Posttraumatic stress disorder (
PTSD) is a
psychiatric disorder that develops after a
psychological trauma usually caused by a situation perceived as deeply threatening to a person's life or integrity. Complex neurobiological changes triggered by such a traumatic and stressful experience may explain a wide range of
PTSD symptoms and provide the rationale for psychopharmacological treatment.
Selective serotonin-reuptake inhibitors make the first-line treatment of
PTSD. Clinical experience has shown that they are more effective than noradrenalin-reuptake inhibitors or
tricyclic antidepressants.
Antipsychotic drugs, especially atypical ones, have been shown effective in
PTSD patients with psychotic characteristics or refractoriness to other treatments. Mood stabilizers seem to reduce mostly autonomous overreactions to stress, whereas the evidence for effectiveness of
monoamine oxidase inhibitors is largely inconclusive. Other groups of medications, such as
serotonin agonists and antagonists, new
antidepressants, dual inhibitors of
serotonin- and noradrenalin-reuptake,
anticonvulsants, and
opiate antagonists are also sometimes used in
PTSD treatment. However, as shown in the present review, most clinical studies performed to date to investigate the effectiveness of different psychopharmacological agents in the
therapy of
PTSD have serious limitations in terms of small sample size, lack of blinding and randomization, and small effect size. More rigorously designed, comparative studies are needed to determine the usefulness, efficacy, tolerability, and safety of particular
psychopharmaceutical drugs in the treatment of this therapeutically and functionally challenging disorder.