engleski

Novel approaches to the treatment of posttraumatic stress disorder

Posttraumatic stress disorder can be treated with educational and psychosocial support, as well as psychotherapy. Another significant aspect of symptom management involves psychopharmacological treatment. The choice of drug, dosage, and duration of treatment depends upon the most prominent symptoms of PTSD, their chronicity, comorbidity of other psychiatric and psychical disorders, side effects of the drugs, contraindication for other medication, and the patients compliance. Pharmacotherapy can be indicated for the specific symptoms of anxiety, depression, impulse control, aggression, etc., or for one of the clusters of PTSD symptoms: core symptoms, intrusive re-experiencing of the traumatic events, avoidance of stimuli associated with the traumatic experience, numbing and anhedonia, hyperarousal, and secondary symptoms (comorbid diagnoses, poor functioning and resilience to stress). The goals of pharmacological treatment for PTSD include: reduction od distress symptoms, bolstering resilience, and restoration of functioning. Several neurobiological systems are involved in the etiology of PTSD. Because of the limited knowledge of the pathophysiology of PTSD and a lack of placebo-controlled clinical pharmacological studies, current clinical findings lead to the conclusion that serotonergic drugs are more effective than dopaminergic treatments, although both neurotransmitter systems are involved in the pathophysiology of PTSD. Benzodiazepines are not effective in the treatment for PTSD because of potential addiction and lack of efficacy. Mood stabilizers can be effective because PTSD patients have affective instability and the mechanism of kindling can contribute to increased reactions to stressors. In chronic and resistant patients, and patients with psychotic features of PTSD, atypical antypsychotics are benficial.

treatment; PTSP; posttraumatic stress disorder

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