title: [Antipsychotics, anticonvulsants, antiadrenergics and other drugs: what to do when posttraumatic stress disorder does not respond to selective serotonin reuptake inhibitors?].
abstract: OBJECTIVE
  In this narrative review, we aimed to describe different pharmacological strategies for the treatment of patients with post-traumatic stress disorder who display different levels of intolerance, resistance, refractoriness, or who are unable to take to antidepressants, especially serotonin reuptake inhibitors.
  
  
  METHODS
  We searched the ISI web of science and the PubMed for original studies focusing in the treatment of PTSD in different clinical scenarios.
  
  
  RESULTS
  Preliminary evidence pointed towards the efficacy of drugs such as risperidone, olanzapine, lamotrigine and prazosin as strategies to be employed in the above mentioned clinical scenarios. The choice of a specific "second line" drug should take into account not only symptoms, but also pattern of comorbidities, previous response to other treatments, pharmacological interactions, side-effects, and patient's physical conditions.
  
  
  CONCLUSIONS
  Future randomized controlled trials should be performed in order to unveil which drugs should be prescribed in the absence of adequate treatment and response to serotonin reuptake inhibitors.
authors.affiliation: Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil. wberger@globo.com
authors.forename: William
authors.initials: W
authors.lastname: Berger
authors.forename: Carla Marques
authors.initials: CM
authors.lastname: Portella
authors.forename: Leonardo F
authors.initials: LF
authors.lastname: Fontenelle
authors.forename: Gustavo
authors.initials: G
authors.lastname: Kinrys
authors.forename: Mauro Vitor
authors.initials: MV
authors.lastname: Mendlowicz
mesh_terms: D018674:Adrenergic Antagonists / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D006801:Humans; D000077213:Lamotrigine; D000077152:Olanzapine; D011224:Prazosin / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D018967:Risperidone / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy*; D017211:Treatment Failure; D014227:Triazines / Q000627:therapeutic use
chemical_list: D018674:Adrenergic Antagonists; D000927:Anticonvulsants; D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000077213:Lamotrigine; D000077152:Olanzapine; D011224:Prazosin; D018967:Risperidone; D017367:Selective Serotonin Reuptake Inhibitors; D014227:Triazines
vernacular_title: Antipsicóticos, anticonvulsivantes, antiadrenérgicos e outras drogas: o que fazer quando o transtorno do estresse pós-traumático não responde aos inibidores seletivos da recaptação da serotonina?