Pharmacologic treatment of acute and chronic stress following trauma: 2006.

Jonathan R. T. Davidson

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Posttraumatic Stress Disorder Research Sleep and related disorders Migration, Health and Trauma

Abstract

This article reviews pharmacologic treatment options for posttraumatic stress disorder (PTSD), focusing on goals of pharmacotherapy and the clinical trial evidence for drug treatments available for PTSD. The selective serotonin reuptake inhibitors (SSRIs) are recommended as first-line therapy for PTSD; the roles of these and other drug classes including anticonvulsants, mood enhancers, atypical antipsychotic agents, benzodiazepines, alpha1-adrenergic antagonists, and beta-blockers in achieving improvement in PTSD symptom and outcome scores, achieving remission, and avoiding relapse are discussed. Treatment of PTSD in association with other comorbid conditions is addressed, and the role of pharmacotherapy in treating early PTSD and acute stress disorder is examined. Dosing strategies for the SSRIs sertraline and paroxetine are provided, and an algorithm for PTSD pharmacotherapy is discussed.

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References

1995Posttraumatic Stress Disorder in the National Comorbidity Survey 2001Clinician-administered PTSD scale: A review of the first ten years of research 1997Assessment of a new self-rating scale for post-traumatic stress disorder 2002Pilot study of secondary prevention of posttraumatic stress disorder with propranolol 2000Efficacy and Safety of Sertraline Treatment of Posttraumatic Stress Disorder 2003Reduction of Nightmares and Other PTSD Symptoms in Combat Veterans by Prazosin: A Placebo-Controlled Study 2003Immediate treatment with propranolol decreases posttraumatic stress disorder two months after trauma 2001Multicenter, Double-blind Comparison of Sertraline and Placebo in the Treatment of Posttraumatic Stress Disorder

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