Same Trauma, Different Day

You can barely pass an alley, without feeling like you're going to vomit or faint. Of course, the alley where you were mugged is 2,000 miles away. Then again you dread the night anyway, that's because you wake in a cold sweat. And what about those little yellow pills that your doctor prescribed? Well, they help some, but not enough. Trauma sufferers—from tsunami survivors to rape victims—can rest easier now that there is a growing array of therapies and medications.

A team led by Barbara Rothbaum, a post-traumatic stress expert at Emory University, explored the effectiveness of psychotherapy among chronic PTSD sufferers already taking medication. In a study that appeared in the Journal of Traumatic Stress, 65 subjects were treated with sertraline, commonly known as Zoloft, for five months. The selective serotonin reuptake inhibitor is used to treat depression, obsessive-compulsive disorder, and PTSD, among other disorders. (It is one of only two medications currently approved by the Federal Drug Administration to treat PTSD.)

The researchers found that the medication helped everyone in the study to some degree: In the first half of the study, all subjects took medication and all showed reductions in PTSD severity, depression, and general anxiety. In the second half of the study, the subjects were randomly split into two groups. While both groups continued taking medication, one group got an extra boost from therapy sessions.

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The team used the technique called prolonged exposure (PE), which gradually exposes a trauma victim to different anxiety-provoking thoughts and situations. For example, a person afraid of heights first imagines standing on a high bridge, afterward he writes his feelings down. Patients also imagined their traumatic event, narrated their memories onto tape recorders, and later listened to these recordings. The patient employs these types of exercises until thinking about the trauma no longer bothers him.

The results are encouraging: The combination therapy seems to give sufferers a much-needed push. That's good news for PTSD sufferers who don't respond well to medication alone. Other similar studies are currently underway: one compares psychotherapy plus placebo to psychotherapy plus paroxetine, also known as Paxil. And another compares the effectiveness of psychotherapy vs. sertraline.

Now, for trauma victims, an alley may become nothing more than an alley.

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