Antidepressants in Post-Traumatic Stress Disorder

This chapter discusses the use of antidepressants in treating symptoms of posttraumatic stress disorder (PTSD). Tricyclic antidepressants were the first psychotropic agents to be studied systematically and rigorously for the treatment of PTSD. While early studies focused both on the tricyclics and monoamine oxidase inhibitors (MAOIs), more recent work has centered on the selective serotonin reuptake inhibitors (SSRIs); and paroxetine and sertraline are currently approved by the U.S. Food and Drug Administration (FDA) for use in this disorder. However, given the relatively small effect sizes in SSRI trials of PTSD, there is a need for ongoing psychopharmacological research to understand underlying mechanisms of antidepressant efficacy and to optimize response to pharmacotherapy. Further data on pediatric PTSD and on medication prophylaxis are needed before routine antidepressant treatment can be endorsed in these contexts.