Article

Posttraumatic stress disorder (PTSD) is a prevalent psychiatric diagnosis among
veterans and has high comorbidity with other medical and psychiatric conditions.
This article reviews the pharmacotherapy recommendations from the 2010 revised
Department of Veterans Affairs/Department of Defense Clinical Practice Guideline
(CPG) for PTSD and provides practical PTSD treatment recommendations for
clinicians. While evidence-based, trauma-focused psychotherapy is the preferred
treatment for PTSD, pharmacotherapy is also an important treatment option.
First-line pharmacotherapy agents include selective serotonin reuptake inhibitors
and the selective serotonin-norepinephrine reuptake inhibitor venlafaxine.
Second-line agents have less evidence for their usefulness in PTSD and carry a
potentially greater side effect burden. They include nefazodone, mirtazapine,
tricyclic antidepressants, and monoamine oxidase inhibitors. Prazosin is
beneficial for nightmares. Benzodiazepines and antipsychotics, either as
monotherapy or used adjunctively, are not recommended in the treatment of PTSD.
Treating co-occurring disorders, such as major depressive disorder, substance use
disorders, and traumatic brain injury, is essential in maximizing treatment
outcomes in PTSD. The CPG provides evidence-based treatment recommendations for
treating PTSD with and without such co-occurring disorders.

Langue : ANGLAIS