Pharmacotherapy for posttraumatic stress disorder: empirical review and clinical recommendations.
OBJECTIVE
Growing awareness of the psychological effects of trauma has emphasized the need for clinicians across a range of practice settings to be aware of evidence-based treatment options for posttraumatic stress disorder (PTSD). The purpose of this article is to review the available empirical data on pharmacological approaches to PTSD and to provide recommendations for clinical practice.


METHODS
Although a comprehensive search of PsychInfo and Medline databases revealed a multitude of case reports and open-label trials, this paper focuses primarily on evidence obtained from randomized controlled trials to determine the most effective pharmacological treatments for PTSD.


RESULTS
The research data overwhelmingly supports antidepressant medication as the first-line pharmacotherapy for PTSD, with selective serotonin re-uptake inhibitors having the strongest body of empirical support. Other medications, and with care, combination pharmacotherapy, may also have a role in the management of certain presentations. Cautions for clinicians in treating this complex disorder are provided.


CONCLUSIONS
Despite a substantial increase in the amount and quality of research into pharmacological treatments for PTSD in recent years, there is still a pressing need for more data to guide routine clinical practice. In particular, future research regarding the psychobiological basis of PTSD may guide the development of a PTSD-specific drug, designed to treat the unique characteristics of this disorder.
Cooper
John
J
Department of Psychiatry, Australian Centre for Posttraumatic Mental Health, University of Melbourne, PO Box 5444, Heidelberg, Victoria 3081, Australia. cooperja@unimelb.edu.au
Carty
Jessica
J
Creamer
Mark
M
D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use*; D036262:Empirical Research; D017408:Guidelines as Topic; D006801:Humans; D011613:Psychotherapy / Q000379:methods; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy* / Q000628:therapy
D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D001569:Benzodiazepines; D017367:Selective Serotonin Reuptake Inhibitors