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Pharmacotherapy for posttraumatic stress disorder in children and adolescents

Authors
Jeffrey Strawn, MD
Brooks Keeshin, MD
Section Editor
David Brent, MD
Deputy Editor
Richard Hermann, MD

INTRODUCTION

Posttraumatic stress disorder (PTSD) in children and adolescents is a severe, often chronic, and impairing mental disorder. PTSD is seen in some children (and not others) after exposure to traumatic experiences involving actual or threatened injury to themselves or others.

PTSD is characterized by intrusive thoughts and reminders of the traumatic experience(s), avoidance of trauma reminders, negative mood and cognitions related to the traumatic experience(s), and physiological hyperarousal that lead to significant social, school, and interpersonal problems. PTSD can occur even in toddlers (one to two years old) [1,2].

This topic will address pharmacotherapy for PTSD in children. The epidemiology, pathogenesis, clinical manifestations, course, assessment, diagnosis, and psychosocial interventions for PTSD in children are addressed separately, as are acute stress disorder and PTSD in adults. (See "Posttraumatic stress disorder in children and adolescents: Epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis" and "Posttraumatic stress disorder in adults: Epidemiology, pathophysiology, clinical manifestations, course, assessment, and diagnosis" and "Psychotherapy for posttraumatic stress disorder in adults" and "Pharmacotherapy for posttraumatic stress disorder in adults" and "Acute stress disorder in adults: Epidemiology, pathogenesis, clinical manifestations, course, and diagnosis" and "Treatment of acute stress disorder in adults".)

APPROACH TO TREATMENT

Our approach to treating posttraumatic stress disorder (PTSD) in children, including selecting among psychotherapies and medications, is described separately. In general, trauma-focused psychotherapy is suggested as first-line treatment for youth with PTSD; adjunctive medications are suggested to treat symptoms that do not adequately respond to psychotherapy. (See "Approach to treating posttraumatic stress disorder in children and adolescents" and "Psychosocial interventions for posttraumatic stress disorder in children and adolescents".)

ANTIDEPRESSANT MEDICATIONS

We agree with the practice parameters developed by the American Academy of Child and Adolescent Psychiatry that clinical trials comparing antidepressant treatment with placebo in pediatric patients with posttraumatic stress disorder (PTSD) are limited and, in general, do not suggest benefit of these medications. [3-5].

           

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Literature review current through: Jul 2017. | This topic last updated: Mar 14, 2017.
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