Psychiatria pre prax 5/2001

Posttraumatic stress disorder – part II. – treatment

Medication is considered an adjunctive rather than a primary treatment for PTSD. It is generally recognized that some form of psychotherapy is necessary in treating the disorder. However, in cases of severe or chronic PTSD, medication may provide enough symptom relief to allow patients to participate in therapy. The antidepressants (especially SSRI) were more effective than other forms of medication. The mood stabilizers and neuroleptics was found to be effective too. Benzodiazepines were not found to be very effective. In cognitive behavioral therapy the treatment package combines anxiety management training, prolonged exposure, and cognitive restructuring to address the symptoms of PTSD. Anxiety management training is used to reduce symptoms of hyperarousal and the emotional distress associated with reexperiencing. Repeated exposure to memories of the event weakens the association between the memories and the emotional reactions they evoke. Cognitive restructuring is used to eliminate the pattern of alternating between thinking about and avoiding thinking about the trauma by altering maladaptive meanings associated with the event.

Keywords: post-traumatic stress disorder, psychotherapy, antidepressants, mood stabilizers, neuroleptics, cognitive behavioural therapy, anxiety management training, exposure, cognitive restructuring.