Pharmacotherapy for posttraumatic stress disorder (PTSD)

Added March 24, 2022

Citation: Williams T, Phillips NJ, Stein DJ, et al. Pharmacotherapy for post traumatic stress disorder (PTSD). Cochrane Database of Systematic Reviews 2022;(3):CD002795.

Language: Abstract available in EN / ES / FA. Plain language summary available in EN / ES / FA / ZH. Full text available in EN.

Free to view: No.

Funding sources: South African Medical Research Council Unit on Risk an​​d Resilience in Mental Disorders, Cape Town, South Africa.

What is this? Posttraumatic stress disorder (PTSD) is a debilitating mental condition that can be caused by experiencing a traumatic event. Pharmacotherapy might be used as part of the efforts to treat it.

In this updated Cochrane review, the authors searched for randomized trials of pharmacotherapy for adults with PTSD. They did not restrict their searches by date or language of publication and did the most recent search in November 2020. They included a total of 66 trials (7442 participants) that had tested a variety of drugs. They also identified 1 additional ongoing trial and 18 trials which are awaiting classification.

What works: Selective serotonin reuptake inhibitors (SSRIs) improved PTSD symptoms in 58% of participants compared with 35% of participants receiving a placebo (8 trials, 1078 participants, moderate certainty evidence), but there were more withdrawals due to adverse events in the SSRI groups than the placebo groups, although the overall withdrawal rate for the SSRI groups was low (9%).

Single trials suggested that the noradrenergic and specific serotonergic antidepressant mirtazapine (26 participants) and the tricyclic antidepressant amitriptyline (40 participants) improved PTSD symptoms compared to a placebo (low certainty evidence).

What doesn’t work: Nothing noted.

What is uncertain: The effects of antipsychotics compared to a placebo are uncertain.

Implications: The authors of the review concluded that medication treatments can be effective in PTSD, increasing treatment response and reducing symptoms, and should be considered as part of its treatment.

Other considerations: The authors of the review did not discuss their findings in the context of issues relating to health equity.

 

This summary was prepared by Catherine Haynes and finalized by Mike Clarke.

Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the health of refugees and asylum seekers but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the health of refugees and asylum seekers on the basis of this summary alone. The text can be shared and re-used without charge, citing Evidence Aid as the source and noting the date on which you took the text.

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