Evidence map›Paper›PMID 35709244›Full record

ArticleJournal of evaluation in clinical practice2023

Comparison of mental health outcomes of augmenting medications for patients with posttraumatic stress disorder: A national veterans affairs study.

Rachel Ranney, Shira Maguen, Anne Woods, Karen H Seal, Thomas C Neylan, Nancy Bernardy, Ilse Wiechers, Annie Ryder, Beth E Cohen

Abstract read
In one paragraph

Article in Journal of evaluation in clinical practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 39% 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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
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

9 authors at 3 institutions in 1 country.

Rachel RanneyVeterans Affairs San Francisco Health Care System, San Francisco, California, USA.ORCID 0000-0001-5446-3690
Shira MaguenVeterans Affairs San Francisco Health Care System, San Francisco, California, USA.
Anne WoodsVeterans Affairs San Francisco Health Care System, San Francisco, California, USA.
Karen H SealVeterans Affairs San Francisco Health Care System, San Francisco, California, USA.
Thomas C NeylanVeterans Affairs San Francisco Health Care System, San Francisco, California, USA.
Nancy BernardyVeterans Affairs White River Junction Health Care System, White River Junction, Vermont, USA.ORCID 0000-0002-2169-5214
Ilse WiechersDepartment of Psychiatry and Behavioral Sciences, San Francisco School of Medicine, University of California, San Francisco, California, USA.
Annie RyderVeterans Affairs San Francisco Health Care System, San Francisco, California, USA.
Beth E CohenVeterans Affairs San Francisco Health Care System, San Francisco, California, USA.
University of California, San Francisco · USSan Francisco VA Health Care System · USWhite River Junction VA Medical Center · US

Funding

Investigating Fear System Myelination in PTSD Using In Vivo and Post Mortem DataR01MH132617 · NIMH · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI HUBER, BERTRAND R, NEYLAN, THOMAS C · 2023 to 2025
$2.1M
Department of Defense Congressionally Directed Medical Research ProgramNIMH NIH HHS R01 MH132617Patient-Centered Outcomes Research Institute
6 · The paper itself

Abstract

rationalePosttraumatic stress disorder (PTSD) is highly prevalent among veterans. Many veterans with PTSD respond well to serotonin reuptake inhibitors (SRIs). Nonresponders may be prescribed augmenting medications, which are not as well-studied in PTSD. AIMS AND

objectivesWe used Veterans Health Administration electronic records to compare mental health outcomes (PTSD symptoms and rates of mental health hospitalizations and psychiatric emergency room visits) in patients with PTSD who were prescribed four different groups of augmenting medications (atypical antipsychotics, mirtazapine, prazosin or tricyclic antidepressants) in addition to SRIs-from the year before to the year after the start of the augmenting medication.

methodWe included data from 169,982 patients with a diagnosis of PTSD (excluding patients with comorbid bipolar or psychotic disorders) seen in Veterans Affairs care from 2007 to 2015 who were taking an SRI and filled a new prescription for one of the four augmenting medications for at least 60 days.

resultsPatients evidenced minimal (<2%) reduction in PTSD symptoms and a larger reduction in psychiatric hospitalizations and psychiatric emergency room visits after receiving augmenting medications; this effect was largely similar across the four medication groups. Initiating augmenting medications was preceded by increases in PTSD symptoms, psychiatric hospitalizations and psychiatric emergency room visits. After initiating an augmenting medication, PTSD symptoms/hospitalizations/emergency room visits returned to baseline levels (before the start of the augmenting medication), but generally did not improve beyond baseline.

conclusionImportantly, these effects could be explained by regression to the mean, additional interventions or confounding. These findings should be further explored with placebo controlled randomized clinical trials.

Indexed as

Antipsychotic AgentsStress Disorders, Post-TraumaticVeteransComorbidityHumansOutcome Assessment, Health CareUnited StatesUnited States Department of Veterans AffairsAntipsychotic Agentsaugmentationmedicationpsychiatric hospitalizationPTSDSRIveteran

Identifiers

PMID35709244
PMCPMC13058844
OpenAlexW4282970994

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.