New directions in the pharmacotherapy of posttraumatic stress disorder (original) (raw)

Pharmacotherapy of PTSD: Current Status and Controversies

Psychiatric Annals, 2009

Posttraumatic stress disorder (PTSD) is a common psychiatric disorder in populations exposed to trauma, and it is among the most functionally-impairing, similar in scope to that observed in mood disorders. Recent years have seen many treatment studies assessing efficacy of diverse pharmacotherapies for PTSD. This article reviews the established, evidence-based pharmacotherapeutic treatments for PTSD and highlights current recommendations and controversial areas. The article primarily focuses on published randomized clinical trials that tested overall symptom reduction in PTSD compared to placebo. We also briefly review efforts to target particular symptoms commonly associated with PTSD (eg, sleep disturbance; psychotic symptoms) and at preventing PTSD among populations recently exposed to trauma. Where appropriate, recommendations are made for use of particular agents as first-line pharmacotherapies.

Pharmacological management of posttraumatic stress disorder

Current Opinion in Psychology, 2017

Posttraumatic stress disorder (PTSD) has been conceptualized as an inability to cope with overwhelming stress that is followed by a distinctive pattern of symptoms. This concept has made it possible to develop therapeutic approaches for PTSD that include medication and psychotherapy options. In this article we summarize research studies on pharmacotherapies for PTSD and review new findings in the neurobiology of PTSD that are promoting the development of targeted treatment options. Research findings that have improved our understanding of psychobiological abnormalities associated with PTSD offer clinicians improved treatment strategies. We review those findings, the developments in the medication management of PTSD and common co-occurring disorders, and new areas of pharmacological research on PTSD treatment.

Pharmacotherapy for PTSD

Psychiatric Annals, 2003

Since each us has previously published reviews of medication treat ment for adults and children with posttraumatic stress disorder (PTSD),[1-3 ] we approach the subject somewhat differently in this arti cle. We ask and answer 11 questions that we believe encompass major con cerns of prescribing psychiatrists about medication treatment for adults or children with PTSD. We hope that this presentation provides a syn thesis of research literature in a form that directly addresses common clinical decisions. When Do You Use Medication for PTSD? There is no simple rule that determines the choice of medication use in PTSD. Rather, medication should be considered an option among several potential therapeu tic interventions including cognitive behavioral thera py, psycho-education, supportive therapy, and family therapy. Decisions to use medications are appropriately tailored to individual patient needs and influenced by patient concerns and preferences.

Pharmacological treatment of post-traumatic stress disorder

Advances in Psychiatric Treatment, 2007

Post-traumatic stress disorder (PTSD) causes significant distress and is often associated with markedly reduced functioning. Recent reviews have consistently recommended trauma-focused psychological therapies as a first-line treatment for PTSD. Pharmacological treatments have also been recommended but not as consistently. This article reviews the available trials of the pharmacological treatment of PTSD and discusses their implications.

Psychopharmacological treatment in PTSD: a critical review

Journal of Psychiatric Research, 2002

Introduction: Posttraumatic stress disorder (PTSD) is a prevalent psychiatric disorder that is heterogeneous in its nature, and often presents with other psychiatric comorbidities. As a result, empirical research on effective pharmacotherapy for PTSD has produced complex findings. This article reviews the existing research literature on pharmacological treatments for PTSD, identifies the most effective treatments, and where possible examines their mechanism of action with respect to the neurobiology of PTSD. Methods: We examined reports of clinical trials of psychotropic agents carried out with PTSD patients and published in peerreviewed journals, as well as reports from presentations at scientific meetings between 1966 and 2001. Results: Numerous medications are effective in treating PTSD. These include tricyclic antidepressants, monoamine oxidase inhibitors, and serotonin reuptake inhibitors. Considering reported overall efficacy and side effects profiles, selective serotonin reuptake inhibitors emerge as the preferred first line treatment for PTSD. Mood stabilizers, atypical neuroleptics, adrenergic agents, and newer antidepressants also show promise, but require further controlled trials to clarify their place in the pharmacopoeia for PTSD. Discussion: There is clear evidence for effective pharmacotherapy of PTSD. Future improvements in the treatment of this disorder await further clinical trials and neurobiological research. Published by Elsevier Science Ltd.

Post-traumatic stress disorder: emerging concepts of pharmacotherapy

Expert Opinion on Emerging Drugs, 2009

Posttraumatic stress disorder (PTSD) can result from a traumatic experience that elicits emotions of fear, helpless or horror. Most individuals remain asymptomatic or symptoms quickly resolve, but in a minority intrusive imagery and nightmares, emotional numbing and avoidance, and hyperarousal persist for decades. PTSD is associated with psychiatric and medical co-morbidities, increased risk for suicide, and with poor social and occupational functioning. Psychotherapy and pharmacotherapy are common treatments. Whereas, research supports the efficacy of the cognitive behavioral psychotherapies, there is insufficient evidence to unequivocally support the efficacy of any specific pharmacotherapy. Proven effective pharmacologic agents are sorely needed to treat core and targeted PTSD symptoms, and for prevention. This review describes current and emerging pharmacotherapies that advance these goals.

Psychopharmacology of Pediatric Posttraumatic Stress Disorder

Journal of Child and Adolescent Psychopharmacology, 1999

Objective: To review the current knowledge of pharmacotherapy in the treatment of Posttraumatic Stress Disorder (PTSD) as it applies to children and adolescents and to provide a rational approach to medication use in Pédiatrie PTSD. Method: The literature on the psychopharmacology of Pédiatrie PTSD is reviewed. Additionally, literature is reviewed on the neurobiological systems presumptively involved in trauma as well as studies in the pharmacology of adult PTSD, as they pertain to the treatment of Pédiatrie PTSD. Results: There are too few studies in the current Pédiatrie PTSD literature to confirm treatment recommendations. Downward extrapolation from the adult literature combined with an understanding of the neurobiology of PTSD and its comorbid conditions may serve as the basis for a rational pharmacotherapy of PTSD in childhood. The effectiveness of targeting pharmacological agents at PTSD symptom clusters and associated comorbid conditions remains to be verified in controlled clinical trials. Conclusions: The state of psychopharmacology for Pédiatrie PTSD is in its earliest stages. While there are insufficient numbers of controlled pharmacological trials to make firm recommendations, the field requires a starting point for a rational psychopharmacological approach. Pharmacotherapy may provide symptom relief of both the debilitating primary symptoms and the comorbid conditions in children suffering from PTSD. Posttraumatic Stress Disorder (PTSD) is a complicated condition involving multiple neurobiological systems which may result in dysregulation of cognitive, affective and behavioral domains of functioning. In this article we review the literature on the pharmacological treatment of Pédiatrie PTSD. We will also discuss the relevant neurobiological systems that may contribute to the pathophysiology of the disorder and offer a rational approach to the treatment of PTSD in children. We will draw inferences from the

Updates on Pharmacological Treatment of Post-Traumatic Stress Disorder

Journal of Nepal Medical Association

Post-Traumatic Stress Disorder affects a significant proportion of those who have been exposed to exceptionally threatening or catastrophic events or situations such as earthquakes, rape and civil war. The condition can often become chronic and disabling. Medical intervention can therefore be of paramount importance. There are no national guidelines for trauma disorders in Nepal and there is a lack of adequate knowledge regarding drug treatment of PTSD among doctors and other service providers. Though psychotherapy is internationally regarded as the first line treatment for PTSD, it is often not feasible in Nepal due to lack of resources and skilled health workers in this field. The use of right psycho-pharmacotherapy is therefore important to reduce the burden of disease. A wide range of pharmacotherapy has been tested in the treatment of PTSD. This article is based on a selected sample of relevant articles from PubMed, PsycINFO, national guidelines from other countries and our own...