Lakshmi N. Ravindran(1), Murray B. Stein(2), Arun V. Ravindran(1)
1. University of Toronto, Toronto, Ontario, Canada
2. University of California San Diego, La Jolla, California, USA
Neurobiology of Post-traumatic Stress Disorder. Hauppauge, New York: Nova Science Publishers, 2010, 376 pages.
Post-traumatic stress disorder (PTSD) is a common psychiatric illness with significant morbidity and impact on function. Several classes of pharmacological agents, including antidepressants, anticonvulsants, atypical antipsychotics, and several novel agents, have been investigated for the treatment of PTSD. This chapter reviews the published literature with an emphasis on randomized controlled trials. The evidence for benefit as monotherapy appears to be strongest for antidepressants, specifically SSRIs and SNRIs, with some benefit from trycyclics and MAOIs. Promising preliminary results have been reported for mirtazapine, prazosin and some anticonvulsant such as lamotrigine. Atypical antipsychotics seem to be most useful as adjunctive agents. Limited efficacy data exists on the efficacy of the combination of medication and psychotherapy but this strategy would likely benefit refractory illness. The general dearth of large, well-designed RCTs on treatments for PTSD must be noted.