2 · 2015: 9 · 2014: 5 · 2013: 6 · 2012: 5
- FWCI
- 5.54
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- public-domain
- doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 3165 d)
- Locations
- Depression and Anxiety (publishedVersion, public-domain)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5k08mh001412-05)
- National Institute of Mental Health (MH01412)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- paroxetine, chronic posttraumatic stress disorder, dissociative symptoms, interpersonal problems, antidepressant efficacy, maintenance therapy, treatment response
- MeSH terms
- Adult, Chronic Disease, Dissociative Disorders, Double-Blind Method, Female, Follow-Up Studies, Hispanic or Latino, Humans, Interpersonal Relations, Male, Middle Aged, Personality Assessment, Stress Disorders, Post-Traumatic, Urban Population, Paroxetine, Antidepressive Agents, Second-Generation, Black People, White People
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