Behavioral therapy works well for PTSD, according to a new meta-analysis

Two psychological therapies provide the most and longest-acting relief to people with post-traumatic stress disorder (PTSD), according to a meta-analysis in press in Clinical Psychology and Psychotherapy.

One of those therapies is the controversial eye-movement desensitization and reprocessing (EMDR). EMDR developer Francine Shapiro, PhD, says that the key to the therapy is having patients recall traumatic events while receiving some type of oscillatory stimulation such as following an object with their eyes as it rapidly moves from side-to-side or hearing tones in one ear and then the other.

The meta-analysis study authors Michelle Van Etten, PhD, of the University of Michigan and Steven Taylor, PhD, of the University of British Columbia, stand by their finding that EMDR works, but caution that there is no data to explain how it works.

And without clarification of how EMDR works, 'the acceptability of EMDR within the professional community is likely to remain controversial,' the researchers write.

It may be that EMDR is merely a hybrid of other behavioral therapies, including exposure therapy, which the authors also found to be useful for treating PTSD.

Serotonin specific reuptake inhibitors (SSRIs), such as Prozac, also appear to alleviate the symptoms of PTSD, the researchers found. However, since none of the studies reviewed provided follow-up data on how well patients do after they stop taking the drug, Taylor and Van Etten are cautious to recommend SSRIs as a treatment of choice.

Taylor and Van Etten analyzed 61 treatment outcome studies of 10 commonly used PTSD treatments, in an attempt to determine the treatment of choice for PTSD. They lumped treatments into two groups: drug therapies, which included SSRIs and benzodiazepines, and psychological therapies, which included behavior therapy and EMDR.

Behavior therapies, EMDR and SSRIs were the most effective treatments, significantly reducing patients? symptoms, including intrusive thoughts, anxiety and depression, Taylor and Van Etten conclude. One downside to SSRIs, however, is that patients tended to drop out of treatment more often than behavior therapy or EMDR?about 14 percent dropped out of the psychological therapies while around 32 percent dropped out of drug therapy.