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Long-term pharmacotherapy for post-traumatic stress disorder
Lori L Davis1, Elizabeth C Frazier, Raela B Williford
1VA Medical Center, Tuscaloosa, Alabama 35404, USA. Lori.davis@va.gov
CNS Drugs
|June 1, 2006
Summary
Long-term pharmacological treatment, particularly with SSRIs, is effective for post-traumatic stress disorder (PTSD), maintaining improvements and preventing relapse. Other medications show promise but require further study.
Area of Science:
- Psychiatry
- Pharmacology
- Neuroscience
Background:
- Post-traumatic stress disorder (PTSD) is a debilitating condition often requiring long-term management.
- Understanding the efficacy of sustained pharmacological interventions is crucial for improving patient outcomes.
Purpose of the Study:
- To review the existing literature on the long-term pharmacological treatment of post-traumatic stress disorder (PTSD).
- To evaluate the effectiveness and safety of various drug classes in managing chronic PTSD symptoms.
Main Methods:
- A comprehensive PUBMED literature search was conducted for studies on long-term (>14 weeks) PTSD pharmacotherapy.
- Included were randomized controlled trials, open-label studies, case series, and pooled analyses involving adult and pediatric populations.
Main Results:
- Selective serotonin reuptake inhibitors (SSRIs) effectively maintain treatment response, improve quality of life, and convert non-responders to responders in PTSD.
- Discontinuing SSRIs after 12 weeks increases relapse risk compared to extended treatment.
- Extended paroxetine treatment improved memory and hippocampal volume in PTSD patients.
- Atypical antipsychotics, nefazodone, and valproate also demonstrated significant improvements in PTSD symptoms.
Conclusions:
- Long-term SSRI treatment for PTSD enhances psychiatric and clinical outcomes, preventing relapse and symptom exacerbation.
- Further controlled studies are needed to confirm the efficacy of atypical antipsychotics, antiepileptic drugs, and other psychotropic medications in PTSD management.
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