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Revista Brasileira de Psiquiatria
Print version ISSN 1516-4446
BERGER, William et al. Antipsychotics, anticonvulsants, antiadrenergics and other drugs: what to do when posttraumatic stress disorder does not respond to selective serotonin reuptake inhibitors?. Rev. Bras. Psiquiatr. [online]. 2007, vol.29, suppl.2, pp. S61-S65. ISSN 1516-4446. http://dx.doi.org/10.1590/S1516-44462007000600005.
OBJECTIVES: In this narrative review, we aimed to describe different pharmacological strategies for the treatment of patients with post-traumatic stress disorder who display different levels of intolerance, resistance, refractoriness, or who are unable to take to antidepressants, especially serotonin reuptake inhibitors. METHOD: We searched the ISI web of science and the PubMed for original studies focusing in the treatment of PTSD in different clinical scenarios. RESULTS: Preliminary evidence pointed towards the efficacy of drugs such as risperidone, olanzapine, lamotrigine and prazosin as strategies to be employed in the above mentioned clinical scenarios. The choice of a specific "second line" drug should take into account not only symptoms, but also pattern of comorbidities, previous response to other treatments, pharmacological interactions, side-effects, and patient's physical conditions. CONCLUSIONS: Future randomized controlled trials should be performed in order to unveil which drugs should be prescribed in the absence of adequate treatment and response to serotonin reuptake inhibitors.
Keywords : Stress disorders, posttraumatic; Pharmacology; Clinical protocols; Review literature.