Key result
Long-term medication use in PTSD is linked to ~13% lower maximum physical performance versus controls.
Why the study?
Deployment-related incidents often require pharmacological intervention, but current medical vocational rehabilitation strategies lack systematic medication assessment.
Does long-term medication use reduce physical performance in soldiers undergoing rehabilitation for physical impairments or PTSD?
Cohort (n=172)
Does long-term medication use reduce physical performance in soldiers undergoing rehabilitation for physical impairments or PTSD?
Long-term medication use, particularly polypharmacy and drug-drug interactions, is associated with significantly reduced physical performance in soldiers with PTSD undergoing rehabilitation.
Objective Military service is demanding and requires maintenance of optimal physical and mental health. Deployment-related incidents can precipitate the onset of physical and/or psychological trauma necessitating appropriate pharmacological intervention. However, current strategies for medical vocational rehabilitation do not include systematic medication assessment. Methods This study analyzed physical performance and long-term medication use in middle-aged soldiers diagnosed with physical impairments and/or posttraumatic stress disorder. Patient records were analyzed to investigate the number of drugs, polypharmacy, drug–drug interactions and drugs targeting the nervous system in relation to bicycle ergometry performance. Results A total of 172 patients were inclusion, with 45 patients (26.6%) receiving comprehensive medication. Patients with posttraumatic stress disorder, who were taking an average of 3.0 medications each, demonstrated significantly lower maximum performance than did the controls [ n = 93, 217 (200–250) W vs. n = 34, 250 (225–267) W, P = 0.006]. Polypharmacy [ n = 42, 217 (200–250) W vs. n = 34, 250 (225–267) W, P = 0.017] and drug–drug interactions [ n = 49, 221 (200–250) W vs. n = 34, n = 34, 250 (225–267) W, P = 0.024] negatively impacted maximum performance, with patients experiencing 1.6 interactions on average of varying severity. A significant negative correlation was observed between the number of drugs, anatomical-therapeutic-chemical classification, polypharmacy, number, and severity of drug–drug interactions and poor maximum performance. Although no other significant differences were noted across all groups, posttraumatic stress disorder patients without medication achieved significantly greater performance than did somatic patients [ n = 34, 250 (225–267) vs. n = 33, 217 (200–250), P = 0.009]. Conclusion In conclusion, highly prevalent polypharmacy may contribute to physical performance limitations, highlighting the need for further research and professional support in medication management within rehabilitation programs for mental illnesses.
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Schmitz et al. (2025) conducted a cohort in Physical impairments and/or posttraumatic stress disorder (n=172). Long-term medication vs. No medication was evaluated on Maximum performance on bicycle ergometry (p-max) in PTSD patients (p=0.006). Long-term medication use in soldiers with posttraumatic stress disorder was associated with significantly lower maximum physical performance compared to unmedicated controls (217 W vs 250 W, P=0.006).
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