Pharmacotherapy for Posttraumatic Stress Disorder: Empirical Review and Clinical Recommendations

2005 ◽  
Vol 39 (8) ◽  
pp. 674-682 ◽  
Author(s):  
John Cooper ◽  
Jessica Carty ◽  
Mark Creamer
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Clinical Practice ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Case Reports ◽  
Antidepressant Medication ◽  
Empirical Support ◽  
Future Research ◽  
Pharmacological Treatments ◽  
Open Label

Objective: Growing awareness of the psychological effects of trauma has emphasized the need for clinicians across a range of practice settings to be aware of evidence-based treatment options for posttraumatic stress disorder (PTSD). The purpose of this article is to review the available empirical data on pharmacological approaches to PTSD and to provide recommendations for clinical practice. Method: Although a comprehensive search of PsychInfo and Medline databases revealed a multitude of case reports and open-label trials, this paper focuses primarily on evidence obtained from randomized controlled trials to determine the most effective pharmacological treatments for PTSD. Results: The research data overwhelmingly supports antidepressant medication as the first-line pharmacotherapy for PTSD, with selective serotonin re-uptake inhibitors having the strongest body of empirical support. Other medications, and with care, combination pharmacotherapy, may also have a role in the management of certain presentations. Cautions for clinicians in treating this complex disorder are provided. Conclusions: Despite a substantial increase in the amount and quality of research into pharmacological treatments for PTSD in recent years, there is still a pressing need for more data to guide routine clinical practice. In particular, future research regarding the psychobiological basis of PTSD may guide the development of a PTSD-specific drug, designed to treat the unique characteristics of this disorder.

scholarly journals The role of memory in posttraumatic stress disorder: implications for clinical practice

2016 ◽  
Vol 38 (3) ◽  
pp. 119-127 ◽  
Author(s):  
Marcelo Montagner Rigoli ◽  
Gustavo Ramos Silva ◽  
Fernando Rainho de Oliveira ◽  
Giovanni Kuckartz Pergher ◽  
Christian Haag Kristensen
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Clinical Practice ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Traumatic Event ◽  
Experimental Studies ◽  
Theoretical Models ◽  
Social Consequences ◽  
Future Research

Abstract Introduction: Posttraumatic stress disorder (PTSD) is a highly prevalent disorder with important social consequences. Several models have been developed with the aim of understanding the mechanisms underlying its symptoms. Intrusions are idiosyncratic symptoms that commonly take the form of involuntary recollection of images or flashbacks about the traumatic event. Objective: To review how memory is conceptualized in each of these models and the implications for clinical practice. Methods: A narrative review of the literature was conducted through analysis of the perspectives of memory in theoretical models of PTSD. Results: Two main perspectives were identified: 1) models in which specific mechanisms of memory for processing traumatic events are proposed, especially those based on clinical studies, and 2) models in which common mnemonic mechanisms are utilized to explain the phenomenon, primarily based on basic experimental research studies investigating memory. The different theories based on these approaches have led to distinct psychotherapy interventions. Conclusion: In order to clarify these discrepancies, future research should aim for the methodological rigor of experimental studies, while maintaining the ecological applicability of findings. Cognitive experimental psychopathology is therefore an area on which research funding should be focused. Such studies could elucidate the role of mnemonic aspects in PTSD and how they impact psychological treatments.

Evidence-Based Psychotherapies for Adults with PTSD

2018 ◽  
Author(s):  
Juliette M. Harik ◽  
Jessica L. Hamblen ◽  
Sonya B. Norman ◽  
Paula P. Schnurr
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Clinical Practice ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Empirical Support ◽  
Evidence Based ◽  
Current Clinical Practice ◽  
Behavioral Therapies ◽  
Cognitive Behavioral Therapies ◽  
Key Techniques

This chapter provides an overview of evidence-based psychotherapies for posttraumatic stress disorder (PTSD) in adults. It defines these psychotherapies as those that received the strongest possible recommendation in any of the current clinical practice guidelines for the treatment of PTSD. These treatments include trauma-focused cognitive-behavioral therapies (which are further categorized as primarily exposure, primarily cognitive, or mixed cognitive-exposure) and Eye Movement Desensitization and Reprocessing. For each approach, the chapter offers a review of the theoretical underpinnings, describes key techniques, and summarizes the existing empirical support. It also briefly discusses efforts to enhance existing evidence-based psychotherapies and to evaluate novel, emerging psychotherapies targeting symptoms of PTSD.

scholarly journals Scaling Up: Multisite Open-Label Clinical Trials of MDMA-Assisted Therapy for Severe Posttraumatic Stress Disorder

2021 ◽  
pp. 002216782110236
Author(s):  
Julie B. Wang ◽  
Jessica Lin ◽  
Leah Bedrosian ◽  
Allison Coker ◽  
Ilsa Jerome ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Clinical Trials ◽  
Posttraumatic Stress ◽  
Clinical Supervision ◽  
Stress Disorder ◽  
The United States ◽  
Health Condition ◽  
Open Label ◽  
Adverse Health Outcomes ◽  
Ptsd Symptom Severity

Background: Posttraumatic stress disorder (PTSD) is a debilitating mental health condition associated with serious adverse health outcomes and functional impairment. Previous MDMA–assisted therapy (MDMA-AT) studies have shown promising results in single site studies. Two open-label studies tested this modality in multisite clinical trials to assess the feasibility of scaling this manualized therapy across 14 North American sites. Method: Cotherapist dyads were trained in the manualized MDMA-AT protocol and administered three experimental sessions 3 to 5 weeks apart among participants with severe PTSD. Cotherapist dyads were provided clinical supervision and evaluated for protocol adherence by centralized raters. Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) assessed change in symptoms severity. Results: Adherence rating scores were high across cotherapist dyads ( M = 95.08%, SD = 3.70%) and sites ( M = 95.23%, SD = 2.20%). CAPS-5 scores decreased following 3 MDMA-AT sessions at 18 weeks post baseline (Δ M = −29.99, Δ SD = 13.45, p < .0001, n = 37, Cohen’s d = 2.2, confidence interval [1.97, 2.47]). MDMA was well tolerated. Conclusions: These findings corroborate previous results that MDMA-AT can achieve significant improvements in PTSD symptom severity and demonstrate scalability of manualized therapy across clinic sites in the United States and Canada.

Factors Associated With Posttraumatic Stress Disorder Symptomology Among Women Who Have Experienced Sexual Assault in Canada

2019 ◽  
pp. 088626051986008
Author(s):  
Janice Du Mont ◽  
Holly Johnson ◽  
Cassandra Hill
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Sexual Assault ◽  
Posttraumatic Stress ◽  
Dating Violence ◽  
Sexual Victimization ◽  
Stress Disorder ◽  
General Social Survey ◽  
Future Research ◽  
Ptsd Symptoms ◽  
Sexually Assaulted

There is a dearth of information about the association of victim-related and assailant-related characteristics and posttraumatic stress disorder (PTSD) among sexually assaulted women. Recently, Statistics Canada included items measuring the possible presence of PTSD symptoms in their 2014 nationally representative General Social Survey on Victimization (GSS-V), for the purpose of improving the understanding of mental health impacts associated with sexual victimization. The present study used the GSS-V to examine the association of sociodemographic, health, and assailant characteristics and prior traumatic experiences in the form of physical or sexual dating violence, physical assault, stalking, childhood abuse, and witnessing of violence between parents with PTSD symptomology among sexually assaulted women. Among 319 women who reported experiencing at least one incident of sexual assault in the 12 months prior to the survey, 68.6% had experienced at least one negative emotional impact as a result, among whom, 43.6% reported past-month PTSD symptoms. Logistic regression modeling revealed that prior traumatic events in the form of physical or sexual dating violence, stalking, and having witnessed violence between parents were associated with higher odds of experiencing PTSD symptoms, as was having been sexually assaulted by a known assailant. In contrast, the odds of experiencing PTSD symptoms was lower for Aboriginal or visible minority women. The results suggest that PTSD symptoms in the near aftermath of sexual victimization are common, and there are a range of factors that contribute to the likelihood of developing these symptoms. Implications for future research are discussed.

scholarly journals A review of medical marijuana for the treatment of posttraumatic stress disorder: Real symptom re-leaf or just high hopes?

2018 ◽  
Vol 8 (2) ◽  
pp. 86-94 ◽  
Author(s):  
Ilona Shishko ◽  
Rosana Oliveira ◽  
Troy A. Moore ◽  
Kenneth Almeida
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Chart Review ◽  
Stress Disorder ◽  
Case Reports ◽  
Retrospective Chart Review ◽  
Current Evidence ◽  
Ptsd Symptoms ◽  
Ovid Medline ◽  
Current Medication

Abstract Introduction: The incidence of posttraumatic stress disorder (PTSD) is common within the population and even more so among veterans. Current medication treatment is limited primarily to antidepressants. Such medicines have shown to produce low remission rates and may require 9 patients to be treated for 1 to have a response. Aside from the Veterans Affairs/Department of Defense guidelines, other guidelines do not recommend pharmacotherapy as a first-line option, particularly in the veteran population. Marijuana has been evaluated as an alternative and novel treatment option with 16 states legalizing its use for PTSD. Methods: A systematic search was conducted to evaluate the evidence for the use of marijuana for PTSD. Studies for the review were included based on a literature search from Ovid MEDLINE and Google Scholar. Results: Five studies were identified that evaluated the use of marijuana for PTSD. One trial was conducted in Israel and actively used marijuana. Three studies did not use marijuana in the treatment arm but instead evaluated the effects postuse. A retrospective chart review from New Mexico relied on patients to recall their change in PTSD symptoms when using marijuana. Three studies concluded there might be a benefit, but two discouraged its use. Although the two negative studies show a statistical difference in worse PTSD outcomes, clinical significance is unclear. Discussion: Conflicting data exist for the use of marijuana for PTSD; however, current evidence is limited to anecdotal experiences, case reports, and observational studies, making it difficult to make clinical recommendations.

scholarly journals Biomarkers in Posttraumatic Stress Disorder: Overview and Implications for Future Research

2013 ◽  
Vol 35 ◽  
pp. 43-54 ◽  
Author(s):  
Ulrike Schmidt ◽  
Sebastian F. Kaltwasser ◽  
Carsten T. Wotjak
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Sexual Abuse ◽  
Anxiety Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Future Research ◽  
Clinical Use ◽  
Current State ◽  
Life Threatening ◽  
State Of Research

PTSD can develop in the aftermath of traumatic incidents like combat, sexual abuse, or life threatening accidents. Unfortunately, there are still no biomarkers for this debilitating anxiety disorder in clinical use. Anyhow, there are numerous studies describing potential PTSD biomarkers, some of which might progress to the point of practical use in the future. Here, we outline and comment on some of the most prominent findings on potential imaging, psychological, endocrine, and molecular PTSD biomarkers and classify them into risk, disease, and therapy markers. Since for most of these potential PTSD markers a causal role in PTSD has been demonstrated or at least postulated, this review also gives an overview on the current state of research on PTSD pathobiology.

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