24 - Treatment of posttraumatic stress disorder

Summary

This chapter reviews evidence-based pharmacotherapeutic and psychotherapeutic treatments for post-traumatic stress disorder (PTSD). It also discusses the pharmacological literature, mainly placebo-controlled randomized clinical trials (RCTs) that targeted global symptom reduction in PTSD. Preclinical neuroscience studies of emotional learning and memory have suggested that pharmacotherapies may prevent the development of PTSD. The chapter reviews the results from a number of RCTs and discusses several RCTs aimed at particular symptoms associated with PTSD, such as sleep disturbance, hyperarousal, and co-occurring psychotic symptoms. It reviews efforts at prevention of PTSD in individuals recently exposed to significant traumas. While pharmacotherapy research in PTSD has yet to provide conclusive results for other classes of medications, psychotherapy research conducted in the last two decades has shown impressive support for a number of psychotherapies, including prolonged exposure (PE), eye movement desensitization and reprocessing (EMDR), stress inoculation therapy (SIT), and trauma management therapy.