Inpharma 1321 - 19 Jan 2002 Drug therapy for PTSD reviewed In a recent review of treatments for post-traumatic stress disorder (PTSD), Dr Rachel Yehuda from the Mount Sinai School of Medicine, New York, US, says that ‘primary care practitioners will play an important part in identifying and treating this disorder’. Dr Yehuda explains that clinical trial data support the use of selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants and monoamine oxidase inhibitors in the treatment of PTSD. In particular, SSRIs ‘are a first-line medication because they are safer and better tolerated than other types of psychotropic medications’, says Dr Yehuda. She adds that in the US, the only SSRIs that have been approved by the FDA for the treatment of PTSD are sertraline [‘Zoloft’] and paroxetine [‘Paxil’]. Expert consensus guidelines recommend that patients with PTSD who show inadequate response after 8 weeks’ SSRI therapy should then receive nefazodone [‘Serzone’] or venlafaxine [‘Effexor’]; add-on therapy with a mood stabiliser such as valproate semisodium [divalproex sodium; ‘Depakote’] should be administered to those patients who show a partial response. ‘Benzodiazepines should be avoided or used very judiciously in patients with PTSD’, advises Dr Yehuda. According to clinical trial data, treatment with alprazolam [‘Xanax’] has failed to demonstrate any advantage over placebo in the treatment of chronic PTSD and neither alprazolam nor clonazepam is superior to placebo in recent trauma survivors. Dr Yeluda notes that ‘pharmacologic agents targeting the specific constellation of biologic alterations in PTSD have not yet been developed’. Yehuda R. Post-traumatic stress disorder. New England Journal of Medicine 346: 108-114, 10 Jan 2002 800896057 1 Inpharma 19 Jan 2002 No. 1321 1173-8324/10/1321-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

Drug therapy for PTSD reviewed

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Inpharma 1321 - 19 Jan 2002

Drug therapy for PTSD reviewedIn a recent review of treatments for post-traumatic

stress disorder (PTSD), Dr Rachel Yehuda from theMount Sinai School of Medicine, New York, US, saysthat ‘primary care practitioners will play an importantpart in identifying and treating this disorder’.

Dr Yehuda explains that clinical trial data support theuse of selective serotonin reuptake inhibitors (SSRIs),tricyclic antidepressants and monoamine oxidaseinhibitors in the treatment of PTSD. In particular, SSRIs‘are a first-line medication because they are safer andbetter tolerated than other types of psychotropicmedications’, says Dr Yehuda. She adds that in the US,the only SSRIs that have been approved by the FDA forthe treatment of PTSD are sertraline [‘Zoloft’] andparoxetine [‘Paxil’]. Expert consensus guidelinesrecommend that patients with PTSD who showinadequate response after 8 weeks’ SSRI therapy shouldthen receive nefazodone [‘Serzone’] or venlafaxine[‘Effexor’]; add-on therapy with a mood stabiliser suchas valproate semisodium [divalproex sodium;‘Depakote’] should be administered to those patientswho show a partial response.

‘Benzodiazepines should be avoided or used veryjudiciously in patients with PTSD’, advises Dr Yehuda.According to clinical trial data, treatment withalprazolam [‘Xanax’] has failed to demonstrate anyadvantage over placebo in the treatment of chronicPTSD and neither alprazolam nor clonazepam issuperior to placebo in recent trauma survivors.

Dr Yeluda notes that ‘pharmacologic agents targetingthe specific constellation of biologic alterations in PTSDhave not yet been developed’.Yehuda R. Post-traumatic stress disorder. New England Journal of Medicine 346:108-114, 10 Jan 2002 800896057