Editorial
Psychopharmacotherapy of Posttraumatic Stress Disorder
Dragica Kozarić-Kovačić
orcid.org/0000-0003-3239-2056
; Department of Psychitry, Dubrava University Hospital
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 serotoninreuptake
inhibitors make the first-line treatment of PTSD. Clinical
experience has shown that they are more effective than noradrenalinreuptake
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.
Keywords
PTSD; psychopharmacotherapy; controlled and open-label clinical trials
Hrčak ID:
29259
URI
Publication date:
15.8.2008.
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