Table 2:
Participants with an Adequate Trial of an Effective Medication for PTSD plus Outcomes Measurement, 2008–2013 (Unweighted)
| Agent | Fluoxetine | Paroxetine | Sertraline | Topiramate | Venlafaxine | |
|---|---|---|---|---|---|---|
| Total Number | 659 | 328 | 1,376 | 105 | 463 | Pairwise Differences |
| Index Year FY08–9, % (n) | 7.1 (47) | 7.6 (25) | 5.2 (72) | 7.6 (8) | 5.4 (25) | |
| Index Year FY10–11, % (n) | 32.5 (214) | 33.2 (109) | 34.0 (468) | 41.9 (44) | 33.0 (153) | |
| Index Year FY12–13, % (n) | 60.4 (398) | 59.1 (194) | 60.8 (836) | 50.5 (53) | 61.6 (285) | |
| Baseline Symptoms and Alignment of Medication Initiation and Baseline Measurement | ||||||
| Baseline PCL Score, M (SD) | 61.8 (11.8) | 62.2 (12.1) | 62.0 (11.7) | 61.5 (12.6) | 62.5 (12.0) | No Differences |
| Baseline PCL Score before initiation, % (n) | 50.7 (334) | 50.0 (164) | 36.9 (508) | 35.2 (37) | 29.6 (137) | F≠STV, P≠SV, S≠V |
| Baseline PCL Score during titration, % (n) | 7.1 (47) | 7.9 (26) | 24.6 (338) | 23.8 (25) | 18.4 (85) | FP≠STV |
| Baseline PCL Score full dose, % (n) | 42.2 (278) | 42.1 (138) | 38.5 (530) | 41.0 (43) | 52.1 (241) | FS≠V |
| Demographic Characteristics | ||||||
| Age, M (SD) | 39.4 (12.4) | 38.7 (13.2) | 41.0 (13.2) | 38.7 (10.8) | 40.2 (12.1) | P≠S |
| Men, % (n) | 88.0 (580) | 87.2 (286) | 89.8 (1,236) | 71.4 (75) | 86.4 (400) | FPSV≠T |
| Married, % (n) | 56.3 (371) | 52.7 (173) | 57.1 (786) | 61.9 (65) | 57.2 (265) | No Differences |
| White Non-Hispanic, % (n) | 63.9 (421) | 66.8 (219) | 60.2 (829) | 62.9 (66) | 73.7 (341) | FS≠V |
| Black Non-Hispanic, % (n) | 17.5 (115) | 15.9 (52) | 18.8 (258) | 17.1 (18) | 10.2 (47) | FS≠V |
| Hispanic, % (n) | 9.1 (60) | 11.9 (39) | 12.1 (166) | 13.3 (14) | 9.3 (43) | No Differences |
| OEF/OIF/OND Veteran, % (n) | 71.2 (469) | 72.0 (236) | 68.2 (938) | 75.2 (79) | 66.1 (306) | No Differences |
| Homeless, % (n) | 5.0 (33) | 5.5 (18) | 5.1 (70) | 2.9 (3) | 5.2 (24) | No Differences |
| Combat Exposure, % (n) | 28.5 (188) | 36.6 (120) | 28.2 (388) | 30.5 (32) | 25.3 (117) | P≠SV |
| Sexual Trauma in Military, % (n) | 12.0 (79) | 13.4 (44) | 11.0 (151) | 24.8 (26) | 13.4 (62) | FSV≠T |
| VA Disability Level ≥ 70, % (n) | 66.3 (437) | 67.4 (221) | 67.0 (922) | 74.3 (78) | 73.4 (340) | No Differences |
| Service Use Characteristics | ||||||
| Plurality of Care at a VAMC, % (n) | 59.9 (395) | 65.9 (216) | 65.9 (907) | 69.5 (73) | 70.2 (325) | F≠V |
| AMT from a MH prescriber, % (n) | 88.9 (586) | 87.8 (288) | 89.9 (1,237) | 33.3 (35) | 85.3 (395) | FPSV≠T |
| Primary Care Visits, M (SD) | 3.5 (2.9) | 3.6 (2.8) | 3.5 (3.0) | 4.9 (4.1) | 4.0 (2.9) | FPS≠T, S≠V |
| Any Individual Therapy, % (n) | 98.5 (649) | 98.5 (323) | 98.3 (1,353) | 98.1 (103) | 98.9 (458) | No Differences |
| Total visits, index year, M (SD) | 16.1 (11.1) | 15.5 (10.5) | 15.8 (11.6) | 16.0 (11.6) | 18.1 (12.6) | FPS≠V |
| EBP-I, index year, M (SD) | 3.4 (4.9) | 3.1 (4.8) | 3.6 (5.1) | 3.8 (5.2) | 3.2 (4.8) | No Differences |
| EBP-I, baseline-midpoint, M (SD) | 0.9 (2.0) | 0.7 (1.7) | 0.8 (1.8) | 1.0 (1.9) | 0.7 (1.6) | No Differences |
| EBP-I, midpoint-end, M (SD) | 1.6 (3.0) | 1.4 (2.6) | 1.7 (3.1) | 1.8 (3.2) | 1.5 (2.8) | No Differences |
| Any Group Therapy, % (n) | 59.9 (395) | 61.6 (202) | 62.8 (864) | 56.2 (59) | 63.7 (295) | No Differences |
| Total Visits, Index Year, M (SD) | 11.9 (24.4) | 12.0 (22.2) | 14.2 (26.2) | 11.3 (24.4) | 16.9 (33.0) | F≠V |
| CPT-G, index year, M (SD) | 2.1 (4.5) | 2.1 (4.0) | 2.5 (4.7) | 2.5 (4.8) | 2.8 (5.1) | No Differences |
| CPT-G, baseline-midpoint, M (SD) | 0.5 (1.9) | 0.4 (1.5) | 0.6 (2.0) | 0.6 (3.2) | 0.5 (1.9) | No Differences |
| CPT-G, mid-endpoint, M (SD) | 1.2 (3.2) | 1.2 (2.9) | 1.2 (3.0) | 1.1 (2.6) | 1.5 (3.3) | No Differences |
| EBP visits before AMT, M (SD) | 0.2 (0.4) | 0.2 (0.4) | 0.2 (0.4) | 0.2 (0.4) | 0.2 (0.4) | No Differences |
| Other Mental Health Visits, M (SD) | 14.1 (11.3) | 15.3 (13.1) | 15.2 (14.2) | 17.0 (16.6) | 17.3 (15.6) | FS≠V |
| Substance Abuse Visits, M (SD) | 3.5 (14.4) | 3.1 (14.3) | 4.1 (17.7) | 1.2 (5.8) | 4.4 (18.4) | No Differences |
| Comorbid Diagnoses | ||||||
| Pain Disorder, % (n) | 73.1 (482) | 78.0 (256) | 75.0 (1,032) | 84.8 (89) | 79.7 (369) | No Differences |
| Headache Disorder, % (n) | 36.9 (243) | 40.2 (132) | 39.0 (537) | 81.9 (86) | 48.8 (226) | FS≠VT, P≠T, T≠V |
| Psychotic Disorders, % (n) | 3.6 (24) | 4.0 (13) | 3.3 (45) | 7.6 (8) | 2.6 (12) | No Differences |
| Bipolar Mood Disorders, % (n) | 5.6 (37) | 5.5 (18) | 5.7 (79) | 8.6 (9) | 5.6 (26) | No Differences |
| Depressive Mood Disorders, % (n) | 79.4 (523) | 77.4 (254) | 79.4 (1,093) | 69.5 (73) | 84.0 (389) | T≠V |
| Anxiety Disorders, % (n) | 41.3 (272) | 44.2 (145) | 41.1 (565) | 41.0 (43) | 52.3 (242) | FS≠V |
| TBI and Cognitive Disorders, % (n) | 25.6 (169) | 26.5 (87) | 26.2 (361) | 43.8 (46) | 29.4 (136) | FPSV≠T |
| Personality Disorders, % (n) | 5.5 (36) | 6.4 (21) | 4.3 (59) | 2.9 (3) | 6.3 (29) | No Differences |
| Nicotine Dependence, % (n) | 42.5 (280) | 52.7 (173) | 42.6 (586) | 32.4 (34) | 48.8 (226) | FST≠P, T≠V |
| Alcohol Dependence, % (n) | 33.1 (218) | 33.2 (109) | 29.0 (399) | 18.1 (19) | 29.2 (135) | FP≠T |
| Marijuana Dependence, % (n) | 6.2 (41) | 4.9 (16) | 4.1 (57) | 2.9 (3) | 5.2 (24) | No Differences |
| Opioid Dependence, % (n) | 4.7 (31) | 6.4 (21) | 3.7 (51) | 2.9 (3) | 5.0 (23) | No Differences |
| Concurrent Medication Use | ||||||
| Other Antidepressant, % (n) | 68.4 (451) | 69.8 (229) | 69.1 (951) | 79.0 (83) | 70.6 (327) | No Differences |
| Other Anticonvulsant, % (n) | 32.6 (215) | 36.0 (118) | 30.5 (419) | 39.0 (41) | 43.8 (203) | FS≠V |
| Lithium, % (n) | 2.7 (18) | 1.2 (4) | 1.6 (22) | 1.9 (2) | 3.0 (14) | No Differences |
| Antipsychotic, % (n) | 25.8 (170) | 28.4 (93) | 25.8 (355) | 30.5 (32) | 35.2 (163) | FS≠V |
| Sedative/Hypnotics, % (n) | 52.8 (348) | 57.0 (187) | 49.0 (674) | 61.0 (64) | 59.4 (275) | S≠V |
| Opioids, % (n) | 38.8 (256) | 45.1 (148) | 37.7 (519) | 54.3 (57) | 49.9 (231) | FS≠VT |
| Prazosin, % (n) | 41.9 (276) | 43.0 (141) | 44.7 (615) | 37.0 (35.2) | 46.7 (216) | No Differences |
| Stimulants, % (n) | 5.8 (38) | 3.0 (10) | 3.3 (46) | 5.7 (6) | 6.3 (29) | No Differences |
Note. PTSD=Posttraumatic Stress Disorder, FY=Fiscal Year, PCL=PTSD Checklist, M=mean, SD=standard Deviation, OEF/OIF/OND=Operations Enduring Freedom/Iraqi Freedom/New Dawn, VA= Veterans Affairs, VAMC=VA Medical Center; AMT=Adequate Medication Trial, MH=Mental Health, EBP-I=Individual Evidence-Based Psychotherapy, CPT-G=Group Cognitive Processing Therapy, TBI=Traumatic Brain Injury