• Judith A Cohen, Anthony P Mannarino, James M Perel, and Virginia Staron.
• Drexel University College of Medicine, Allegheny General Hospital, Department of Psychiatry, Pittsburgh, USA. jcohen1@wpahs.org
• J Am Acad Child Adolesc Psychiatry. 2007 Jul 1; 46 (7): 811-9.

ObjectiveTo examine the potential benefits of adding a selective serotonin reuptake inhibitor, sertraline, versus placebo, to trauma-focused cognitive-behavioral therapy (TF-CBT) for improving posttraumatic stress disorder and related psychological symptoms in children who have experienced sexual abuse.MethodTwenty-four 10- to 17-year-old female children and adolescents and their primary caretakers were randomly assigned to receive TF-CBT + sertraline or TF-CBT + placebo for 12 weeks.ResultsBoth groups experienced significant improvement in posttraumatic stress disorder and other clinical outcomes from pre- to posttreatment with no significant group x time differences between groups except in Child Global Assessment Scale ratings, which favored the TF-CBT + sertraline group.ConclusionsOnly minimal evidence suggests a benefit to adding sertraline to TF-CBT. A drawback of adding sertraline was determining whether TF-CBT or sertraline caused clinical improvement for children with comorbid depression. Current evidence therefore supports an initial trial of TF-CBT or other evidence-supported psychotherapy for most children with PTSD symptoms before adding medication.

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