Skip to main content
SpringerLink
Log in

Pharmacotherapy of Post-Traumatic Stress Disorder

  • Chapter
  • First Online:
Behavioral Neurobiology of Anxiety and Its Treatment

Part of the book series: Current Topics in Behavioral Neurosciences ((CTBN,volume 2))

Abstract

Post-traumatic stress disorder (PTSD) is a prevalent psychiatric disorder that may result in significant social and occupational debilitation unless symptoms are recognized and treated appropriately. Considerable research effort has been devoted over the last 20years to developing effective pharmacological treatments for this illness. At this time, the bulk of the agents investigated include antidepressants, anticonvulsants, atypical antipsychotics, benzodiazepines, and antiadrenergic agents. Herein, we review the existing evidence base for these different classes of psychotropics in PTSD. Emphasis is placed on discussion of evidence stemming from randomized placebo-controlled clinical trials wherever possible. A brief description of novel agents that have shown initial promise for PTSD treatment is also provided.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

BZD:

Benzodiazepine

CAPS:

Clinician Administered PTSD Scale

DCS:

d-Cycloserine

DSM-III:

Diagnostic and Statistical Manual, Third Edition

FDA:

United States Food and Drug Administration

GABA:

Gamma Aminobutyric Acid

GC:

Glucocorticoid

HAM-A:

Hamilton Rating Scale for Anxiety

HAM-D:

Hamilton Rating Scale for Depression

MAOI:

Monoamine oxidase inhibitor (irreversible)

PTSD:

Post-traumatic stress disorder

RIMA:

Reversible inhibitor of monoamine oxidase type A

RCT:

Randomized clinical trial

SSRI:

Selective serotonin reuptake inhibitor

SNRI:

Serotonin norepinephrine reuptake inhibitor

TCA:

Tricyclic antidepressant

VA:

Veterans administration

References

  • Aerni A, Traber R, Hock C, Roozendaal B, Schelling G, Papassotiropoulos A, Nitsch RM, Schnyder U, de Quervain DJ (2004) Low-dose cortisol for symptoms of posttraumatic stress disorder. Am J Psychiatry 161:1488–1490

    Article  PubMed  Google Scholar 

  • Bahk WM, Pae CU, Tsoh J, Chae JH, Jun TY, Chul L, Kim KS (2002) Effects of mirtazapine in patients with post-traumatic stress disorder in Korea: a pilot study. Hum Psychopharmacol 17:341–344

    Article  PubMed  CAS  Google Scholar 

  • Baker DG, Diamond BI, Gillette G, Hamner M, Katzelnick D, Keller T, Mellman TA, Pontius E, Rosenthal M, Tucker P (1995) A double-blind, randomized, placebo-controlled, multi-center study of brofaromine in the treatment of post-traumatic stress disorder. Psychopharmacology (Berl) 122:386–389

    Article  CAS  Google Scholar 

  • Bandelow B, Zohar J, Hollander E, Kasper S, Moller HJ, Zohar J, Hollander E, Kasper S, Moller HJ, Bandelow B, Allgulander C, Ayuso-Gutierrez J, Baldwin DS, Buenvicius R, Cassano G, Fineberg N, Gabriels L, Hindmarch I, Kaiya H, Klein DF, Lader M, Lecrubier Y, Lepine JP, Liebowitz MR, Lopez-Ibor JJ, Marazziti D, Miguel EC, Oh KS, Preter M, Rupprecht R, Sato M, Starcevic V, Stein DJ, van Ameringen M, Vega J (2008) World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety, obsessive-compulsive and post-traumatic stress disorders – first revision. World J Biol Psychiatry 9:248–312

    Article  PubMed  Google Scholar 

  • Bartzokis G, Lu PH, Turner J, Mintz J, Saunders CS (2005) Adjunctive risperidone in the treatment of chronic combat-related posttraumatic stress disorder. Biol Psychiatry 57: 474–479

    Article  PubMed  CAS  Google Scholar 

  • Battista MA, Hierholzer R, Khouzam HR, Barlow A, O’Toole S (2007) Pilot trial of memantine in the treatment of posttraumatic stress disorder. Psychiatry 70:167–174

    PubMed  Google Scholar 

  • Becker ME, Hertzberg MA, Moore SD, Dennis MF, Bukenya DS, Beckham JC (2007) A placebo-controlled trial of bupropion SR in the treatment of chronic posttraumatic stress disorder. J Clin Psychopharmacol 27:193–197

    Article  PubMed  CAS  Google Scholar 

  • Brady K, Pearlstein T, Asnis GM, Baker D, Rothbaum B, Sikes CR, Farfel GM (2000) Efficacy and safety of sertraline treatment of posttraumatic stress disorder: a randomized controlled trial. JAMA 283:1837–1844

    Article  PubMed  CAS  Google Scholar 

  • Braun P, Greenberg D, Dasberg H, Lerer B (1990) Core symptoms of posttraumatic stress disorder unimproved by alprazolam treatment. J Clin Psychiatry 51:236–238

    PubMed  CAS  Google Scholar 

  • Buchanan TW, Tranel D, Adolphs R (2006) Impaired memory retrieval correlates with individual differences in cortisol response but not autonomic response. Learn Mem 13:382–387

    Article  PubMed  CAS  Google Scholar 

  • Butterfield MI, Becker ME, Connor KM, Sutherland S, Churchill LE, Davidson JR (2001) Olanzapine in the treatment of post-traumatic stress disorder: a pilot study. Int Clin Psychopharmacol 16:197–203

    Article  PubMed  CAS  Google Scholar 

  • Cahill L, Prins B, Weber M, McGaugh JL (1994) Beta-adrenergic activation and memory for emotional events. Nature 371:702–704

    Article  PubMed  CAS  Google Scholar 

  • Cates ME, Bishop MH, Davis LL, Lowe JS, Woolley TW (2004) Clonazepam for treatment of sleep disturbances associated with combat-related posttraumatic stress disorder. Ann Pharmacother 38:1395–1399

    Article  PubMed  CAS  Google Scholar 

  • Clark RD, Canive JM, Calais LA, Qualls C, Brugger RD, Vosburgh TB (1999) Cyproheptadine treatment of nightmares associated with posttraumatic stress disorder. J Clin Psychopharmacol 19:486–487

    Article  PubMed  CAS  Google Scholar 

  • Connor KM, Sutherland SM, Tupler LA, Malik ML, Davidson JR (1999) Fluoxetine in post-traumatic stress disorder. Randomised, double-blind study. Br J Psychiatry 175:17–22

    Article  PubMed  CAS  Google Scholar 

  • Connor KM, Davidson JR, Weisler RH, Zhang W, Abraham K (2006) Tiagabine for posttraumatic stress disorder: effects of open-label and double-blind discontinuation treatment. Psychopharmacology (Berl) 184:21–25

    Article  CAS  Google Scholar 

  • Copeland WE, Keeler G, Angold A, Costello EJ (2007) Traumatic events and posttraumatic stress in childhood. Arch Gen Psychiatry 64:577–584

    Article  PubMed  Google Scholar 

  • Chung MY, Min KH, Jun YJ, Kim SS, Kim WC, Jun EM (2004) Efficacy and tolerability of mirtazapine and sertraline in Korean veterans with posttraumatic stress disorder: a randomized open label trial. Hum Psychopharmacol 19:489–94

    Google Scholar 

  • Davidson J, Kudler H, Smith R, Mahorney SL, Lipper S, Hammett E, Saunders WB, Cavenar JO Jr (1990) Treatment of posttraumatic stress disorder with amitriptyline and placebo. Arch Gen Psychiatry 47:259–266

    Article  PubMed  CAS  Google Scholar 

  • Davidson JR, Weisler RH, Malik M, Tupler LA (1998) Fluvoxamine in civilians with posttraumatic stress disorder. J Clin Psychopharmacol 18:93–95

    Article  PubMed  CAS  Google Scholar 

  • Davidson JR, Rothbaum BO, van der Kolk BA, Sikes CR, Farfel GM (2001a) Multicenter, double-blind comparison of sertraline and placebo in the treatment of posttraumatic stress disorder. Arch Gen Psychiatry 58:485–492

    Article  PubMed  CAS  Google Scholar 

  • Davidson J, Pearlstein T, Londborg P, Brady KT, Rothbaum B, Bell J, Maddock R, Hegel MT, Farfel G (2001b) Efficacy of sertraline in preventing relapse of posttraumatic stress disorder: results of a 28-week double-blind, placebo-controlled study. Am J Psychiatry 158:1974–1981

    Article  PubMed  CAS  Google Scholar 

  • Davidson JR, Weisler RH, Butterfield MI, Casat CD, Connor KM, Barnett S, van Meter S (2003) Mirtazapine vs. placebo in posttraumatic stress disorder: a pilot trial. Biol Psychiatry 53:188–191

    Article  PubMed  CAS  Google Scholar 

  • Davidson J, Rothbaum BO, Tucker P, Asnis G, Benattia I, Musgnung JJ (2006a) Venlafaxine extended release in posttraumatic stress disorder: a sertraline- and placebo-controlled study. J Clin Psychopharmacol 26:259–267

    Article  PubMed  CAS  Google Scholar 

  • Davidson J, Baldwin D, Stein DJ, Kuper E, Benattia I, Ahmed S, Pedersen R, Musgnung J (2006b) Treatment of posttraumatic stress disorder with venlafaxine extended release: a 6-month randomized controlled trial. Arch Gen Psychiatry 63:1158–1165

    Article  PubMed  CAS  Google Scholar 

  • Davidson JR, Brady K, Mellman TA, Stein MB, Pollack MH (2007) The efficacy and tolerability of tiagabine in adult patients with post-traumatic stress disorder. J Clin Psychopharmacol 27:85–88

    Article  PubMed  CAS  Google Scholar 

  • Davis R, Whittington R, Bryson HM (1997) Nefazodone. A review of its pharmacology and clinical efficacy in the management of major depression. Drugs 53:608–636

    Article  PubMed  CAS  Google Scholar 

  • Davis LL, Jewell ME, Ambrose S, Farley J, English B, Bartolucci A, Petty F (2004) A placebo-controlled study of nefazodone for the treatment of chronic posttraumatic stress disorder: a preliminary study. J Clin Psychopharmacol 24:291–297

    Article  PubMed  CAS  Google Scholar 

  • Davis LL, Davidson JR, Ward LC, Bartolucci A, Bowden CL, Petty F (2008a) Divalproex in the treatment of posttraumatic stress disorder: a randomized, double-blind, placebo-controlled trial in a veteran population. J Clin Psychopharmacol 28:84–88

    Article  PubMed  CAS  Google Scholar 

  • Davis LL, Ward C, Rasmusson A, Newell JM, Frazier E, Southwick SM (2008b) A placebo-controlled trial of guanfacine for the treatment of posttraumatic stress disorder in veterans. Psychopharmacol Bull 41:8–18

    PubMed  Google Scholar 

  • de Jong JT, Komproe IH, Van Ommeren M, El Masri M, Araya M, Khaled N, van De PW, Somasundaram D (2001) Lifetime events and posttraumatic stress disorder in 4 postconflict settings. JAMA 286:555–562

    Article  PubMed  Google Scholar 

  • Drake RG, Davis LL, Cates ME, Jewell ME, Ambrose SM, Lowe JS (2003) Baclofen treatment for chronic posttraumatic stress disorder. Ann Pharmacother 37:1177–1181

    Article  PubMed  CAS  Google Scholar 

  • English BA, Jewell M, Jewell G, Ambrose S, Davis LL (2006) Treatment of chronic posttraumatic stress disorder in combat veterans with citalopram: an open trial. J Clin Psychopharmacol 26:84–88

    Article  PubMed  CAS  Google Scholar 

  • Escalona R, Canive JM, Calais LA, Davidson JR (2002) Fluvoxamine treatment in veterans with combat-related post-traumatic stress disorder. Depress Anxiety 15:29–33

    Article  PubMed  Google Scholar 

  • Foa EB, Davidson JR, Frances A (1999) The expert consensus guidelines series: treatment of posttraumatic stress disorder. J Clin Psychiatry 60(Suppl 16):3–76

    Google Scholar 

  • Foa EB, Keane TM, Friedman MJ (2000) Guidelines for treatment of PTSD. J Trauma Stress 13:539–588

    Article  Google Scholar 

  • Frank JB, Kosten TR, Giller EL Jr, Dan E (1988) A randomized clinical trial of phenelzine and imipramine for posttraumatic stress disorder. Am J Psychiatry 145:1289–1291

    PubMed  CAS  Google Scholar 

  • Friedman MJ, Marmar CR, Baker DG, Sikes CR, Farfel GM (2007) Randomized, double-blind comparison of sertraline and placebo for posttraumatic stress disorder in a Department of Veterans Affairs setting. J Clin Psychiatry 68:711–720

    Article  PubMed  CAS  Google Scholar 

  • Gelpin E, Bonne O, Peri T, Brandes D, Shalev AY (1996) Treatment of recent trauma survivors with benzodiazepines: a prospective study. J Clin Psychiatry 57:390–394

    PubMed  CAS  Google Scholar 

  • Hamner MB, Faldowski RA, Ulmer HG, Frueh BC, Huber MG, Arana GW (2003) Adjunctive risperidone treatment in post-traumatic stress disorder: a preliminary controlled trial of effects on comorbid psychotic symptoms. Int Clin Psychopharmacol 18:1–8

    Article  PubMed  CAS  Google Scholar 

  • Heresco-Levy U, Kremer I, Javitt DC, Goichman R, Reshef A, Blanaru M, Cohen T (2002) Pilot-controlled trial of d-cycloserine for the treatment of post-traumatic stress disorder. Int J Neuropsychopharmacol 5:301–307

    Article  PubMed  CAS  Google Scholar 

  • Hertzberg MA, Butterfield MI, Feldman ME, Beckham JC, Sutherland SM, Connor KM, Davidson JR (1999) A preliminary study of lamotrigine for the treatment of posttraumatic stress disorder. Biol Psychiatry 45:1226–1229

    Article  PubMed  CAS  Google Scholar 

  • Hertzberg MA, Feldman ME, Beckham JC, Kudler HS, Davidson JR (2000) Lack of efficacy for fluoxetine in PTSD: a placebo controlled trial in combat veterans. Ann Clin Psychiatry 12:101–105

    PubMed  CAS  Google Scholar 

  • Hertzberg MA, Moore SD, Feldman ME, Beckham JC (2001) A preliminary study of bupropion sustained-release for smoking cessation in patients with chronic posttraumatic stress disorder. J Clin Psychopharmacol 21:94–98

    Article  PubMed  CAS  Google Scholar 

  • Katz RJ, Lott MH, Arbus P, Crocq L, Herlobsen P, Lingjaerde O, Lopez G, Loughrey GC, MacFarlane DJ, McIvor R (1994) Pharmacotherapy of post-traumatic stress disorder with a novel psychotropic. Anxiety 1:169–174

    PubMed  Google Scholar 

  • Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62:593–602

    Article  PubMed  Google Scholar 

  • Kim W, Pae CU, Chae JH, Jun TY, Bahk WM (2005) The effectiveness of mirtazapine in the treatment of post-traumatic stress disorder: a 24-week continuation therapy. Psychiatry Clin Neurosci 59:743–747

    Article  PubMed  Google Scholar 

  • Kindt M, Soeter M, Vervliet B (2009) Beyond extinction: erasing human fear responses and preventing the return of fear. Nat Neurosci. doi:10.1038/nn.2271

    PubMed  Google Scholar 

  • Kinzie JD, Leung P (1989) Clonidine in Cambodian patients with posttraumatic stress disorder. J Nerv Ment Dis 177:546–550

    Article  PubMed  CAS  Google Scholar 

  • Kosten TR, Frank JB, Dan E, McDougle CJ, Giller EL Jr (1991) Pharmacotherapy for posttraumatic stress disorder using phenelzine or imipramine. J Nerv Ment Dis 179:366–370

    Article  PubMed  CAS  Google Scholar 

  • Lindley SE, Carlson EB, Hill K (2007) A randomized, double-blind, placebo-controlled trial of augmentation topiramate for chronic combat-related posttraumatic stress disorder. J Clin Psychopharmacol 27:677–681

    Article  PubMed  CAS  Google Scholar 

  • Londborg PD, Hegel MT, Goldstein S, Goldstein D, Himmelhoch JM, Maddock R, Patterson WM, Rausch J, Farfel GM (2001) Sertraline treatment of posttraumatic stress disorder: results of 24 weeks of open-label continuation treatment. J Clin Psychiatry 62:325–331

    Article  PubMed  CAS  Google Scholar 

  • Marmar CR, Schoenfeld F, Weiss DS, Metzler T, Zatzick D, Wu R, Smiga S, Tecott L, Neylan T (1996) Open trial of fluvoxamine treatment for combat-related posttraumatic stress disorder. J Clin Psychiatry 57(Suppl 8):66–70

    PubMed  CAS  Google Scholar 

  • Marshall RD, Beebe KL, Oldham M, Zaninelli R (2001) Efficacy and safety of paroxetine treatment for chronic PTSD: a fixed-dose, placebo-controlled study. Am J Psychiatry 158:1982–1988

    Article  PubMed  CAS  Google Scholar 

  • Marshall RD, Lewis-Fernandez R, Blanco C, Simpson HB, Lin SH, Vermes D, Garcia W, Schneier F, Neria Y, Sanchez-Lacay A, Liebowitz MR (2007) A controlled trial of paroxetine for chronic PTSD, dissociation, and interpersonal problems in mostly minority adults. Depress Anxiety 24:77–84

    Article  PubMed  CAS  Google Scholar 

  • Martenyi F, Brown EB, Zhang H, Prakash A, Koke SC (2002a) Fluoxetine versus placebo in posttraumatic stress disorder. J Clin Psychiatry 63:199–206

    Article  PubMed  CAS  Google Scholar 

  • Martenyi F, Brown EB, Zhang H, Koke SC, Prakash A (2002b) Fluoxetine v. placebo in prevention of relapse in post-traumatic stress disorder. Br J Psychiatry 181:315–320

    Article  PubMed  Google Scholar 

  • Martenyi F, Brown EB, Caldwell CD (2007) Failed efficacy of fluoxetine in the treatment of posttraumatic stress disorder: results of a fixed-dose, placebo-controlled study. J Clin Psychopharmacol 27:166–170

    Article  PubMed  CAS  Google Scholar 

  • McRae AL, Brady KT, Mellman TA, Sonne SC, Killeen TK, Timmerman MA, Bayles-Dazet W (2004) Comparison of nefazodone and sertraline for the treatment of posttraumatic stress disorder. Depress Anxiety 19:190–196

    Article  PubMed  CAS  Google Scholar 

  • Mellman TA, Bustamante V, David D, Fins AI (2002) Hypnotic medication in the aftermath of trauma. J Clin Psychiatry 63:1183–1184

    Article  PubMed  Google Scholar 

  • Milliken CS, Auchterlonie JL, Hoge CW (2007) Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq war. JAMA 298:2141–2148

    Article  PubMed  CAS  Google Scholar 

  • Mohamed S, Rosenheck RA (2008) Pharmacotherapy of PTSD in the U.S. Department of Veterans Affairs: diagnostic- and symptom-guided drug selection. J Clin Psychiatry 69:959–965

    Article  PubMed  Google Scholar 

  • Monnelly EP, Ciraulo DA, Knapp C, Keane T (2003) Low-dose risperidone as adjunctive therapy for irritable aggression in posttraumatic stress disorder. J Clin Psychopharmacol 23:193–196

    Article  PubMed  CAS  Google Scholar 

  • Nair J, Singh AS (2008) The role of the glutamatergic system in posttraumatic stress disorder. CNS Spectr 13:585–591

    PubMed  Google Scholar 

  • Neylan TC, Lenoci M, Samuelson KW, Metzler TJ, Henn-Haase C, Hierholzer RW, Lindley SE, Otte C, Schoenfeld FB, Yesavage JA, Marmar CR (2006) No improvement of posttraumatic stress disorder symptoms with guanfacine treatment. Am J Psychiatry 163:2186–2188

    Article  PubMed  Google Scholar 

  • Onder E, Tural U, Aker T (2006) A comparative study of fluoxetine, moclobemide, and tianeptine in the treatment of posttraumatic stress disorder following an earthquake. Eur Psychiatry 21:174–179

    Article  PubMed  CAS  Google Scholar 

  • Padala PR, Madison J, Monnahan M, Marcil W, Price P, Ramaswamy S, Din AU, Wilson DR, Petty F (2006) Risperidone monotherapy for post-traumatic stress disorder related to sexual assault and domestic abuse in women. Int Clin Psychopharmacol 21:275–280

    Article  PubMed  Google Scholar 

  • Pitman RK (1989) Post-traumatic stress disorder, hormones, and memory. Biol Psychiatry 26:221–3

    Google Scholar 

  • Pitman RK, Sanders KM, Zusman RM, Healy AR, Cheema F, Lasko NB, Cahill L, Orr SP (2002) Pilot study of secondary prevention of posttraumatic stress disorder with propranolol. Biol Psychiatry 51:189–192

    Article  PubMed  CAS  Google Scholar 

  • Post RM, Weiss SR, Smith M, Li H, McCann U (1997) Kindling versus quenching. Implications for the evolution and treatment of posttraumatic stress disorder. Ann N Y Acad Sci 821:285–295

    Article  PubMed  CAS  Google Scholar 

  • Rapaport MH, Endicott J, Clary CM (2002) Posttraumatic stress disorder and quality of life: results across 64 weeks of sertraline treatment. J Clin Psychiatry 63:59–65

    Article  PubMed  CAS  Google Scholar 

  • Raskind MA, Peskind ER, Kanter ED, Petrie EC, Radant A, Thompson CE, Dobie DJ, Hoff D, Rein RJ, Straits-Troster K, Thomas RG, McFall MM (2003) Reduction of nightmares and other PTSD symptoms in combat veterans by prazosin: a placebo-controlled study. Am J Psychiatry 160:371–373

    Article  PubMed  Google Scholar 

  • Raskind MA, Peskind ER, Hoff DJ, Hart KL, Holmes HA, Warren D, Shofer J, O’Connell J, Taylor F, Gross C, Rohde K, McFall ME (2007) A parallel group placebo controlled study of prazosin for trauma nightmares and sleep disturbance in combat veterans with post-traumatic stress disorder. Biol Psychiatry 61:928–934

    Article  PubMed  CAS  Google Scholar 

  • Reich DB, Winternitz S, Hennen J, Watts T, Stanculescu C (2004) A preliminary study of risperidone in the treatment of posttraumatic stress disorder related to childhood abuse in women. J Clin Psychiatry 65:1601–1606

    Article  PubMed  CAS  Google Scholar 

  • Reist C, Kauffmann CD, Haier RJ, Sangdahl C, DeMet EM, Chicz-DeMet A, Nelson JN (1989) A controlled trial of desipramine in 18 men with posttraumatic stress disorder. Am J Psychiatry 146:513–516

    PubMed  CAS  Google Scholar 

  • Robert S, Hamner MB, Ulmer HG, Lorberbaum JP, Durkalski VL (2006) Open-label trial of escitalopram in the treatment of posttraumatic stress disorder. J Clin Psychiatry 67:1522–1526

    Article  PubMed  CAS  Google Scholar 

  • Roozendaal B, Okuda S, Van der Zee EA, McGaugh JL (2006) Glucocorticoid enhancement of memory requires arousal-induced noradrenergic activation in the basolateral amygdala. Proc Natl Acad Sci USA 103:6741–6746

    Article  PubMed  CAS  Google Scholar 

  • Rothbaum BO, Killeen TK, Davidson JR, Brady KT, Connor KM, Heekin MH (2008) Placebo-controlled trial of risperidone augmentation for selective serotonin reuptake inhibitor-resistant civilian posttraumatic stress disorder. J Clin Psychiatry 69:520–525

    Article  PubMed  CAS  Google Scholar 

  • Rush AJ (2007) STAR*D: what have we learned? Am J Psychiatry 164:201–204

    Article  PubMed  Google Scholar 

  • Sageman S, Brown RP (2006) 3-acetyl-7-oxo-dehydroepiandrosterone for healing treatment-resistant posttraumatic stress disorder in women: 5 case reports. J Clin Psychiatry 67:493–496

    Article  PubMed  Google Scholar 

  • Sargant W, Slater E (1940) Acute war neuroses. Lancet 236:1–2

    Article  Google Scholar 

  • Seedat S, Stein DJ, Ziervogel C, Middleton T, Kaminer D, Emsley RA, Rossouw W (2002) Comparison of response to a selective serotonin reuptake inhibitor in children, adolescents, and adults with posttraumatic stress disorder. J Child Adolesc Psychopharmacol 12:37–46

    Article  PubMed  Google Scholar 

  • Shestatzky M, Greenberg D, Lerer B (1988) A controlled trial of phenelzine in posttraumatic stress disorder. Psychiatry Res 24:149–155

    Article  PubMed  CAS  Google Scholar 

  • Stahl SM (1998) Mechanism of action of serotonin selective reuptake inhibitors. Serotonin receptors and pathways mediate therapeutic effects and side effects. J Affect Disord 51:215–235

    Article  PubMed  CAS  Google Scholar 

  • Stein DJ, Bandelow B, Hollander E, Nutt DJ, Okasha A, Pollack MH, Swinson RP, Zohar J (2003) WCA Recommendations for the long-term treatment of posttraumatic stress disorder. CNS Spectr 8:31–39

    PubMed  Google Scholar 

  • Stein MB, Kline NA, Matloff JL (2002) Adjunctive olanzapine for SSRI-resistant combat-related PTSD: a double-blind, placebo-controlled study. Am J Psychiatry 159:1777–1779

    Article  PubMed  Google Scholar 

  • Stein MB, Kerridge C, Dimsdale JE, Hoyt DB (2007) Pharmacotherapy to prevent PTSD: Results from a randomized controlled proof-of-concept trial in physically injured patients. J Trauma Stress 20:923–932

    Article  PubMed  Google Scholar 

  • Taylor FB, Martin P, Thompson C, Williams J, Mellman TA, Gross C, Peskind ER, Raskind MA (2008) Prazosin effects on objective sleep measures and clinical symptoms in civilian trauma posttraumatic stress disorder: a placebo-controlled study. Biol Psychiatry 63:629–632

    Article  PubMed  CAS  Google Scholar 

  • Tucker P, Zaninelli R, Yehuda R, Ruggiero L, Dillingham K, Pitts CD (2001) Paroxetine in the treatment of chronic posttraumatic stress disorder: results of a placebo-controlled, flexible-dosage trial. J Clin Psychiatry 62:860–868

    Article  PubMed  CAS  Google Scholar 

  • Tucker P, Trautman RP, Wyatt DB, Thompson J, Wu SC, Capece JA, Rosenthal NR (2007) Efficacy and safety of topiramate monotherapy in civilian posttraumatic stress disorder: a randomized, double-blind, placebo-controlled study. J Clin Psychiatry 68:201–206

    Article  PubMed  CAS  Google Scholar 

  • Ursano RJ, Bell C, Eth S, Friedman M, Norwood A, Pfefferbaum B, Pynoos RS, Zatzick DF, Benedek DM (2004) American Psychiatric Association Practice Guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder. American Psychiatric, Arlington, VA, pp 1–96

    Google Scholar 

  • Vaiva G, Ducrocq F, Jezequel K, Averland B, Lestavel P, Brunet A, Marmar CR (2003) Immediate treatment with propranolol decreases posttraumatic stress disorder two months after trauma. Biol Psychiatry 54:947–949

    Article  PubMed  CAS  Google Scholar 

  • van der Kolk BA, Dreyfuss D, Michaels M, Shera D, Berkowitz R, Fisler R, Saxe G (1994) Fluoxetine in posttraumatic stress disorder. J Clin Psychiatry 55:517–522

    PubMed  Google Scholar 

  • Zohar J, Amital D, Miodownik C, Kotler M, Bleich A, Lane RM, Austin C (2002) Double-blind placebo-controlled pilot study of sertraline in military veterans with posttraumatic stress disorder. J Clin Psychopharmacol 22:190–195

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, University of California San Diego, 8939 Villa La Jolla Drive, Suite 200, La Jolla, CA, 92037, USA

    Lakshmi N. Ravindran & Murray B. Stein

  2. Department of Psychiatry, VA San Diego Healthcare System, San Diego, CA, USA

    Lakshmi N. Ravindran

Authors
  1. Lakshmi N. Ravindran
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Murray B. Stein
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Murray B. Stein .

Editor information

Editors and Affiliations

  1. Dept. Psychiatry, University of California, San Diego, Gilman Drive 9500, La Jolla, 92093-0985, USA

    Murray B. Stein

  2. Research & Development, CNS - Affective Spectrum, Johnson & Johnson Pharmaceutical, Turnhoutseweg 30, Beerse, 2340, Belgium

    Thomas Steckler

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Ravindran, L.N., Stein, M.B. (2009). Pharmacotherapy of Post-Traumatic Stress Disorder. In: Stein, M., Steckler, T. (eds) Behavioral Neurobiology of Anxiety and Its Treatment. Current Topics in Behavioral Neurosciences, vol 2. Springer, Berlin, Heidelberg. https://doi.org/10.1007/7854_2009_15

Download citation

Publish with us

Policies and ethics

Search

Navigation