Sertraline in the treatment of co-occurring alcohol dependence and posttraumatic stress disorder

Alcohol Clin Exp Res. 2005 Mar;29(3):395-401. doi: 10.1097/01.alc.0000156129.98265.57.


Background: Posttraumatic stress disorder (PTSD) frequently co-occurs with alcohol use disorders. This study investigated the use of sertraline, a serotonin reuptake inhibitor, in treating co-occurring symptoms of alcohol dependence and PTSD.

Methods: A total of 94 individuals with current alcohol dependence and PTSD were randomly assigned to receive sertraline (150 mg/day) or placebo for 12 weeks. Post hoc cluster analysis of baseline characteristics was used to define subgroups of participants.

Results: There was a significant decrease in alcohol use during the trial in both the sertraline and the placebo groups. Cluster analysis revealed significant medication group by cluster interactions for alcohol-related outcomes. Sertraline-treated participants with less severe alcohol dependence and early-onset PTSD had significantly fewer drinks per drinking day (p < 0.001). For participants with more severe alcohol dependence and later onset PTSD, the placebo group had significantly greater decreases in drinks per drinking day (p < 0.01) and average number of drinks consumed per day (p < 0.05).

Conclusions: There may be subtypes of alcohol-dependent individuals who respond differently to serotonin reuptake inhibitor treatment. Further investigation of differential responders may lead to improvements in the pharmacological treatment of co-occurring alcohol dependence and PTSD.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Alcoholism / complications*
  • Alcoholism / drug therapy*
  • Cluster Analysis
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Psychiatric Status Rating Scales
  • Serotonin Uptake Inhibitors / therapeutic use*
  • Sertraline / therapeutic use*
  • Stress Disorders, Post-Traumatic / complications*
  • Stress Disorders, Post-Traumatic / drug therapy*
  • Treatment Outcome


  • Serotonin Uptake Inhibitors
  • Sertraline