Posttraumatic Stress Disorder: Drug Therapy

Therapy target

• Relief of symptoms or freedom from symptoms

Therapy recommendations

Note: The S3 guideline emphasizes that psychotropic drugs should not be used alone or as primary therapy for post-traumatic stress disorder (PTSD)!

Possible psychotropic drug therapy for chronic PTSD:

• Selective serotonin reuptake inhibitors (SSRIs) (1st-line agent).
  • Paroxetine (Germany); paroxetine and sertraline (United States).
• Selective serotonin–norepinephrine reuptake inhibitors (SSNRI/SNIR).
  • Venlafaxine (1st-line agent).
• Tricyclic antidepressants (TCA).
  • Amitriptyline, imipramine
• Monoamine oxidase inhibitors (MAO inhibitors).
  • Moclobemide, phenelzine
• Norepinephrine–serotonin-selective antidepression (NaSSa).
  • Mirtazapine
• Mood stabilizers: carbamazepine, lamotrigine.

Other notes

• Treatment with MDMA (3,4-methylenedioxy-N-methylamphetamine; ecstasy) relieved symptoms of posttraumatic stress disorder (PTSD) in a small randomized double-blind study. The result will be verified in a phase III study.