There are several open-label trials or trials in MAOIs with no comparison group, none of which were included (Davidson et al., 1987; Lerer et al., 1987; Neal et al., 1997). There was one head-to-head study comparing moclobemide and tianeptine. The efficacy of either of these drugs has not been proven, so this trial was excluded from the committee’s review. See Table 3-5 for a summary of the four included clinical trials.

The committee found that the literature on SSRIs was the most extensive for any of the pharmacotherapies, identifying 14 studies meeting inclusion criteria (Brady et al., 2000; Connor et al., 1999; Davidson et al., 2001a, 2006b; Friedman et al., 2007; Hertzberg et al., 2000; Marshall et al., 2001, 2007; Martenyi et al., 2002a; Tucker et al., 2001, 2003; van der Kolk et al., 1994, 2007; Zohar et al., 2002). The studies examined different drugs (sertraline, fluoxetine, paroxetine, and citalopram) and dosage regimens for varying periods of time and differed in dropout rates (which were generally in the range of 30 percent), and many studies handled missing values with LOCF or conducted the analysis only on those completing treatment.

Participants in the SSRI studies had suffered a variety of traumas including combat-related (U.S. and international participants), sexual and