Treatment-refractory posttraumatic stress disorder (TRPTSD): a review and framework for the future

摘要: Post-traumatic stress disorder (PTSD) is a serious psychiatric consequence of trauma that occurs in proportion individuals exposed to life-threatening events. Trauma-focused psychotherapy often recommended as first choice for those who do not recover spontaneously. But many require medications. In the US, only paroxetine (PRX) and sertraline (SRT) are FDA approved PTSD. response remission rates with these medications low, so numerous other pharmacologic interventions have been tried. To date, there has systematic review data on what best next-step strategies fail standard treatments. end, we 168 published trials than PRX or SRT provide detailed analysis 88/168 studies describe alternative patients refractory treatment. We also clinical factors relevant treatment-refractory PTSD; neurobiology extinction, well evidence-based neuromodulation this condition.