Post-traumatic stress disorder (
PTSD) is a serious
mental illness of considerable importance from a public health perspective. Management of
PTSD may involve the use of various treatment modalities, involving both nondrug treatments and
pharmacotherapy. Nondrug treatment is regarded as the first-line option for
PTSD and should be routinely incorporated into management plans for patients with
PTSD. However, some patients do not achieve a sufficient response to nondrug
therapy or are left with disabling residual symptoms in one or more areas.
Antidepressants are currently the preferred medication for
PTSD, with the most substantial evidence available to support the use of the
selective serotonin reuptake inhibitors. Many patients with
PTSD have symptoms that are resistant to initial
drug treatment, meaning that it is often necessary to explore additional
pharmacotherapy options to achieve optimal symptom control:
antipsychotics, anti-
adrenergic drugs,
anxiolytics and
anticonvulsants have all been advocated as treatments for
PTSD. In addition to the management of core
PTSD symptoms, it is also necessary for clinicians to address important associated comorbidities, most notably,
substance-use disorders and mood disturbances. Interpretation of research studies of the efficacy and safety of
PTSD pharmacotherapy is often difficult owing to methodological limitations and factors such as inclusion bias. Further research in fundamental neurosciences and pharmacogenomics may help to elucidate optimal
pharmacotherapy options for
PTSD in the future.