Prescribing With a Trauma-Informed Perspective.

Area of Science:

• Psychiatric-Mental Health Nursing
• Neurobiology of Trauma
• Psychopharmacology

Background:

• Trauma activates neurobiological survival mechanisms that can cause chronic stress and disability if not managed.
• Posttraumatic stress disorder (PTSD) is a distinct psychiatric disorder that can underlie other conditions like depression, anxiety, and substance use disorders.

Purpose of the Study:

• To highlight the importance of trauma symptomatology assessment in diverse patient populations.
• To provide guidance on pharmacotherapy and psychotherapy for trauma-related conditions.

Main Methods:

• Review of neurobiological mechanisms of trauma.
• Discussion of pharmacotherapeutic options, including first-line medications and contraindications.
• Emphasis on the role of psychotherapy as an adjunct treatment.

Main Results:

• Trauma can lead to severe chronic stress responses and disability.
• PTSD is linked to various psychiatric disorders.
• Serotonin reuptake inhibitors (SRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and adrenergic blockers are recommended first-line pharmacotherapies.
• Second-generation antipsychotics and benzodiazepines should be used cautiously.

Conclusions:

• Psychiatric-mental health nurses must assess for trauma in all patients, including vulnerable populations.
• A combination of pharmacotherapy and psychotherapy is effective for managing trauma-related conditions.