Pharmacotherapy for posttraumatic stress disorder: review with clinical applications
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This article and any supplementary material should be cited as follows: Jeffreys M, Capehart B, Friedman MM. Pharmacotherapyfor posttraumatic stress disorder: review with clinical applications. J Rehabil Res Dev. 2012;49(5):703–16. http://dx.doi.org/10.1682/JRRD.2011.09.0183 Slideshow Project DOI:10.1682/ JRRD.2011.09.0183JSP Pharmacotherapy for posttraumatic stress disorder: review with clinical applications Matthew Jeffreys, MD; Bruce Capehart, MD, MBA; Matthew J. Friedman, MD, PhD
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Pharmacotherapy for posttraumatic stress disorder: review with clinical applications. Matthew Jeffreys, MD; Bruce Capehart, MD, MBA; Matthew J. Friedman, MD, PhD. Aim - PowerPoint PPT Presentation
Transcript of Pharmacotherapy for posttraumatic stress disorder: review with clinical applications
This article and any supplementary material should be cited as follows: Jeffreys M, Capehart B, Friedman MM. Pharmacotherapyfor posttraumatic stress disorder: review with clinical applications. J Rehabil Res Dev. 2012;49(5):703–16. http://dx.doi.org/10.1682/JRRD.2011.09.0183
Slideshow ProjectDOI:10.1682/JRRD.2011.09.0183JSP
Pharmacotherapy for posttraumatic stress disorder:
review with clinical applications
Matthew Jeffreys, MD; Bruce Capehart, MD, MBA;Matthew J. Friedman, MD, PhD
This article and any supplementary material should be cited as follows: Jeffreys M, Capehart B, Friedman MM. Pharmacotherapyfor posttraumatic stress disorder: review with clinical applications. J Rehabil Res Dev. 2012;49(5):703–16. http://dx.doi.org/10.1682/JRRD.2011.09.0183
Slideshow ProjectDOI:10.1682/JRRD.2011.09.0183JSP
• Aim– Review pharmacotherapy recommendations from
2010 Department of Veterans Affairs (VA)/Department of Defense (DOD) Clinical Practice Guideline for posttraumatic stress disorder (PTSD).
– Provide practical PTSD treatment recommendations for clinicians.
• Relevance– While evidence-based, trauma-focused
psychotherapy is preferred, pharmacotherapy is also important PTSD treatment option.
This article and any supplementary material should be cited as follows: Jeffreys M, Capehart B, Friedman MM. Pharmacotherapyfor posttraumatic stress disorder: review with clinical applications. J Rehabil Res Dev. 2012;49(5):703–16. http://dx.doi.org/10.1682/JRRD.2011.09.0183
Slideshow ProjectDOI:10.1682/JRRD.2011.09.0183JSP
Stepped care for pharmacotherapy inPTSD.
Adapted from VA/DOD Clinical Practice Guideline for PTSD.
This article and any supplementary material should be cited as follows: Jeffreys M, Capehart B, Friedman MM. Pharmacotherapyfor posttraumatic stress disorder: review with clinical applications. J Rehabil Res Dev. 2012;49(5):703–16. http://dx.doi.org/10.1682/JRRD.2011.09.0183
Slideshow ProjectDOI:10.1682/JRRD.2011.09.0183JSP
Recommendations• First-line:
– Selective serotonin reuptake inhibitors. – Venlafaxine.
• Selective serotonin-norepinephrine reuptake inhibitor.
• Second-line: – Nefazodone, mirtazapine, tricyclic antidepressants,
monoamine oxidase inhibitors. – Less evidence for usefulness and potentially greater side
effect burden.
• Prazosin beneficial for nightmares.• Benzodiazepines, antipsychotics not recommended.
This article and any supplementary material should be cited as follows: Jeffreys M, Capehart B, Friedman MM. Pharmacotherapyfor posttraumatic stress disorder: review with clinical applications. J Rehabil Res Dev. 2012;49(5):703–16. http://dx.doi.org/10.1682/JRRD.2011.09.0183
Slideshow ProjectDOI:10.1682/JRRD.2011.09.0183JSP
Conclusions• Effective screening for PTSD and trauma-related
distress helps patient and staff understand emotional factors affecting recovery.
• First- and second-line pharmacotherapy must be distinguished and discussed with patients in context of strong treatment alliance.
• Co-occurring disorders (e.g., major depressive disorder, substance use disorder, and traumatic brain injury) must be treated to maximize PTSD treatment outcomes.
