Psychopharmacotherapy of Posttraumatic Stress Disorder

Abstract

Posttraumatic stress disorder (PTSD) is a psychiatric disorder that develops after a psychological trauma usually caused by a situation perceived as deeply threatening to a person's life or integrity. Complex neurobiological changes triggered by such a traumatic and stressful experience may explain a wide range of PTSD symptoms and provide the rationale for psychopharmacological treatment. Selective serotonin-reuptake inhibitors make the first-line treatment of PTSD. Clinical experience has shown that they are more effective than noradrenalin-reuptake inhibitors or tricyclic antidepressants. Antipsychotic drugs, especially atypical ones, have been shown effective in PTSD patients with psychotic characteristics or refractoriness to other treatments. Mood stabilizers seem to reduce mostly autonomous overreactions to stress, whereas the evidence for effectiveness of monoamine oxidase inhibitors is largely inconclusive. Other groups of medications, such as serotonin agonists and antagonists, new antidepressants, dual inhibitors of serotonin- and noradrenalin-reuptake, anticonvulsants, and opiate antagonists are also sometimes used in PTSD treatment. However, as shown in the present review, most clinical studies performed to date to investigate the effectiveness of different psychopharmacological agents in the therapy of PTSD have serious limitations in terms of small sample size, lack of blinding and randomization, and small effect size. More rigorously designed, comparative studies are needed to determine the usefulness, efficacy, tolerability, and safety of particular psychopharmaceutical drugs in the treatment of this therapeutically and functionally challenging disorder.

Tailoring therapeutic strategies for treating posttraumatic stress disorder symptom clusters

“…The most effective pharmacotherapies to date have been antidepressant SSRIs 89. It has been widely demonstrated that SSRIs are effective in reducing a number of PTSD symptoms across clusters;55 this includes several groups reporting a decrease in avoidant symptoms with the administration of the SSRIs fluoxetine,90 escitalopram,108 and sertraline 109.…”

Therapeutic Potential of 5-HT6 Antagonist SB399885 in Traumatic Stress Disorder

“…For such people there is a flashback of the traumatic events even a month after the incident. Generally, selective serotonin reuptake inhibitors (SSRIs), antipsychotics and anticonvulsants are administered to such patients [2]. However, there is a large subset of patients that do not respond satisfactorily to treatment [3].…”

Patients with Combat-related and War-related Posttraumatic Stress Disorder 10 Years After Diagnosis

“…There was a marked lack of mood stabilizers use, although guidelines show that mood stabilizers are useful in treatment of PTSD symptoms (26,27).…”