Treatment of acute posttraumatic stress disorder with tricyclic antidepressants

The diagnostic concept of posttraumatic stress disorder (PTSD) has long been recognized but usually applied in postwar circumstances. Recently developed criteria have allowed the disorder to be recognized in civilian patients having stress from such common insults as trauma, burns, or rape. Because PTSD may become chronic and difficult to treat if unrecognized, early intervention is desirable. In this report I describe three patients with acute PTSD who had favorable therapeutic response to tricyclic antidepressants. Although the use of the tricyclic agents in PTSD is rational because of their antianxiety and antidepressant properties, little has previously been said of their effectiveness in this disorder. These agents may provide an effective means of diminishing or preventing chronic PTSD.