title: Benzodiazepines for PTSD: A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  Although benzodiazepines (BZDs) are commonly used in the treatment of posttraumatic stress disorder (PTSD), no systematic review or meta-analysis has specifically examined this treatment. The goal of this study was to analyze and summarize evidence concerning the efficacy of BZDs in treating PTSD.
  
  
  METHODS
  The review protocol was undertaken according to the principles recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and is registered with the PROSPERO international prospective register of systematic reviews (http://www.crd.york.ac.uk/PROSPERO, registration number CRD42014009318). Two authors independently conducted a search of all relevant articles using multiple electronic databases and independently abstracted information from studies measuring PTSD outcomes in patients using BZDs. Eighteen clinical trials and observational studies were identified, with a total of 5236 participants. Outcomes were assessed using qualitative and quantitative syntheses, including meta-analysis.
  
  
  RESULTS
  BZDs are ineffective for PTSD treatment and prevention, and risks associated with their use tend to outweigh potential short-term benefits. In addition to adverse effects in general populations, BZDs are associated with specific problems in patients with PTSD: worse overall severity, significantly increased risk of developing PTSD with use after recent trauma, worse psychotherapy outcomes, aggression, depression, and substance use. Potential biopsychosocial explanations for these results are proposed based on studies that have investigated BZDs, PTSD, and relevant animal models.
  
  
  CONCLUSIONS
  The results of this systematic review suggest that BZDs should be considered relatively contraindicated for patients with PTSD or recent trauma. Evidence-based treatments for PTSD should be favored over BZDs.
authors.affiliation: GUINA: Wright State University Department of Psychiatry and Wright-Patterson Air Force Base Medical Center, Dayton, OH ROSSETTER: Wright State University Department of Psychiatry DERHODES: Wright State University Department of Psychiatry and Miami Valley Hospital, Dayton, OH NAHHAS: Wright State University Department of Community Health WELTON: Wright State University Department of Psychiatry and Veterans Affairs Medical Center, Dayton, OH.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Guina
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Rossetter
authors.forename: Bethany J
authors.initials: BJ
authors.lastname: DeRHODES
authors.forename: Ramzi W
authors.initials: RW
authors.lastname: Nahhas
authors.forename: Randon S
authors.initials: RS
authors.lastname: Welton
mesh_terms: D000818:Animals; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects; D002986:Clinical Trials as Topic; D003863:Depression / Q000209:etiology; D006801:Humans; D023421:Models, Animal; D011569:Psychiatric Status Rating Scales; D018570:Risk Assessment; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D019966:Substance-Related Disorders / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D001569:Benzodiazepines