Some drugs have a small positive impact on PTSD symptoms and are acceptable. Fluoxetine, paroxetine and venlafaxine may be considered as potential treatments for the disorder. For most drugs there is inadequate evidence regarding efficacy for PTSD, pointing to the need for more research in this area.

Background: Pharmacological approaches are widely used for post-traumatic stress disorder (PTSD) despite uncertainty over efficacy. Objectives: To determine the efficacy of all pharmacological approaches, including monotherapy, augmentation and head-to-head approaches (drug versus drug, drug versus psychotherapy), in reducing PTSD symptom severity. Method: A systematic review and meta-analysis of randomised controlled trials were undertaken; 115 studies were included. Results: Selective serotonin reuptake inhibitors (SSRIs) were found to be statistically superior to placebo in reduction of PTSD symptoms but the effect size was small (standardised mean difference −0.28, 95% CI −0.39 to −0.17). For individual monotherapy agents compared to placebo in two or more studies, we found small statistically significant evidence for the antidepressants fluoxetine, paroxetine, sertraline, venlafaxine and the antipsychotic quetiapine. For pharmacological augmentation, we found small statistically significant evidence for prazosin and risperidone. Conclusions: Some medications have a small positive effect on reducing PTSD symptom severity and can be considered as potential monotherapy treatments; these include fluoxetine, paroxetine, sertraline, venlafaxine and quetiapine. Two medications, prazosin and risperidone, also have a small positive effect when used to augment pharmacological monotherapy. There was no evidence of superiority for one intervention over another in the small number of head-to-head comparison studies. Tratamiento farmacologico para el trastorno de estres postraumatico: una revision sistematica y metanalisis de monoterapia, potenciacion y abordajes comparativos Antecedentes: Los abordajes farmacológicos se usan ampliamente para el trastorno de estrés postraumático (TEPT) a pesar de su eficacia incierta. Objetivos: Determinar la eficacia de todos los abordajes farmacológicos, incluyendo monoterapia, potenciación y abordajes comparativos (droga versus droga, droga versus psicoterapia), en la reducción de la severidad de los síntomas de TEPT. Método: Se llevó a cabo una revisión sistemática y metanálisis de estudios controlados aleatorizados; se incluyeron 115 estudios. Resultados: Se encontró que los inhibidores selectivos de la recaptación de serotonina (ISRSs) fueron estadísticamente superiores a placebo en la reducción de los síntomas de TEPT, pero el tamaño de efecto fue pequeño (diferencia media estandarizada −0.28, IC 95% −0.39 a −0.17). Para agentes en monoterapia individuales comparados con placebo en dos o más estudios, encontramos para los antidepresivos fluoxetina, paroxetina, sertralina, venlafaxina y el antipsicótico quetiapina una evidencia estadísticamente significativa pequeña. Para la potenciación farmacológica, encontramos para prazosina y risperidona, evidencia estadísticamente significativa pequeña. Conclusiones: Algunos medicamentos tienen un efecto positivo pequeño en la reducción de la severidad de los síntomas de TEPT y pueden ser considerados como potenciales tratamientos en monoterap...

The introduction of case-based learning (CBL) by the School of Medicine at Cardiff University has encouraged innovation in medical teaching and learning. During years one and two of the modernized MBBCh program, students complete 17 cases as part of the newly developed C21 curriculum that emphasizes a patient-oriented and student-centered approach to learning. The mental health case, which is presented in year 2, incorporates a number of novel teaching resources that aim to enhance the students' learning experience and to further reinforce the patient-oriented and community-based philosophy of C21. These include the use of fictionalized video diaries, virtual patient cases, e-learning workbooks, an interactive practical session, and community placements. Novel teaching methods and resources were evaluated by students in terms of effectiveness and value as learning resources through the administration of a structured mixed questionnaire. The results revealed that students valued the inclusion of these resources, which they evaluated as having contributed to their understanding of the subject area. Furthermore, the case was found to have had an impact on student interest in psychiatry as a specialty as well as a career choice. The positive student evaluation of this case supports the innovations in teaching delivery inspired by C21.

Objective Research into psychedelic therapy models has shown promise for the treatment of specific psychiatric conditions. Mystical‐type experiences occasioned by psilocybin have been correlated with therapeutic benefits and long‐term improvements in positive mental outlook and attitudes. This article aims to provide an overview of the topic, highlight strengths and weaknesses in current research, generate novel perspectives and discussion, and consider future avenues for research. Design This narrative review was designed to summarise and assess the state of research on psilocybin occasioned mystical‐type experiences and applications for the treatment of specific psychiatric conditions. Results Contemporary methods on the quantification of mystical‐type experiences and their acute subjective effects are discussed. Recent studies provide some understanding of the pharmacological actions of psychedelics although the neurological similarities and differences between spontaneous and psychedelic mystical‐type experiences are not well described. Applicability to modern clinical settings is assessed. Potential novel therapeutic applications include use in positive psychology interventions in healthy individuals. Conclusions Since 2006 significant advancements in understanding the therapeutic potential of psilocybin‐assisted psychotherapy have been made; however, more work is required to understand the neuromechanistic processes and applicability in modern clinical settings. Despite promising results in recent studies, funding issues for clinical trials, legal concerns and socio‐cultural resistance provide a counterpoint to experimental evidence.