Post-traumatic stress disorder (PTSD) is a severe anxiety disorder with clinical and social repercussions. The first line of treatment is psychotherapy, but the most advanced forms require, in addition, a drug treatment. Currently, the treatments used are few in number and not very effective. The objective is to review the recent literature on curative drug treatments for PTSD. We conducted a literature review on the Medline database to include articles less than 10 years old dealing with curative drug treatments for PTSD. We identified inclusion and exclusion criteria to frame our research. We first selected articles by reading the title, then the abstract, and finally the full text. Each clinical study was placed in a table with its main characteristics and then analyzed in order to determine the effectiveness of the treatment studied. 51 references were included. Beta-blockers, corticosteroids and D-cycloserine show positive results in combination with various psychotherapy methods. Antiepileptics, oxytocin, atypical antipsychotics and prazosin showed divergent results. The use of prazosin, currently used to treat PTSD-induced sleep disorders, is being questioned. Ketamine, MDMA and cannabinoids have shown satisfactory results in terms of efficacy, but the question of their safety of use remains. The risks of overdose and illegal use should not be overlooked. Molecules such as ketamine, MDMA or cannabinoids will require further studies to conclude their efficacy and safety. They appear to be the most promising molecules currently available for the treatment of PTSD.
| Published in | American Journal of Internal Medicine (Volume 10, Issue 3) |
| DOI | 10.11648/j.ajim.20221003.12 |
| Page(s) | 39-50 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
PTSD, Pharmacotherapy, Psychotherapy, Treatment, Drug
| [1] | American Psychiatric Association, American Psychiatric Association (eds). Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Washington, D. C: American Psychiatric Association, 2013. |
| [2] | Stein DJ, McLaughlin KA, Koenen KC, et al. DSM-5 AND ICD-11 DEFINITIONS OF POSTTRAUMATIC STRESS DISORDER: INVESTIGATING "NARROW" AND "BROAD" APPROACHES: Research Article: DSM-5 and ICD-11 Definitions of PTSD. Depress Anxiety 2014; 31: 494-505. |
| [3] | Management of Post-Traumatic Stress Disorder and Acute Stress Reaction 2017. 3.0, US Department of Veterans Affairs, https://www.healthquality.va.gov/guidelines/MH/ptsd/VADoDPTSDCPGFinal012418.pdf (2017, accessed 31 March 2021). |
| [4] | Post-traumatic stress disorder. NG116, United-Kingdom: National Institute for Health and Care Excellence, https://www.nice.org.uk/guidance/ng116/resources/posttraumatic-stress-disorder-pdf-66141601777861 (2018, accessed 31 March 2021). |
| [5] | Shiner B, Westgate CL, Gui J, et al. A Retrospective Comparative Effectiveness Study of Medications for Posttraumatic Stress Disorder in Routine Practice. J Clin Psychiatry; 79. Epub ahead of print 18 September 2018. DOI: 10.4088/JCP.18m12145. |
| [6] | Krystal AD, Zhang W, Davidson JRT, et al. The sleep effects of tiagabine on the first night of treatment predict post-traumatic stress disorder response at three weeks. J Psychopharmacol Oxf Engl 2014; 28: 457-465. |
| [7] | Yeh MSL, Mari JJ, Costa MCP, et al. A double-blind randomized controlled trial to study the efficacy of topiramate in a civilian sample of PTSD. CNS Neurosci Ther 2011; 17: 305-310. |
| [8] | Baniasadi M, Hosseini G, Fayyazi Bordbar MR, et al. Effect of pregabalin augmentation in treatment of patients with combat-related chronic posttraumatic stress disorder: a randomized controlled trial. J Psychiatr Pract 2014; 20: 419-427. |
| [9] | Brunet A, Saumier D, Liu A, et al. Reduction of PTSD Symptoms with Pre-Reactivation Propranolol Therapy: A Randomized Controlled Trial. Am J Psychiatry 2018; 175: 427-433. |
| [10] | Mahabir M, Ashbaugh AR, Saumier D, et al. Propranolol's impact on cognitive performance in post-traumatic stress disorder. J Affect Disord 2016; 192: 98-103. |
| [11] | Michopoulos V, Norrholm SD, Stevens JS, et al. Dexamethasone facilitates fear extinction and safety discrimination in PTSD: A placebo-controlled, double-blind study. Psychoneuroendocrinology 2017; 83: 65-71. |
| [12] | Surís A, Holliday R, Adinoff B, et al. Facilitating Fear-Based Memory Extinction with Dexamethasone: A Randomized Controlled Trial in Male Veterans With Combat-Related PTSD. Psychiatry 2017; 80: 399-410. |
| [13] | Ludäscher P, Schmahl C, Feldmann RE, et al. No evidence for differential dose effects of hydrocortisone on intrusive memories in female patients with complex post-traumatic stress disorder--a randomized, double-blind, placebo-controlled, crossover study. J Psychopharmacol Oxf Engl 2015; 29: 1077-1084. |
| [14] | Yehuda R, Bierer LM, Pratchett LC, et al. Cortisol augmentation of a psychological treatment for warfighters with posttraumatic stress disorder: Randomized trial showing improved treatment retention and outcome. Psychoneuroendocrinology 2015; 51: 589-597. |
| [15] | Rasmusson AM, Marx CE, Jain S, et al. A randomized controlled trial of ganaxolone in posttraumatic stress disorder. Psychopharmacology (Berl) 2017; 234: 2245-2257. |
| [16] | de Kleine RA, Smits JAJ, Hendriks G-J, et al. Extinction learning as a moderator of d-cycloserine efficacy for enhancing exposure therapy in posttraumatic stress disorder. J Anxiety Disord 2015; 34: 63-67. |
| [17] | Rothbaum BO, Price M, Jovanovic T, et al. A randomized, double-blind evaluation of D-cycloserine or alprazolam combined with virtual reality exposure therapy for posttraumatic stress disorder in Iraq and Afghanistan War veterans. Am J Psychiatry 2014; 171: 640-648. |
| [18] | Difede J, Cukor J, Wyka K, et al. D-cycloserine augmentation of exposure therapy for post-traumatic stress disorder: a pilot randomized clinical trial. Neuropsychopharmacol Off Publ Am Coll Neuropsychopharmacol 2014; 39: 1052-1058. |
| [19] | Litz BT, Salters-Pedneault K, Steenkamp MM, et al. A randomized placebo-controlled trial of D-cycloserine and exposure therapy for posttraumatic stress disorder. J Psychiatr Res 2012; 46: 1184-1190. |
| [20] | Jerome L, Feduccia AA, Wang JB, et al. Long-term follow-up outcomes of MDMA-assisted psychotherapy for treatment of PTSD: a longitudinal pooled analysis of six phase 2 trials. Psychopharmacology (Berl) 2020; 237: 2485-2497. |
| [21] | Ot'alora G M, Grigsby J, Poulter B, et al. 3,4-Methylenedioxymethamphetamine-assisted psychotherapy for treatment of chronic posttraumatic stress disorder: A randomized phase 2 controlled trial. J Psychopharmacol Oxf Engl 2018; 32: 1295-1307. |
| [22] | Mithoefer MC, Mithoefer AT, Feduccia AA, et al. 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for post-traumatic stress disorder in military veterans, firefighters, and police officers: a randomised, double-blind, dose-response, phase 2 clinical trial. Lancet Psychiatry 2018; 5: 486-497. |
| [23] | Corey VR, Pisano VD, Halpern JH. Effects of 3,4-Methylenedioxymethamphetamine on Patient Utterances in a Psychotherapeutic Setting. J Nerv Ment Dis 2016; 204: 519-523. |
| [24] | Mithoefer MC, Wagner MT, Mithoefer AT, et al. Durability of improvement in post-traumatic stress disorder symptoms and absence of harmful effects or drug dependency after 3,4-methylenedioxymethamphetamine-assisted psychotherapy: a prospective long-term follow-up study. J Psychopharmacol Oxf Engl 2013; 27: 28-39. |
| [25] | Oehen P, Traber R, Widmer V, et al. A randomized, controlled pilot study of MDMA (± 3,4-Methylenedioxymethamphetamine)-assisted psychotherapy for treatment of resistant, chronic Post-Traumatic Stress Disorder (PTSD). J Psychopharmacol Oxf Engl 2013; 27: 40-52. |
| [26] | Mithoefer MC, Wagner MT, Mithoefer AT, et al. The safety and efficacy of {+/-}3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study. J Psychopharmacol Oxf Engl 2011; 25: 439-452. |
| [27] | Koek RJ, Luong TN. Theranostic pharmacology in PTSD: Neurobiology and timing. Prog Neuropsychopharmacol Biol Psychiatry 2019; 90: 245-263. |
| [28] | Flanagan JC, Hand A, Jarnecke AM, et al. Effects of oxytocin on working memory and executive control system connectivity in posttraumatic stress disorder. Exp Clin Psychopharmacol 2018; 26: 391-402. |
| [29] | Flanagan JC, Sippel LM, Wahlquist A, et al. Augmenting Prolonged Exposure therapy for PTSD with intranasal oxytocin: A randomized, placebo-controlled pilot trial. J Psychiatr Res 2018; 98: 64-69. |
| [30] | Sack M, Spieler D, Wizelman L, et al. Intranasal oxytocin reduces provoked symptoms in female patients with posttraumatic stress disorder despite exerting sympathomimetic and positive chronotropic effects in a randomized controlled trial. BMC Med 2017; 15: 40. |
| [31] | Nawijn L, van Zuiden M, Koch SBJ, et al. Intranasal oxytocin increases neural responses to social reward in post-traumatic stress disorder. Soc Cogn Affect Neurosci 2017; 12: 212-223. |
| [32] | Palgi S, Klein E, Shamay-Tsoory S. The role of oxytocin in empathy in PTSD. Psychol Trauma Theory Res Pract Policy 2017; 9: 70-75. |
| [33] | McCall WV, Pillai A, Case D, et al. A Pilot, Randomized Clinical Trial of Bedtime Doses of Prazosin Versus Placebo in Suicidal Posttraumatic Stress Disorder Patients With Nightmares. J Clin Psychopharmacol 2018; 38: 618-621. |
| [34] | Ahmadpanah M, Sabzeiee P, Hosseini SM, et al. Comparing the effect of prazosin and hydroxyzine on sleep quality in patients suffering from posttraumatic stress disorder. Neuropsychobiology 2014; 69: 235-242. |
| [35] | Raskind MA, Peterson K, Williams T, et al. A trial of prazosin for combat trauma PTSD with nightmares in active-duty soldiers returned from Iraq and Afghanistan. Am J Psychiatry 2013; 170: 1003-1010. |
| [36] | Raskind MA, Peskind ER, Chow B, et al. Trial of Prazosin for Post-Traumatic Stress Disorder in Military Veterans. N Engl J Med 2018; 378: 507-517. |
| [37] | Raskind MA, Millard SP, Petrie EC, et al. Higher Pretreatment Blood Pressure Is Associated With Greater Posttraumatic Stress Disorder Symptom Reduction in Soldiers Treated With Prazosin. Biol Psychiatry 2016; 80: 736-742. |
| [38] | Germain A, Richardson R, Moul DE, et al. Placebo-controlled comparison of prazosin and cognitive-behavioral treatments for sleep disturbances in US Military Veterans. J Psychosom Res 2012; 72: 89-96. |
| [39] | Feder A, Parides MK, Murrough JW, et al. Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder: a randomized clinical trial. JAMA Psychiatry 2014; 71: 681-688. |
| [40] | Hartberg J, Garrett-Walcott S, De Gioannis A. Impact of oral ketamine augmentation on hospital admissions in treatment-resistant depression and PTSD: a retrospective study. Psychopharmacology (Berl) 2018; 235: 393-398. |
| [41] | Rabinak CA, Blanchette A, Zabik NL, et al. Cannabinoid modulation of corticolimbic activation to threat in trauma-exposed adults: a preliminary study. Psychopharmacology (Berl) 2020; 237: 1813-1826. |
| [42] | Bonn-Miller MO, Babson KA, Vandrey R. Using cannabis to help you sleep: heightened frequency of medical cannabis use among those with PTSD. Drug Alcohol Depend 2014; 136: 162-165. |
| [43] | Bonn-Miller MO, Boden MT, Bucossi MM, et al. Self-reported cannabis use characteristics, patterns and helpfulness among medical cannabis users. Am J Drug Alcohol Abuse 2014; 40: 23-30. |
| [44] | Cameron C, Watson D, Robinson J. Use of a synthetic cannabinoid in a correctional population for posttraumatic stress disorder-related insomnia and nightmares, chronic pain, harm reduction, and other indications: a retrospective evaluation. J Clin Psychopharmacol 2014; 34: 559-564. |
| [45] | Greer GR, Grob CS, Halberstadt AL. PTSD symptom reports of patients evaluated for the New Mexico Medical Cannabis Program. J Psychoactive Drugs 2014; 46: 73-77. |
| [46] | Roitman P, Mechoulam R, Cooper-Kazaz R, et al. Preliminary, open-label, pilot study of add-on oral Δ9-tetrahydrocannabinol in chronic post-traumatic stress disorder. Clin Drug Investig 2014; 34: 587-591. |
| [47] | Jetly R, Heber A, Fraser G, et al. The efficacy of nabilone, a synthetic cannabinoid, in the treatment of PTSD-associated nightmares: A preliminary randomized, double-blind, placebo-controlled cross-over design study. Psychoneuroendocrinology 2015; 51: 585-588. |
| [48] | Wilkinson ST, Stefanovics E, Rosenheck RA. Marijuana use is associated with worse outcomes in symptom severity and violent behavior in patients with posttraumatic stress disorder. J Clin Psychiatry 2015; 76: 1174-1180. |
| [49] | Johnson MJ, Pierce JD, Mavandadi S, et al. Mental health symptom severity in cannabis using and non-using Veterans with probable PTSD. J Affect Disord 2016; 190: 439-442. |
| [50] | Ruglass LM, Shevorykin A, Radoncic V, et al. Impact of Cannabis Use on Treatment Outcomes among Adults Receiving Cognitive-Behavioral Treatment for PTSD and Substance Use Disorders. J Clin Med; 6. Epub ahead of print 7 February 2017. DOI: 10.3390/jcm6020014. |
| [51] | Naylor JC, Kilts JD, Bradford DW, et al. A pilot randomized placebo-controlled trial of adjunctive aripiprazole for chronic PTSD in US military Veterans resistant to antidepressant treatment. Int Clin Psychopharmacol 2015; 30: 167-174. |
| [52] | Krystal JH, Rosenheck RA, Cramer JA, et al. Adjunctive risperidone treatment for antidepressant-resistant symptoms of chronic military service-related PTSD: a randomized trial. JAMA 2011; 306: 493-502. |
| [53] | Villarreal G, Hamner MB, Cañive JM, et al. Efficacy of Quetiapine Monotherapy in Posttraumatic Stress Disorder: A Randomized, Placebo-Controlled Trial. Am J Psychiatry 2016; 173: 1205-1212. |
| [54] | Villarreal G, Hamner MB, Qualls C, et al. Characterizing the Effects of Quetiapine in Military Post-Traumatic Stress Disorder. Psychopharmacol Bull 2018; 48: 8-17. |
| [55] | Carey P, Suliman S, Ganesan K, et al. Olanzapine monotherapy in posttraumatic stress disorder: efficacy in a randomized, double-blind, placebo-controlled study. Hum Psychopharmacol 2012; 27: 386-391. |
| [56] | Youssef NA, Marx CE, Bradford DW, et al. An open-label pilot study of aripiprazole for male and female veterans with chronic post-traumatic stress disorder who respond suboptimally to antidepressants. Int Clin Psychopharmacol 2012; 27: 191-196. |
| [57] | Richardson JD, Fikretoglu D, Liu A, et al. Aripiprazole augmentation in the treatment of military-related PTSD with major depression: a retrospective chart review. BMC Psychiatry 2011; 11: 86. |
| [58] | Hamner MB, Hernandez-Tejada MA, Zuschlag ZD, et al. Ziprasidone Augmentation of SSRI Antidepressants in Posttraumatic Stress Disorder: A Randomized, Placebo-Controlled Pilot Study of Augmentation Therapy. J Clin Psychopharmacol 2019; 39: 153-157. |
APA Style
Cyril Coquemont, Cyril Georges, Bernard Massoubre, Catherine Massoubre, Caroline Boulliat. (2022). Curative Drug Treatments for Post-Traumatic Stress Disorder: A Systematic Review of the Effectiveness of Recent Treatments. American Journal of Internal Medicine, 10(3), 39-50. https://doi.org/10.11648/j.ajim.20221003.12
ACS Style
Cyril Coquemont; Cyril Georges; Bernard Massoubre; Catherine Massoubre; Caroline Boulliat. Curative Drug Treatments for Post-Traumatic Stress Disorder: A Systematic Review of the Effectiveness of Recent Treatments. Am. J. Intern. Med. 2022, 10(3), 39-50. doi: 10.11648/j.ajim.20221003.12
AMA Style
Cyril Coquemont, Cyril Georges, Bernard Massoubre, Catherine Massoubre, Caroline Boulliat. Curative Drug Treatments for Post-Traumatic Stress Disorder: A Systematic Review of the Effectiveness of Recent Treatments. Am J Intern Med. 2022;10(3):39-50. doi: 10.11648/j.ajim.20221003.12
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Download@article{10.11648/j.ajim.20221003.12,
author = {Cyril Coquemont and Cyril Georges and Bernard Massoubre and Catherine Massoubre and Caroline Boulliat},
title = {Curative Drug Treatments for Post-Traumatic Stress Disorder: A Systematic Review of the Effectiveness of Recent Treatments},
journal = {American Journal of Internal Medicine},
volume = {10},
number = {3},
pages = {39-50},
doi = {10.11648/j.ajim.20221003.12},
url = {https://doi.org/10.11648/j.ajim.20221003.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20221003.12},
abstract = {Post-traumatic stress disorder (PTSD) is a severe anxiety disorder with clinical and social repercussions. The first line of treatment is psychotherapy, but the most advanced forms require, in addition, a drug treatment. Currently, the treatments used are few in number and not very effective. The objective is to review the recent literature on curative drug treatments for PTSD. We conducted a literature review on the Medline database to include articles less than 10 years old dealing with curative drug treatments for PTSD. We identified inclusion and exclusion criteria to frame our research. We first selected articles by reading the title, then the abstract, and finally the full text. Each clinical study was placed in a table with its main characteristics and then analyzed in order to determine the effectiveness of the treatment studied. 51 references were included. Beta-blockers, corticosteroids and D-cycloserine show positive results in combination with various psychotherapy methods. Antiepileptics, oxytocin, atypical antipsychotics and prazosin showed divergent results. The use of prazosin, currently used to treat PTSD-induced sleep disorders, is being questioned. Ketamine, MDMA and cannabinoids have shown satisfactory results in terms of efficacy, but the question of their safety of use remains. The risks of overdose and illegal use should not be overlooked. Molecules such as ketamine, MDMA or cannabinoids will require further studies to conclude their efficacy and safety. They appear to be the most promising molecules currently available for the treatment of PTSD.},
year = {2022}
}
TY - JOUR T1 - Curative Drug Treatments for Post-Traumatic Stress Disorder: A Systematic Review of the Effectiveness of Recent Treatments AU - Cyril Coquemont AU - Cyril Georges AU - Bernard Massoubre AU - Catherine Massoubre AU - Caroline Boulliat Y1 - 2022/05/10 PY - 2022 N1 - https://doi.org/10.11648/j.ajim.20221003.12 DO - 10.11648/j.ajim.20221003.12 T2 - American Journal of Internal Medicine JF - American Journal of Internal Medicine JO - American Journal of Internal Medicine SP - 39 EP - 50 PB - Science Publishing Group SN - 2330-4324 UR - https://doi.org/10.11648/j.ajim.20221003.12 AB - Post-traumatic stress disorder (PTSD) is a severe anxiety disorder with clinical and social repercussions. The first line of treatment is psychotherapy, but the most advanced forms require, in addition, a drug treatment. Currently, the treatments used are few in number and not very effective. The objective is to review the recent literature on curative drug treatments for PTSD. We conducted a literature review on the Medline database to include articles less than 10 years old dealing with curative drug treatments for PTSD. We identified inclusion and exclusion criteria to frame our research. We first selected articles by reading the title, then the abstract, and finally the full text. Each clinical study was placed in a table with its main characteristics and then analyzed in order to determine the effectiveness of the treatment studied. 51 references were included. Beta-blockers, corticosteroids and D-cycloserine show positive results in combination with various psychotherapy methods. Antiepileptics, oxytocin, atypical antipsychotics and prazosin showed divergent results. The use of prazosin, currently used to treat PTSD-induced sleep disorders, is being questioned. Ketamine, MDMA and cannabinoids have shown satisfactory results in terms of efficacy, but the question of their safety of use remains. The risks of overdose and illegal use should not be overlooked. Molecules such as ketamine, MDMA or cannabinoids will require further studies to conclude their efficacy and safety. They appear to be the most promising molecules currently available for the treatment of PTSD. VL - 10 IS - 3 ER -
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