{
    "abstract": "There are high rates of comorbid alcohol use disorder (AUD) among those who have posttraumatic stress disorder (PTSD). Ideally, treatment for comorbidity should address both disorders simultaneously. Zonisamide, an anticonvulsant, may be effective in decreasing alcohol use and may attenuate symptoms of PTSD. Treatment strategies can include medication in combination with a proven evidence-based psychotherapy designed to treat PTSD, such as cognitive processing therapy (CPT).\nThis 12-week pilot study was designed to test feasibility, acceptability, and preliminary efficacy of zonisamide (400\u2009mg) as an adjunct to CPT for veterans with PTSD and comorbid AUD. Veterans (n\u2009=\u200924) with PTSD and current alcohol dependence were randomized in a 3:1 ratio to receive zonisamide or placebo in a double-blind fashion. All subjects received CPT enhanced to include sessions addressing drinking behavior.\nSubjects overall reported a significant decrease in drinking outcomes, craving, and symptoms of PTSD. Zonisamide was well-tolerated and easily administered with CPT, which was also well-tolerated. Exploratory analysis of comparison of groups suggests there was no advantage of zonisamide vs placebo in drinking or PTSD outcomes. There was a numeric but nonsignificant higher rate of abstinence with zonisamide (50%) vs placebo (33%).\nThe interpretation of the results is limited by the pilot nature of this study. The combination of psychosocial treatment with medication management mimics real-world treatment. In order to isolate the individual contributions of medication vs psychotherapy a much larger study would need to be conducted. (Am J Addict 2020;29:515-524).",
    "authors": [
        {
            "affiliation": "Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.\nDepartment of Veterans Affairs, VA Connecticut Healthcare System, West Haven, Connecticut.",
            "firstname": "Ismene",
            "initials": "I",
            "lastname": "Petrakis"
        },
        {
            "affiliation": "Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.\nDepartment of Veterans Affairs, VA Connecticut Healthcare System, West Haven, Connecticut.",
            "firstname": "Elizabeth",
            "initials": "E",
            "lastname": "Ralevski"
        },
        {
            "affiliation": "Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, Virginia.",
            "firstname": "Albert J",
            "initials": "AJ",
            "lastname": "Arias"
        },
        {
            "affiliation": "Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.\nDepartment of Veterans Affairs, VA Connecticut Healthcare System, West Haven, Connecticut.",
            "firstname": "Diana",
            "initials": "D",
            "lastname": "DeNegre"
        },
        {
            "affiliation": "Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.\nDepartment of Veterans Affairs, VA Connecticut Healthcare System, West Haven, Connecticut.",
            "firstname": "Jenelle",
            "initials": "J",
            "lastname": "Newcomb"
        },
        {
            "affiliation": "Department of Veterans Affairs, VA Connecticut Healthcare System, West Haven, Connecticut.",
            "firstname": "Mayumi",
            "initials": "M",
            "lastname": "Gianoli"
        },
        {
            "affiliation": "National Center for Posttraumatic Stress Disorder, White River Junction VA Medical Center, White River Junction, Vermont.",
            "firstname": "Elissa",
            "initials": "E",
            "lastname": "McCarthy"
        },
        {
            "affiliation": "Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.\nDepartment of Veterans Affairs, VA Connecticut Healthcare System, West Haven, Connecticut.",
            "firstname": "Sarah",
            "initials": "S",
            "lastname": "Meshberg-Cohen"
        },
        {
            "affiliation": "Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.\nDepartment of Veterans Affairs, VA Connecticut Healthcare System, West Haven, Connecticut.",
            "firstname": "Gihyun",
            "initials": "G",
            "lastname": "Yoon"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2020 American Academy of Addiction Psychiatry.",
    "doi": "10.1111/ajad.13061",
    "journal": "The American journal on addictions",
    "keywords": [],
    "methods": null,
    "publication_date": "2020-05-29",
    "pubmed_id": "32462773",
    "results": "Subjects overall reported a significant decrease in drinking outcomes, craving, and symptoms of PTSD. Zonisamide was well-tolerated and easily administered with CPT, which was also well-tolerated. Exploratory analysis of comparison of groups suggests there was no advantage of zonisamide vs placebo in drinking or PTSD outcomes. There was a numeric but nonsignificant higher rate of abstinence with zonisamide (50%) vs placebo (33%).",
    "title": "Zonisamide as an Adjunctive Treatment to Cognitive Processing Therapy for Veterans With Posttraumatic Stress Disorder and Comorbid Alcohol Use Disorder: A Pilot Study.",
    "xml": "<Element 'PubmedArticle' at 0x788502c3ec00>"
}