Evidence map›Paper›PMID 30698839›Full record

Trial reportAlcoholism, clinical and experimental research2019

Alcohol Abstainer Status and Prazosin Treatment in Association with Changes in Posttraumatic Stress Disorder Symptoms in Veterans with Comorbid Alcohol Use Disorder and Posttraumatic Stress Disorder.

Terril L Verplaetse, Elizabeth Ralevski, Walter Roberts, Ralitza Gueorguieva, Sherry A McKee, Ismene L Petrakis

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Alcoholism, clinical and experimental research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pharmacotherapy for post traumatic stress disorder (PTSD).The Cochrane database of systematic reviews · 2022
    Pooled it
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Terril L VerplaetseDepartment of Psychiatry, Yale School of Medicine, New Haven, Connecticut.ORCID 0000-0002-2531-6656
Elizabeth RalevskiDepartment of Psychiatry, Yale School of Medicine, New Haven, Connecticut.
Walter RobertsDepartment of Psychiatry, Yale School of Medicine, New Haven, Connecticut.ORCID 0000-0001-6817-884X
Ralitza GueorguievaDepartment of Biostatistics, Yale School of Public Health, New Haven, Connecticut.
Sherry A McKeeDepartment of Psychiatry, Yale School of Medicine, New Haven, Connecticut.
Ismene L PetrakisDepartment of Psychiatry, Yale School of Medicine, New Haven, Connecticut.
Yale University · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Yale-SCORE Resource Support CoreU54AA027989 · NIAAA · YALE UNIVERSITY · PI Ralitza Gueorguieva · 2020 to 2026
$13.0M
Behavioral and Neurochemical Mechanisms Underlying Stress-Precipitated DrinkingK01AA025670 · NIAAA · YALE UNIVERSITY · PI VERPLAETSE, TERRIL L · 2018 to 2023
$882k
NEUROBIOLOGY OF ALCOHOL CUE-INDUCED CRAVINGR01AA010107 · NIAAA · YALE UNIVERSITY · PI PETRAKIS, ISMENE L · 1995 to 1999
–
Mental Illness Research Education and Clinical Center (VISN I MIRECC)NCATS NIH HHS UL1 TR001863NIAAA NIH HHS K01 AA025670NIAAA NIH HHS R01AA010107NIAAA NIH HHS U54 AA027989
6 · The paper itself

Abstract

backgroundThe noradrenergic system has been implicated in alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD), with adrenergic agents reducing drinking in individuals with AUD and improving sleep disturbances in individuals with PTSD. In a recent clinical trial, prazosin, an α1-adrenergic antagonist, was not superior to placebo in reducing PTSD symptoms, sleep problems, or alcohol consumption in a comorbid population; however, patients in both treatment conditions improved in all symptom domains over the course of treatment. It remains unknown whether alcohol abstinence is related to changes in PTSD symptoms and medication effects in individuals with this comorbidity.

methodsVeterans with comorbid alcohol dependence and PTSD (n = 96) were randomized to prazosin (16 mg) or placebo in a 12-week outpatient, double-blind clinical trial. In this secondary data analysis, we examined main effects of alcohol abstainer status (abstainer vs. nonabstainer), treatment, and their interaction on changes in PTSD symptoms over time using linear mixed models.

resultsThere was a main effect of alcohol abstainer status on symptoms of PTSD (p = 0.03), such that nonabstainers had lower total Clinician-Administered PTSD Scale (CAPS) scores than abstainers. There was a significant treatment by alcohol abstainer status interaction (p = 0.01); specifically, among placebo-treated individuals, those who did not abstain from alcohol had lower total CAPS scores compared to alcohol abstainers. Within the prazosin-treated group, abstainers and nonabstainers did not differ on total CAPS scores. Results were similar for the avoidance (p = 0.02), reexperiencing (p = 0.01), and hyperarousal (p = 0.04) subscales, such that placebo-treated nonabstainers had lower CAPS scores overall.

conclusionsOverall, prazosin treatment was not significantly related to changes in PTSD symptoms over the course of the 12-week clinical trial in a comorbid population. Interestingly, placebo-treated alcohol nonabstainers had a significant reduction in PTSD symptoms. Whether placebo-treated individuals continued to use alcohol because of ongoing symptoms of PTSD is not known.

Indexed as

Alcohol AbstinenceAdrenergic alpha-1 Receptor AntagonistsAdultAgedAlcohol DrinkingAlcoholismComorbidityDouble-Blind MethodFemaleHumansMaleMiddle AgedNew EnglandPrazosinStress Disorders, Post-TraumaticTreatment OutcomeAdrenergic alpha-1 Receptor AntagonistsPrazosinAUDCAPSComorbid AUD and PTSDPrazosinPTSD

Identifiers

PMID30698839
PMCPMC6443463
OpenAlexW2912338759

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.