Treatments for Post-traumatic Stress Disorder: Pharmaceutical and Electrophysiologic Considerations

Abstract

Most individuals who experience traumatic events remain asymptomatic or symptoms resolve quickly, but in a minority who develop post-traumatic stress disorder (PTSD), symptoms can persist for decades and can be associated with psychiatric and medical co-morbidities and poor social and occupational functioning. Currently, first-line pharmacotherapies are selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) for core symptoms and in individuals with unremitting nightmares, prazosin, is commonly used and often effective. This review appraises these commonly used evidence-based treatments and their conceptual underpinnings. It follows with a discussion of concepts underlying emerging treatment research and development, in particular the use of combined psychotherapeutic-pharmacologic approaches and electro-physiological technologies that stimulate neural circuits and their potential uses. While the evidence for combined psychotherapy and either pharmacological or physiological treatments is only now emerging, some of these modalities appear promising.