Pharmacotherapy Trials in Posttraumatic Stress Disorder: Prospects and Problems
Although a clinical symptom picture resembling the currently accepted DSM-III diagnosis of posttraumatic stress disorder (PTSD) has been recognized for decades, focused trials of psychopharmacological agents are a relatively recent development. The initial report by Hogben and Cornfield1 of a dramatic effect of treatment with the monoamine oxidase inhibitor phenelzine in patients with “traumatic war neurosis” has been followed by a spate of positive reports. These reports have attributed beneficial effects to a variety of drugs including tricyclic antidepressants,2,3 the limbic anticonvulsant carbamazepine,4 and the β-receptor blocker propranolol.5 Contrary to these generally optimistic reports, our experience with psychotropic agents in Israeli samples of PTSD patients has been less encouraging. This experience has been for the most part prospective and, in two studies, double-blind in nature using a drug/placebo crossover design.
KeywordsPlacebo Depression Propranolol Carbamazepine Monoamine
Unable to display preview. Download preview PDF.
- 3.Burstein A. The treatment of post-traumatic stress disorder with imipramine. Psychosomatics 1983; 25: 683 – 687.Google Scholar
- 4.Wolf ME, Alavi A, Mosanaim AD. Post traumatic stress disorder in Vietnam veterans’ clinical and EEG findings: possible therapeutic effects of carbamazepine. Biol Psychiatry 19878 press.Google Scholar
- 5.Kolb LC, Burris BC, Griffiths S. Propanolol and clonidine in treatment of the chronic post traumatic stress disorders of war. In van der Kolk B (ed): Post Traumatic Stress Disorder: Psychological and Biological Sequelae. Washington, DC: American Psychiatric Press, 1984; 97 – 105.Google Scholar
- 9.Braun P, Greenberg D, Lerer B. Modest effects of alprazolam on anxiety symptoms in post traumatic stress disorder. Submitted for publication.Google Scholar