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Research Article| Volume 54, ISSUE 7, P693-702, October 01, 2003

Long-term treatment with paroxetine increases verbal declarative memory and hippocampal volume in posttraumatic stress disorder

  • Eric Vermetten
    Correspondence
    Address reprint requests to Eric Vermetten, M.D., Ph.D., Rudolf Magnus Institute of Neurosciences, Department of Psychiatry, University Medical Center, Internal mailbox B01206, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
    Affiliations
    Department of Psychiatry and Behavioral Sciences (EV, JDB), Emory University School of Medicine, Atlanta, Georgia, USA

    Positron Emission Tomography Center/Nuclear Medicine (EV, JDB), Emory University School of Medicine, Atlanta, Georgia, USA

    Veterans Affairs Medical Center (EV, JDB), Decatur, Georgia, USA
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  • Meena Vythilingam
    Affiliations
    Program for Mood and Anxiety Disorders (MV, DSC), National Institute of Mental Health, Bethesda, Maryland, USA
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  • Steven M. Southwick
    Affiliations
    Department of Psychiatry (SMS), Yale University School of Medicine, New Haven, Connecticut, USA

    National Center for Posttraumatic Stress Disorder (SMS), West Haven Veterans Affairs Medical Center, West Haven, Connecticut, USA
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  • Dennis S. Charney
    Affiliations
    Program for Mood and Anxiety Disorders (MV, DSC), National Institute of Mental Health, Bethesda, Maryland, USA
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  • J.Douglas Bremner
    Affiliations
    Department of Psychiatry and Behavioral Sciences (EV, JDB), Emory University School of Medicine, Atlanta, Georgia, USA

    Positron Emission Tomography Center/Nuclear Medicine (EV, JDB), Emory University School of Medicine, Atlanta, Georgia, USA

    Veterans Affairs Medical Center (EV, JDB), Decatur, Georgia, USA
    Search for articles by this author

      Abstract

      Background

      Animal studies have shown that stress is associated with damage to the hippocampus, inhibition of neurogenesis, and deficits in hippocampal-based memory dysfunction. Studies in patients with posttraumatic stress disorder (PTSD) found deficits in hippocampal-based declarative verbal memory and smaller hippocampal volume, as measured with magnetic resonance imaging (MRI). Recent preclinical evidence has shown that selective serotonin reuptake inhibitors promote neurogenesis and reverse the effects of stress on hippocampal atrophy. This study assessed the effects of long-term treatment with paroxetine on hippocampal volume and declarative memory performance in PTSD.

      Methods

      Declarative memory was assessed with the Wechsler Memory Scale–Revised and Selective Reminding Test before and after 9–12 months of treatment with paroxetine in PTSD. Hippocampal volume was measured with MRI. Of the 28 patients who started the protocol, 23 completed the full course of treatment and neuropsychological testing. Twenty patients were able to complete MRI imaging.

      Results

      Patients with PTSD showed a significant improvement in PTSD symptoms with treatment. Treatment resulted in significant improvements in verbal declarative memory and a 4.6% increase in mean hippocampal volume.

      Conclusions

      These findings suggest that long-term treatment with paroxetine is associated with improvement of verbal declarative memory deficits and an increase in hippocampal volume in PTSD.

      Keywords

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