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PHARMACOLOGY OF POST-TRAUMATIC STRESS DISORDER
T Tregub1, M Lytvynenko1, V Kukushkin2
11Odessa National Medical University, Ukraine.
Georgian Medical News
|November 22, 2023
Summary
Current posttraumatic stress disorder pharmacotherapy lacks unified approaches. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are first-line, but vortioxetine shows promise for cognitive benefits.
Area of Science:
- Psychiatry
- Pharmacology
- Clinical Medicine
Background:
- Posttraumatic stress disorder (PTSD) pharmacotherapy lacks standardized treatment guidelines.
- Existing treatments, including SSRIs and SNRIs, have limitations and side effects.
- Benzodiazepine use requires caution due to potential risks.
Purpose of the Study:
- To evaluate current pharmacotherapeutic strategies for PTSD.
- To synthesize evidence for effective medication use in PTSD management.
- To identify emerging and promising treatment options.
Main Methods:
- Comprehensive literature search of PubMed, Ovid, and EMBASE databases (2012-2022).
- Keywords: "posttraumatic stress disorder", "treatment", "medications".
- Content analysis of 14 highly relevant articles to formulate recommendations.
Main Results:
- No consensus exists on optimal PTSD pharmacotherapy.
- SSRIs and SNRIs are first-line, with FDA approval for sertraline, paroxetine, and fluoxetine, despite side effects.
- Vortioxetine demonstrates potential benefits for cognitive functions (attention, memory, executive function).
- Alpha-1 and alpha-2 adrenoceptor antagonists/agonists show some therapeutic evidence.
- Prazosin and trazodone are recommended for insomnia associated with PTSD.
Conclusions:
- PTSD pharmacotherapy necessitates medications with multimodal action.
- Further randomized clinical trials are essential for developing effective PTSD treatments.
- Vortioxetine represents a promising avenue for PTSD treatment, particularly for cognitive deficits.
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