In sum, while medication treatments can be effective in treating core symptomsof PTSD as well as the associated depression and disability, existing agents stillfall short of being ideal due to limited response and remission rates and tolerabilityissues. There are significant gaps in assessing the efficacy of pharmacotherapyin different trauma subpopulations (e.g. combat veterans, refugees)including ethnic and cultural minorities, women, and older individuals. Furthermore,adequately powered, appropriately designed trials to determine if pharmacologicaltreatments are superior in terms of efficacy and cost effectivenessto trauma-focused psychological treatments (such as CBT) in the treatment ofPTSD, and whether they are efficacious and cost-effective in combination aresorely needed. The need for improving the pharmacotherapy of PTSD remainscompelling.ReferencesBandelow B, Zohar J, Hollander E, Kasper S, Möller HJ on behalf of the WFSBPTask Force on Treatment Guidelines for Anxiety, Obsessive-Compulsive andPosttraumatic Stress Disorders. World Federation of Societies of Biological Psychiatry(WFSBP) Guidelines for the pharmacological treatment of anxiety, obsessive-compulsiveand posttraumatic stress disorders - first revision. World JBiol Psychiatry 9: 248-312, 2008.<strong>Institute</strong> of Medicine (IOM). Treatment of posttraumatic stress disorder: Anassessment of the evidence. Washington, DC: The National Academies Press,2008.Ipser JC, Carey P, Dhansay Y, Fakier N, Seedat S, Stein DJ: Pharmacotherapyaugmentation strategies in treatment-resistant anxiety disorders. CochraneDatabase Syst Rev 18;(4): CD005473, 2006.Stein DJ, Ipser JC, Seedat S: Pharmacotherapy for post traumatic stress disorder(PTSD). Cochrane Database of Systematic Reviews 25;(1):CD002795,2006.National <strong>Institute</strong> for Health and Clinical Excellence. The management of posttraumatic stress disorder in primary and secondary care. London, NICE, 2005.Stein DJ, Bandelow B, Hollander E, Nutt DJ, Okasha A, Pollack MH, Swinson RP,Zohar J: WCA recommendations for the long-term treatment of posttraumaticstress disorder. Cns Spectrums 8:31-39, 2003.Bandelow, B, Zohar, J, Hollander, E, Kasper, S, Moller, H-J, and WFSBP TaskForce on Treatment Guidelines for Anxiety, Obsessive-Compulsive and PosttraumaticStress Disorders. World Federation of Societies of Biological Psychiatry(WFSBP) guidelines for the pharmacological treatment of anxiety, obsessivecompulsiveand posttraumatic stress disorders. World J Biol Psychiatry 3: 171-199, 2002.26
Ballenger, J C, Davidson, J R, Lecrubier, Y, Nutt, D J, Foa, E B, Kessler, R C,McFarlane, A C, and Shalev, A Y. Consensus statement on posttraumatic stressdisorder from the International Consensus Group on Depression and Anxiety. JClin Psychiatry 61S5: 60-66. 2000.Foa, E B, Davidson, J R T, and Frances, A. Treatment of posttraumatic stressdisorder: The expert consensus guideline series. J Clin Psychiatry 60, 1-76.1999.27
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