Selective serotonin reuptake inhibitors in post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) is a complex psychiatric condition, which can be triggered by a variety of traumatic events. Lifetime prevalence rates range from 1.3% to 10.4%, with women twice as likely as men to be affected. The clinical management of this condition is complex, since PTSD is associated with high rates of comorbid psychiatric disorders, particularly major depression, other anxiety and panic disorders, substance abuse and antisocial behaviour. Broadly, there are two main approaches to treatment: pharmacotherapy and cognitive or behavioural therapy. This paper reviews available pharmacological approaches for the treatment of PTSD and comorbid disorders. Although the optimal pharmacological approach has yet to be established, there is increasing evidence to support the use of antidepressants, and particularly selective serotonin reuptake inhibitors (SSRIs), as first-line therapy. In addition to alleviating the core symptoms of PTSD, some SSRIs are also effective for the treatment of common comorbidities, such as depression, panic disorder and social anxiety disorder; a fact which would appear to have important implications for patient management.