By Ágnes Szirmai
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The problem of adverse effects is extremely important because the negative influence on adherence to treatment, and efficacy also. Clomipramine usefulness is limited by side effects typical of tricyclic antidepressants. Long-term studies conclusion is that SSRI efficacy is maintained. If treatment is interrupted, a considerable number of patients will relapse. For this reason, treatment should be followed for long periods of time. It was very clear that the antiobsessive efficacy of clomipramine and SSRIs is independent of their antidepressant activity.
The positive association of bomb-related PTSS with physical exposure and with acute response supports the stressor criterion of the diagnosis of PTSD. The finding that posttraumatic stress related to other negative life events was associated with higher bomb-related posttraumatic stress. Posttraumatic stress associated with prior negative experiences may increase the vulnerability of children exposed to later traumatic events. The results suggested that having additional negative life events and losses subsequent to the bombing may also have increased the children’s vulnerability to posttraumatic stress [18-19].
Even if other compounds were tried to be used for this purpose - buspirone (20-60 mg/day), lithium (300-600 mg/day), gabapentin (300-2400 mg/day), inositol (16-18 mg/day), L-tryptophan (4-6 g/day), fenfluramine (20-60 mg/day), topiramate (250 Anxiety Disorders 4. 5. , 1996). Clonazepam that has serotonergic action too, has proved to be effective as monotherapy in a double blind study. However, there were presented cases in which clonazepam augmentation was beneficial in cases resistant to treatment.