
Contents
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Brief Description of PTSD as Currently Defined in DSM-IV Brief Description of PTSD as Currently Defined in DSM-IV
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Diagnostic Criteria Diagnostic Criteria
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Prevalence Prevalence
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Etiology Etiology
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Brief Overview of Psychotherapy in PTSD Brief Overview of Psychotherapy in PTSD
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Pharmacotherapy in Adults with PTSD Pharmacotherapy in Adults with PTSD
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Rationale for the Use of Pharmacotherapy in PTSD Rationale for the Use of Pharmacotherapy in PTSD
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Assessment of the Efficacy of Pharmacotherapy in PTSD Assessment of the Efficacy of Pharmacotherapy in PTSD
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Acute Phase Treatment in PTSD Acute Phase Treatment in PTSD
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Monoamine Oxidase Inhibitors Monoamine Oxidase Inhibitors
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Tricyclic and Tetracyclic Antidepressants Tricyclic and Tetracyclic Antidepressants
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Selective Serotonin Reuptake Inhibitors Selective Serotonin Reuptake Inhibitors
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Other Antidepressants Other Antidepressants
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Antipsychotics Antipsychotics
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Benzodiazepines Benzodiazepines
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Mood Stabilizers and Anticonvulsants Mood Stabilizers and Anticonvulsants
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Sympatholytic Agents Sympatholytic Agents
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Sedatives and Hypnotics Sedatives and Hypnotics
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Other Agents Other Agents
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Summary of the Results of Acute Phase Treatment Trials of Chronic PTSD Summary of the Results of Acute Phase Treatment Trials of Chronic PTSD
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Maintenance Treatment and Relapse Prevention Maintenance Treatment and Relapse Prevention
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Secondary Prevention of PTSD Secondary Prevention of PTSD
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Future Directions Future Directions
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References References
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17 Pharmacological Treatment of Posttraumatic Stress Disorder
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Published:February 2007
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Abstract
There have been rapid advances made in the pharmacological treatment of chronic posttraumatic stress disorder (PTSD) in the last decade. Based on numerous controlled clinical trials, antidepressants are the first-line pharmacological treatment for this disorder. Multiple studies suggest the selective serotonin reuptake inhibitors (fluoxetine, sertraline, and paroxetine) are efficacious in reducing PTSD-specific symptoms and improving global outcome; tricyclic anti-depressants (imipramine) and monoamine oxidase inhibitors (phenelzine) have also been found to be efficacious. For those who are resistant or refractory to antidepressant treatment, prazosin is emerging as a beneficial adjunctive agent in treating PTSD-related sleep disturbances and nightmares, and atypical antipsychotics (risperidone, olanzapine) appear to be efficacious against a broad range of symptoms, though their potential for causing metabolic side effects may limit their use. Controlled clinical trials are needed to assess whether anticonvulsants, cortisol, and sympatholytics are efficacious, and how and when pharmacotherapy can supplement or enhance psychotherapy outcomes. The pace of advances in recent years suggests that the promise of even more effective pharmacological treatments for PTSD is likely to be realized in the coming years.
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