PTSD Prevention Using Escitalopram

Inclusion criteria

• The patient is able to read and understand the Patient Informed Consent.
• The patient has signed the Patient Informed Consent.
• The patient has sufficient knowledge of Hebrew in order to understand the study procedure and instruments
• The patient is male or female aged between 18 and 65 years (extremes included).
• The patient underwent a traumatic event, such as vehicle or other accident, terror attack, physical or sexual assault within the last 3 weeks, and no more than 4 weeks ago.
• The patient meets either of the following criteria:

• Full DSM-IV criteria for ASD 2. Intrusion and hyperarousal criteria only

Exclusion criteria

• The patient refuses having any medication therapy. This patient will be referred to another treatment outside the study frame.
• The patient has a serious physical injury at inclusion, in which his Abbreviated Injury Scale (AIS) score, for at least one of his body regions, is 3 or more, or that according to the judgment of the clinician his injury sequelae would interfere with the study treatment.
• The patient uses concomitant medications not allowed in the study:

• Antidepressants, including MAOI, RIMA within the last 3 weeks prior to screening.
• Mood stabilizers within the last 3 weeks prior to screening.
• Antipsychotic medications within the last 3 weeks prior to screening.
• Anxiolytics 2 weeks in a row before randomization. Patient can participate in the study if did not take the medications for 3 days over the two weeks before randomization. Except for oxazepam 10-20 mg/day no more than 7 days in a raw.
• Serotonergic agonists (e.g. triptans) within the last 2 weeks prior to screening.
• Prophylactic treatment with any anticonvulsant drug.
• Herbal remedies that are psychoactive (e.g. St John's Wort, Kava kava, valerian, gingko biloba) within the last 3 weeks prior to screening.
• The patient meets lifetime DSM-IV-TR criteria for:

• Mania or Bipolar disorder
• Schizophrenia
• Any personality disorder judged by the investigator to jeopardize the evaluation of the treatment.
• Mental retardation or pervasive disorder
• Cognitive disorder (inc. dementia)
• The patient has or has had alcohol or drug abuse related disorders in the last year prior to the screening visit.
• The patient has, in the investigator's opinion, significant suicide risk and/or a score of ≥ 5 on question 10 in the MADRS scale.
• The patient has a history of severe suicide attempt.
• The patient requires ElectroConvulsive Therapy (ECT) or has received ECT within the last year prior to the screening visit.
• The patient is currently serving in the Israeli security forces.
• The patient has a history of drug allergy or hypersensitivity, or known hypersensitivity to escitalopram or citalopram.
• The patient has an illness and/or serious sequelae thereof, severe enough according to the clinician judgment, to prevent his participation in the study, including liver or renal insufficiency; cardiovascular, pulmonary, gastrointestinal, endocrine (inc. uncontrolled thyroid), neurological (inc. epilepsy), infectious, neoplastic, or metabolic disturbances
• The patient is pregnant or breast-feeding.
• The patient, if woman of childbearing potential, is not using adequate contraception (adequate contraception is defined as sexual abstinence, oral/systemic contraception, surgical sterilisation, intrauterine device, diaphragm in combination with spermicide, or condom for male partner in combination with spermicide).
• The patient, in the opinion of the investigator, is unlikely to comply with the clinical study protocol.
• The patient has previously participated in the current study or in any other study within the last 30 days.
• The patient has familial relationships with the investigator.