Use of pharmacological treatment for posttraumatic stress disorder: Analysis of a psychiatric population in Switzerland and comparison with international guidelines.
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Version: Author's accepted manuscript
License: Not specified
Serval ID
serval:BIB_29F467041DCE
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Use of pharmacological treatment for posttraumatic stress disorder: Analysis of a psychiatric population in Switzerland and comparison with international guidelines.
Journal
L'Encephale
ISSN
0013-7006 (Print)
ISSN-L
0013-7006
Publication state
Published
Issued date
10/2023
Peer-reviewed
Oui
Volume
49
Number
5
Pages
446-452
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Several international guidelines for the pharmacological treatment of posttraumatic stress disorder (PTSD) have been published. However, it is unclear whether clinicians use these procedures in their daily practice. We compared the psychopharmacological prescription patterns in a Swiss adult psychiatric center with international clinical guidelines at admission and discharge.
Retrospective chart review study between 2005 and 2015 of adult patients with PTSD and no other documented psychiatric comorbidity.
Fifty-two outpatients and 21 inpatients were included; 47% had at least one psychopharmacological treatment at admission. Among them, 47% had one or several antidepressants, mainly escitalopram (31%, n=5) or citalopram. At discharge, 68% had at least one psychopharmacological treatment. Among them, 76% had at least one antidepressant, mainly escitalopram (34%, n=13) or mirtazapine (21%, n=8). They were compared to the guidelines of the Department of Veterans Affairs and Department of Defense (VA/DoD), showing 19% of the patients treated with antidepressants at admission were in agreement with the guidelines (sertraline, fluoxetine, paroxetine, venlafaxine), and 26% at discharge. In addition, we found prescriptions of benzodiazepines (62% at admission and 50% at discharge), antipsychotics (12% and 22%), Z-drugs (zolpidem, zopiclone: 15 and 40%) and a few pregabalin prescriptions (n=4).
Clinicians in this study frequently prescribed antidepressants to treat PTSD, as recommended. However, most of the antidepressants used were not recommended in the VA/DoD guidelines. Benzodiazepines and Z-drugs remained widely used, although they are not recommended.
Retrospective chart review study between 2005 and 2015 of adult patients with PTSD and no other documented psychiatric comorbidity.
Fifty-two outpatients and 21 inpatients were included; 47% had at least one psychopharmacological treatment at admission. Among them, 47% had one or several antidepressants, mainly escitalopram (31%, n=5) or citalopram. At discharge, 68% had at least one psychopharmacological treatment. Among them, 76% had at least one antidepressant, mainly escitalopram (34%, n=13) or mirtazapine (21%, n=8). They were compared to the guidelines of the Department of Veterans Affairs and Department of Defense (VA/DoD), showing 19% of the patients treated with antidepressants at admission were in agreement with the guidelines (sertraline, fluoxetine, paroxetine, venlafaxine), and 26% at discharge. In addition, we found prescriptions of benzodiazepines (62% at admission and 50% at discharge), antipsychotics (12% and 22%), Z-drugs (zolpidem, zopiclone: 15 and 40%) and a few pregabalin prescriptions (n=4).
Clinicians in this study frequently prescribed antidepressants to treat PTSD, as recommended. However, most of the antidepressants used were not recommended in the VA/DoD guidelines. Benzodiazepines and Z-drugs remained widely used, although they are not recommended.
Keywords
Adult, Humans, Stress Disorders, Post-Traumatic/drug therapy, Stress Disorders, Post-Traumatic/epidemiology, Switzerland, Escitalopram, Retrospective Studies, Antidepressive Agents/therapeutic use, Benzodiazepines/therapeutic use, Guideline, Posttraumatic stress disorder, Psychiatrie, Psychiatry, Psychopharmacological treatment, Recommandations internationales, Traitement psychopharmacologique, État de stress post-traumatique
Pubmed
Web of science
Open Access
Yes
Create date
22/08/2022 9:59
Last modification date
27/11/2024 7:09