Laura Wolfe, M.D., is an adult psychiatrist who works for Kaiser Permanente in Santa Clara, California. Her experience treating a man with PTSD is helpful in understanding the role of SSRIs.
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Let's face it, when our patients are in distress, we use whatever meds we think might be helpful, whether the FDA has given its blessing or not. Not a single one of the nostrums discussed in this article is FDA-approved for PTSD, but they are all commonly used when nothing else works.
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As you can see from this issue's lead article, SSRIs help alleviate core PTSD symptoms, but hardly roar by the placebo response rate in clinical trials. And anytime the placebo effect is this robust, you can predict that psychotherapy will be very effective. This is certainly true in the world of PTSD.
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TCR: Dr. Foa, how common is PTSD? Dr. Foa: The epidemiological studies tell us that 60% of men in the United States and over 50% of women have been traumatized at least once in their lifetime.
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Strangely enough, there are only two medications FDA-approved for PTSD--Zoloft (sertraline) and Paxil (paroxetine). This is despite the fact that PTSD is a common problem, with a lifetime prevalence of between 5 and 10%, and can be extremely debilitating.
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Dr. Aiken is the Editor in Chief of The Carlat Psychiatry Report; director of the Mood Treatment Center in North Carolina, where he maintains a private practice combining medication and therapy along with evidence-based complementary and alternative treatments; and Assistant Professor NYU Langone Department of Psychiatry. He has worked as a research assistant at the NIMH and a sub-investigator on clinical trials, and conducts research on a shoestring budget out of his private practice. Follow him on Twitter and find him on LinkedIn.
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