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Updated: Jun 23, 2025

Simultaneous Application of Transcranial Direct Current Stimulation during Virtual Reality Exposure
Published on: January 18, 2021
[Pharmacological treatment of posttraumatic stress disorder]
Stefan Roepke1,2, Julia Schellong3, Niels Bergemann4,5
1Klinik für Psychiatrie und Psychotherapie, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Deutschland. stefan.roepke@charite.de.
Abstract:
In addition to trauma-focussed psychotherapy, pharmacological treatment is often unavoidable, especially in patients with severe posttraumatic stress disorder (PTSD). As long as comorbid disorders do not dictate the pharmacotherapy approach, sertraline and paroxetine, along with other off-label prescribable substances approved in Germany, can be used for the treatment of PTSD. Venlafaxine, in particular, has shown good effectiveness in studies, whereas risperidone has shown lower effectiveness in augmentation. Overall, only a small to medium effect size is to be expected for all substances. Psychopharmacotherapy plays an important role in addressing sleep disorders, which are highly prevalent in PTSD. Treatment of trauma-related nightmares can be attempted with doxazosin or clonidine. In contrast, there are limited empirical data available for sleep disorders associated with PTSD, but the pharmacological treatment of insomnia can provide some guidance.
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