Abstract
There is good evidence that some pharmacological treatments can effectively reduce symptoms of some trauma-related disorders. There is more evidence for posttraumatic stress disorder (PTSD) than for other specific trauma-related disorders. It is important that practitioners are aware of this and that appropriate prescribing of drugs occurs, when indicated. This chapter provides an overview of the evidence for the pharmacological treatment of PTSD and introduces the Cardiff PTSD prescribing algorithm, a tool designed to facilitate evidence-based prescribing.
The results of systematic reviews and meta-analyses support fluoxetine, paroxetine, sertraline and venlafaxine as the drugs with the best evidence for the treatment of PTSD when prescribed on their own. Prazosin and risperidone are the best evidenced drugs for augmentation. Based on these findings, the prescribing algorithm provides clear guidance with respect to dose, dose escalation, augmentation, common adverse effects, drug interactions and monitoring requirements. The final step in the algorithm involves considering changing to an alternative medication (amitriptyline, mirtazapine or phenelzine) that has a weaker evidence base but works in a different way to the other medications suggested.
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Notes
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Taylor D, Barnes TRE, Young AH. The Maudsley Prescribing Guidelines in Psychiatry. Newark: John Wiley & Sons, Incorporated; 2018.
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Bisson, J.I. (2022). Pharmacological Treatment for Trauma-Related Psychological Disorders. In: Schnyder, U., Cloitre, M. (eds) Evidence Based Treatments for Trauma-Related Psychological Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-97802-0_27
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DOI: https://doi.org/10.1007/978-3-030-97802-0_27
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