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Long-Term Treatment and Prevention of Posttraumatic Stress Disorder

Jonathan R. T. Davidson, M.D.

Posttraumatic stress disorder (PTSD) is a disabling condition almost universally associated with psychiatric comorbidity, reduced quality of life, and a chronic, often lifelong, course. Although acute treatment with selective serotonin reuptake inhibitors (SSRIs) has been shown to be effective, successful strategies for preventing PTSD have not been established. In addition, studies of the long-term treatment of chronic PTSD are just beginning to emerge. This review considers available evidence for the secondary prevention of PTSD in the acute aftermath of trauma and the long-term treatment of established PTSD. Unanswered questions pertaining to duration of treatment, candidates for longterm treatment, and potentially harmful treatments will also be considered.

(J Clin Psychiatry 2004;65[suppl 1]:44–48)

From the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, N.C.

The International Consensus Group on Depression and Anxiety held the meeting "Update on Posttraumatic Stress Disorder," July 11–12, 2002, in Adare, County Limerick, Ireland. The Consensus Meeting was supported by an unrestricted educational grant from GlaxoSmithKline.

Dr. Davidson has received grant/research support and honoraria from and has served as a consultant and speakers/advisory board member for Solvay, Pfizer, GlaxoSmithKline, Bristol-Myers Squibb, Organon, Wyeth, Forest, Sanofi-Synthelabo, Lilly, Novartis, Roche, Ancile, Cephalon, Nutrition 21, Boots, and Boehringer Ingelheim.

Dr. Marshall has served as a consultant for Wyeth, received grant/research support and honoraria from Pfizer and GlaxoSmithKline, and served on the speakers/ advisory boards of Pfizer, GlaxoSmithKline, and Wyeth.

Corresponding author and reprints: Jonathan R.T. Davidson, M.D., Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Box 3812, Durham, NC 27710 (e-mail: jonathan.davidson@duke.edu).