Pharmacotherapy for Posttraumatic Stress Disorder Using Phenelzine or Imipramine

Kosten, Thomas R.; Frank, Julia B.; Dan, Elisheva; McDougle, Christopher J.; Giller, Earl L.

doi:10.1097/00005053-199106000-00011

Cited by 224 publications

(142 citation statements)

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“…Á In a comparison with phenelzine, imipramine was superior to placebo. It was as effective as phenelzine on the CGI, but less effective on one scale (Kosten et al 1991). Another small study showed equal efficacy for phenelzine and imipramine (Frank et al 1988)(B).…”

Section: )(A)tricyclic Antidepressants (Tcas)mentioning

confidence: 98%

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World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Bandelow

Zohar

Hollander

et al. 2008

The World Journal of Biological Psychiatry

711

410

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In this report, which is an update of a guideline published in 2002 (Bandelow et al. 2002, recommendations for the pharmacological treatment of anxiety disorder, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are presented. Since the publication of the first version of this guideline, a substantial number of new randomized controlled studies of anxiolytics have been published. In particular, more relapse prevention studies are now available that show sustained efficacy of anxiolytic drugs. The recommendations, developed by the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders, a consensus panel of 30 international experts, are now based on 510 published randomized, placebo-or comparator-controlled clinical studies (RCTs) and 130 open studies and case reports. First-line treatments for these disorders are selective serotonin reuptake inhibitors (SSRIs), serotonin-noradrenaline reuptake inhibitors (SNRIs) and the calcium channel modulator pregabalin. Tricyclic antidepressants (TCAs) are equally effective for some disorders, but many are less well tolerated than the SSRIs/ SNRIs. In treatment-resistant cases, benzodiazepines may be used when the patient does not have a history of substance abuse disorders. Potential treatment options for patients unresponsive to standard treatments are described in this overview. Although these guidelines focus on medications, non-pharmacological were also considered. Cognitive behavioural therapy (CBT) and other variants of behaviour therapy have been sufficiently investigated in controlled studies in patients with anxiety disorders, OCD, and PTSD to support them being recommended either alone or in combination with the above medicines.

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Section: )(A)tricyclic Antidepressants (Tcas)mentioning

confidence: 98%

“…Phenelzine has been studied and shown to be effective in the abovementioned comparisons with imipramine (Frank et al 1988;Kosten et al 1991). It was shown to be effective with a rather significant effect size.…”

Section: )(A)tricyclic Antidepressants (Tcas)mentioning

confidence: 99%

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Bandelow

Zohar

Hollander

et al. 2008

The World Journal of Biological Psychiatry

711

410

View full text Add to dashboard Cite

show abstract

“…The neocortex is also distinguished by regional specialization for information processing (Benson, 1993 In a preliminary sample of male veterans with PTSD related to their service during the Vietnam war, both phenelzine and imipramine were found to be superior to placebo in relieving distress related to intrusive phenomena (nightmares, fl ashbacks, recollections) but not in addressing non-specifi c anxiety or avoidance . The results were confi rmed in the full patient sample with phenelzine showing a modest advantage over imipramine (Kosten et al, 1991). The potential side effects and dietary measures associated with MAOI use, however, limited the appeal of this drug class.…”

Section: Introductionmentioning

confidence: 82%

Posttraumatic stress disorder — the neuroscientific basis of evidence-based treatments

Jaskiw

2017

NTSN MS

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“…Interestingly, there is evidence of cardiac conduction prolongation with citalopram, a drug in the SSRI family, above dosages of 40 mg daily or in overdose [52][53]. Early studies showed both the TCAs and MAOIs to be effective in PTSD, though the outcome measures in those early studies had less sensitivity and specificity than outcome measures in more recent studies [54][55]. Adding to the complexity with MAOIs are the relatively high rates of hypotension and the stringent restrictions for a tyramine-free diet to prevent hypertensive crisis.…”

Section: Initiating Effective Pharmacotherapymentioning

confidence: 99%

Pharmacotherapy for posttraumatic stress disorder: Review with clinical applications

Jeffreys

Capehart²,

Friedman³

2012

JRRD

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Abstract-Posttraumatic stress disorder (PTSD) is a prevalent psychiatric diagnosis among veterans and has high comorbidity with other medical and psychiatric conditions. This article reviews the pharmacotherapy recommendations from the 2010 revised Department of Veterans Affairs/Department of Defense Clinical Practice Guideline (CPG) for PTSD and provides practical PTSD treatment recommendations for clinicians. While evidence-based, trauma-focused psychotherapy is the preferred treatment for PTSD, pharmacotherapy is also an important treatment option. First-line pharmacotherapy agents include selective serotonin reuptake inhibitors and the selective serotonin-norepinephrine reuptake inhibitor venlafaxine. Second-line agents have less evidence for their usefulness in PTSD and carry a potentially greater side effect burden. They include nefazodone, mirtazapine, tricyclic antidepressants, and monoamine oxidase inhibitors. Prazosin is beneficial for nightmares. Benzodiazepines and antipsychotics, either as monotherapy or used adjunctively, are not recommended in the treatment of PTSD. Treating co-occurring disorders, such as major depressive disorder, substance use disorders, and traumatic brain injury, is essential in maximizing treatment outcomes in PTSD. The CPG provides evidence-based treatment recommendations for treating PTSD with and without such cooccurring disorders.

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Pharmacotherapy for Posttraumatic Stress Disorder Using Phenelzine or Imipramine

Cited by 224 publications

References 0 publications

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

Posttraumatic stress disorder — the neuroscientific basis of evidence-based treatments

Pharmacotherapy for posttraumatic stress disorder: Review with clinical applications

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