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Related Experiment Videos

Pharmacotherapy for post-traumatic stress disorder

S M Sutherland1, J R Davidson

  • 1Department of Psychiatry, Duke University Medical Center, Durham, North Carolina.

The Psychiatric Clinics of North America
|June 1, 1994
PubMed
Summary

Post-traumatic stress disorder (PTSD) treatment often requires a combined approach. Antidepressants, particularly SSRIs, show promise for core PTSD symptoms, while other medications target specific issues like hyperarousal.

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Area of Science:

  • Psychiatry
  • Pharmacology
  • Clinical Psychology

Background:

  • Post-traumatic stress disorder (PTSD) is a chronic condition with high comorbidity, often resistant to treatment.
  • A combined treatment approach is generally beneficial, especially in acute stages.
  • Pharmacotherapy is a crucial component, potentially requiring long-term use.

Purpose of the Study:

  • To review current pharmacotherapeutic options for PTSD.
  • To evaluate the efficacy of different drug classes for various PTSD symptoms.
  • To provide guidance on medication selection based on symptom profiles.

Main Methods:

  • Review of controlled trials and available data on pharmacotherapy for PTSD.
  • Analysis of antidepressant efficacy, including TCAs and SSRIs.

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  • Examination of adjunctive treatments for specific symptoms like hyperarousal and impulse control.

    • Main Results:

    • Antidepressants, especially SSRIs, are effective for core PTSD symptoms at higher doses over 5-8 weeks.
    • TCAs help with intrusive and anxiety/depressive symptoms but not avoidance.
    • SSRIs show potential for improving avoidance, numbing, and global symptoms.
    • Buspirone, benzodiazepines (e.g., clonazepam), phenelzine, lithium, anticonvulsants, clonidine, and neuroleptics may address specific symptoms like hyperarousal, impulse control, and psychosis.

    Conclusions:

    • Pharmacotherapy, particularly with antidepressants like SSRIs, is a vital part of PTSD management.
    • Medication choice should be tailored to individual symptom clusters, including core symptoms, hyperarousal, and impulse control.
    • Further research is needed to establish a definitive, evidence-based consensus for PTSD pharmacotherapy.