Table of Contents Vietnam still haunts the American conscience. Not only did nearly 58, Americans die there, but—by some estimates—1.
Recognition of neurobiological abnormalities associated with this condition suggests the potential efficacy of medication in its treatment. Nevertheless, questions regarding the efficacy of medications remain, despite general endorsement by clinical practice guidelines of selective serotonin reuptake inhibitors SSRIs as first-line agents in treating PTSD.
In addition, we conducted a systematic meta-analysis to compare the efficacy of different medications in treating PTSD.
The effects of methodological study features including year of publication, duration, number of centres and sample characteristics proportion of combat veterans, gender composition were also tested. The largest body of evidence for short- and long-term efficacy of medication currently exists for SSRIs, with promising initial findings for the selective noradrenergic reuptake inhibitor venlafaxine and the atypical antipsychotic risperidone.
Treatment effect was predicted by number of centres and recency of the study, with little evidence that sample characteristics predicted response. Evidence for the effectiveness of benzodiazepines is lacking, despite their continued use in clinical practice. Adequately powered trials that are designed in accordance with best-practice guidelines are required to provide conclusive evidence of clinically relevant differences in efficacy between agents in treating PTSD, and to help estimate clinical and methodological predictors of treatment response.
This constellation of symptoms satisfy the criteria for PTSD when they extend beyond a month after exposure to the trauma and cause clinically significant functional disability, as conceptualized in current psychiatry diagnostic systems such as DSM-IV APA, PTSD is frequently chronic and associated with significant morbidity, poor quality of life, and high personal, social and economic costs.
It additionally represents a risk factor for developing other mood and anxiety disorders, as well as substance use disorders. It has been estimated that the US economy alone loses in the region of 3 billion dollars annually due to PTSD-related loss in productivity Brunello et al.
PTSD is characterized by a range of neurobiological disruptions that may be responsive to medication, including changes in the hypothalamus—pituitary—adrenal axis, as well as alterations in the serotonergic, and noradrenergic neurotransmitter systems.
Conversely, reports of the efficacy of selective serotonin reuptake inhibitors SSRIsin treating PTSD implicates involvement of the serotonin system in its aetiology. Indeed, on the basis of both open-label and controlled trials of these agents the majority of clinical practice guidelines have recommended SSRIs as first-line agents in treating PTSD.
Despite the general acceptance of SSRIs as first-line medication interventions for treating PTSD, a recent analysis of clinical practice treatment guidelines revealed considerable variability in conclusions regarding their efficacy Stein et al.
In addition, not all patients with PTSD respond to the SSRIs, leading to the need for augmentation or combination treatment strategies, and to interest in agents such as tiagabine that employ novel mechanisms of action.
A comprehensive review of the efficacy of medication in treating PTSD is therefore warranted. In addition, a quantitative estimate of treatment efficacy was obtained by synthesizing trial data as part of a meta-analysis. Finally, a review of pharmacotherapy RCTs for treatment-resistant patients was also conducted.
This review addresses the following questions: Is medication effective in treating PTSD? Are some agents more effective than others?Post-traumatic stress disorder or PTSD is an anxiety condition that may develop as a result of experiencing first hand or witnessing traumatic events, such as: sudden death of a family member or close friend, domestic violence, combat, victim or witness of a crime event, an accident, natural disaster, or national crisis.
This study aimed to investigate the effect of peer support group on subjective well-being (SWB) of wives of war veterans with post-traumatic stress disorder (PTSD).
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In , the A.P.A. finally included post-traumatic stress disorder in the third edition of the Diagnostic and Statistical Manual of Mental Disorders. Post traumatic stress disorder is characterized by a history of exposure to a traumatic event and symptoms in two of the three clusters of symptoms categorized by intrusive recollections, avoidant/numbing symptoms, and hyper-arousal symptoms.
It is associated with a significant decrease in daily functioning (American Psychiatric Association, ). Post Traumatic Stress Disorder Introduction “There are currently over , Veterans in treatment for PTSD (Post Traumatic Stress Disorder) and it is estimated that with the Iraq and Afghanistan wars there is an additional 33% increase in our returning soldiers.”.