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Current concepts in pharmacotherapy for posttraumatic stress disorder
Frank B Schoenfeld1, Charles R Marmar, Thomas C Neylan
1Department of Veterans Affairs Medical Center in San Francisco, San Francisco, California 94121, USA. schoen@itsa.ucsf.edu
Psychiatric Services (Washington, D.C.)
|May 7, 2004
Summary
Selective serotonin reuptake inhibitors like sertraline and paroxetine are effective pharmacologic treatments for posttraumatic stress disorder (PTSD). Further research is needed for other agents, with treatment choice depending on symptoms and comorbidities.
Area of Science:
- Psychiatry
- Pharmacology
- Neuroscience
Background:
- Posttraumatic stress disorder (PTSD) is a debilitating condition with complex psychophysiological alterations.
- Pharmacologic interventions are a key component of PTSD management, particularly when comorbid psychiatric disorders are present.
Purpose of the Study:
- To review current pharmacologic treatment approaches for PTSD.
- To examine classes of pharmacologic agents utilized in PTSD treatment.
- To highlight pharmacotherapy for PTSD with comorbid conditions.
Main Methods:
- Comprehensive MEDLINE search for primary-source literature.
- Inclusion of secondary-source review articles and book chapters.
- Emphasis on controlled studies and evidence-based recommendations, informed by PTSD psychophysiology.
Main Results:
- Selective serotonin reuptake inhibitors (SSRIs), specifically sertraline and paroxetine, are FDA-approved and demonstrate efficacy in placebo-controlled trials for PTSD.
- Emerging research explores adrenergic-inhibiting agents and mood stabilizers, informed by psychophysiologic findings in PTSD.
- Controlled trials are necessary to establish the efficacy of these newer agent classes.
Conclusions:
- Pharmacologic treatment for PTSD is supported by a growing evidence base.
- Sertraline and paroxetine are established first-line pharmacotherapies for PTSD.
- Treatment selection requires consideration of symptom presentation and comorbid psychiatric conditions, with ongoing research into novel therapeutic agents.