Pharmacological treatment of post-traumatic stress disorder: a treatment guide based on a systematic literature review

Authors

  • Cauê do Prado Nascimento Graduando, Faculdade de Medicina, Faculdade Israelita de Ciências da Saúde Albert Einstein, FICSAE, São Paulo, SP, Brasil https://orcid.org/0000-0002-9574-412X
  • Heitor Zuleta Couto Graduando, Faculdade de Medicina, Faculdade Israelita de Ciências da Saúde Albert Einstein, FICSAE, São Paulo, SP, Brasil https://orcid.org/0009-0000-4255-9185
  • Leonardo Baldaçara Professor, Universidade Federal do Tocantins, UFT, Palmas, TO, Brasil https://orcid.org/0000-0002-5201-8515
  • Antônio Geraldo da Silva Pós-doutorando, Universidade Federal de Minas Gerais, UFMG, Belo Horizonte, MG, Brasil https://orcid.org/0000-0003-3423-7076
  • Marcelo Feijó de Mello Professor, Faculdade Israelita de Ciências da Saúde Albert Einstein, FICSAE, São Paulo, SP, Brasil https://orcid.org/0000-0002-0475-4729
  • Andrea Feijó de Mello Coordenadora do Programa de Atendimento e Pesquisa em Violência, PROVE, Universidade Federal de São Paulo, UNIFESP, São Paulo, SP, Brasil https://orcid.org/0000-0001-8498-7751

DOI:

https://doi.org/10.25118/2763-9037.2023.v13.1037

Keywords:

Post-traumatic stress disorder, pharmacology, Psychopharmacology, stress disorders, post-traumatic, drug therapy

Abstract

Objective: To review the literature from the last twenty years on pharmacological treatments for post-traumatic stress disorder to clarify questions about the efficacy and tolerability of pharmacotherapy and the superiority of one specific agent over another for creating a treatment guideline based on levels of evidence. Methods: Randomized clinical trials and systematic reviews were searched in  Medline-PubMed, PsycINFO, Web of Science, Scielo, and Lilacs. The screening of the criteria established by the Transparent Reporting of Systematic Reviews and Meta-Analyses was used, followed by the analysis of risk of bias of the Critical Appraisal Skills Programme. Lastly, the level of evidence and grade of recommendation was acquired, following the Oxford Center for Evidence-based Medicine 2009 Levels of Evidence. Results: The search retrieved double-blind, randomized and placebo-controlled clinical trials. Comparative clinical trials between different drugs were also evaluated and systematic reviews on drug efficacy and meta-analyses. A total of 1.458 studies were found; 58 of these studies were pre-selected and the final sample was composed of 20 studies. Conclusions: Of the 17 drugs included, the following is the order of recommendation based on the levels of evidence established in this study - 1st sertraline; 2nd venlafaxine and paroxetine; 3rd atypical antipsychotics.

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Author Biographies

Cauê do Prado Nascimento, Graduando, Faculdade de Medicina, Faculdade Israelita de Ciências da Saúde Albert Einstein, FICSAE, São Paulo, SP, Brasil

http://lattes.cnpq.br/5316711720722006

Heitor Zuleta Couto, Graduando, Faculdade de Medicina, Faculdade Israelita de Ciências da Saúde Albert Einstein, FICSAE, São Paulo, SP, Brasil

http://lattes.cnpq.br/6563515135671163

Leonardo Baldaçara, Professor, Universidade Federal do Tocantins, UFT, Palmas, TO, Brasil

http://lattes.cnpq.br/7014751113831877

Antônio Geraldo da Silva, Pós-doutorando, Universidade Federal de Minas Gerais, UFMG, Belo Horizonte, MG, Brasil

http://lattes.cnpq.br/9471338065453170

Marcelo Feijó de Mello, Professor, Faculdade Israelita de Ciências da Saúde Albert Einstein, FICSAE, São Paulo, SP, Brasil

http://lattes.cnpq.br/9828693113292175

Andrea Feijó de Mello, Coordenadora do Programa de Atendimento e Pesquisa em Violência, PROVE, Universidade Federal de São Paulo, UNIFESP, São Paulo, SP, Brasil

http://lattes.cnpq.br/5024373026936383

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Published

2023-11-20

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1.
Nascimento C do P, Couto HZ, Baldaçara L, Silva AG da, Mello MF de, Mello AF de. Pharmacological treatment of post-traumatic stress disorder: a treatment guide based on a systematic literature review . Debates em Psiquiatria [Internet]. 2023 Nov. 20 [cited 2025 Apr. 17];13:1-72. Available from: https://revistardp.org.br/revista/article/view/1037

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