4.3.2.3 Post-traumatic stress disorder

ChoiceDrugDosage
1st choiceNon-pharmacological treatment
2nd choicesSertraline 50mg, 100mg tabletsDose:
Initially 25mg daily for 1 week, then increased to 50mg daily, then increased in steps of 50mg at intervals of at least 1 week if required, increase only if response is partial and if drug is tolerated; max 200mg per day
Or

Venlafaxine MR tablets 75mg, 150mg, 225mg; capsules 75mg, 150mg, 225mg
[unlicensed]

Dose:
Initially 75mg once daily, increased if necessary up to 225mg once daily. Dose to be increased at intervals of at least 2 weeks; maximum 225mg per day

Prescribing Notes

  • See NICE NG116 Post-traumatic stress disorder
  • Trauma focused psychological therapy is the first line treatment for PTSD. Choice of treatment in individual cases will usually be determined by patient preference, service availability and the severity of the condition. Evidence on the pharmacological treatment of PTSD is limited
  • Response to SSRIs is usually seen within 8 weeks, but can take up to 12 weeks. Treatment should be continued for at least six months and probably longer
  • Antipsychotics such as risperidone can be considered for patients with disabling symptoms and behaviours that have not responded to other drug or psychological treatments. Antipsychotic treatment should be started and reviewed regularly by a specialist

Cautions

See section 4.3.1