Vintage treatments for PTSD: a reconsideration of tricyclic drugs.

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2015-03

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Abstract

Serotonin (SSRI) and serotonin-norepinephrine (SNRI) reuptake inhibitors (SSRI) are the first-line recommended drug treatments for post-traumatic stress disorder (PTSD); but despite their benefits, much residual pathology remains and no new drugs have yet emerged with a clearly demonstrated benefit for treating the disorder. A case is made that tricyclic drugs deserve a closer look, based on their ability to affect several of the main neurotransmitters that are relevant to PTSD. Their promising efficacy, which was shown 30 years ago, had not been followed up, until a recent trial of desipramine found advantages over a SSRI in PTSD with comorbid alcohol dependence. Opportunities exist for studying newer and purportedly safer tricyclic formulations, as well as further the work with older, established compounds. A reappraisal of their risk:benefit ratio seems in order, when treating PTSD.

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10.1177/0269881114565143

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Davidson, Jonathan (2015). Vintage treatments for PTSD: a reconsideration of tricyclic drugs. Journal of psychopharmacology (Oxford, England), 29(3). pp. 264–269. 10.1177/0269881114565143 Retrieved from https://hdl.handle.net/10161/25996.

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Jonathan R.T. Davidson

Professor Emeritus of Psychiatry and Behavioral Sciences

Currently, my research focuses upon the theoretical aspects of homeopathy and its clinical utilization, as well as the broader field of alternative (complementary) medicine. this is a field which has traditionally been overlooked as a legitimate scientific discipline. Other areas of activity are as in the past, i.e., clinical treatment, epidemiology, risk factors, pathogenesis of posttraumatic stress, social phobia, other anxiety status, and depression. These are illustrated by recent publications on treatment, epidemiology, health service utilization and quality of life in social phobia and PTSD, drug treatment of panic disorder. Magnetic resonance studies of social phobia have been completed and further studies are planned.


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