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Related Experiment Videos

Pharmacotherapy for posttraumatic stress disorder.

D J Stein1, N Zungu-Dirwayi, van Der Linden GJ

  • 1University of Stellenboseh, Tygerberg 7505, South Africa. djs1001@ibm.net

The Cochrane Database of Systematic Reviews
|October 18, 2000
PubMed
Summary

Medication can effectively reduce posttraumatic stress disorder (PTSD) core symptoms. While specific predictors and superior medication classes remain unclear, SSRIs show promise in treating this prevalent condition.

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Area of Science:

  • Psychiatry and Clinical Psychology
  • Pharmacology and Therapeutics

Background:

  • Posttraumatic stress disorder (PTSD) is a common and debilitating condition linked to psychological trauma.
  • While psychotherapy is a primary treatment, growing evidence of psychobiological dysfunctions in PTSD fuels interest in pharmacotherapy.
  • This review systematically evaluates the efficacy of medications for PTSD treatment.

Purpose of the Study:

  • To conduct a systematic review of randomized controlled trials (RCTs) on PTSD pharmacotherapy.
  • To estimate the overall effect of medication in treating PTSD.
  • To explore medication class efficacy, tolerability, and predictors of treatment response.

Main Methods:

  • Comprehensive literature searches of databases (MEDLINE, PSYCLIT, etc.) and direct requests for RCTs (1966-1999).

Related Experiment Videos

  • Inclusion of published and unpublished RCTs (placebo-controlled and comparative) completed before the end of 1999.
  • Independent assessment and data extraction by two raters using Review Manager software, analyzing symptom ratings and clinical/methodological factors.

    • Main Results:

    • Nine of fifteen identified short-term RCTs provided sufficient data for analysis.
    • Despite methodological limitations in some early studies, many trials showed medication efficacy over placebo.
    • Statistically significant reductions in PTSD symptoms (intrusion, avoidance, total) and improved Clinical Global Impressions were observed with pharmacotherapy compared to placebo.

    Conclusions:

    • Medication is an effective treatment for reducing core PTSD symptoms and should be considered in patient management.
    • Current evidence is insufficient to identify specific treatment predictors or definitively recommend one medication class over another, though SSRIs show efficacy.
    • Further research is needed on medication's impact on quality of life, optimal dosing, use in diverse populations, and prophylactic, combined, or maintenance therapies.