Numerous depression-fighting medications are available today, so talk to a psychiatrist to learn which treatment may be best for you. According to the FDA, “From the FDA perspective, once the FDA approves a drug, healthcare providers generally may prescribe the drug for an unapproved use when they judge that it is medically appropriate for their patient.Depression isn’t the same for everyone - multiple types exist, and people experience this treatable illness in varying degrees of severity.įor some people with depression, nonpharmacological interventions such as psychotherapy, lifestyle changes, and natural remedies may be enough to lift the cloud and improve symptoms.īut for many other people, these steps aren’t enough, and medication is needed. It is estimated that 1 in 5 outpatient prescriptions are written off-label. An off-label use of a medication means that it is being used for an indication other than one for which is was approved by the FDA. The FDA regulates approval of medications, not prescribing of medications. Friedman, MD, PhD, Thomas Mellman, MD and Jeffrey Sonis, MD, MPH also contributed. Topiramate has also been found helpful in reducing alcohol consumption in those with an alcohol use disorder, which frequently accompanies PTSD.Īdapted from with original content written by Matt Jeffreys, MD. It is not uncommon for patients taking topiramate to note side effects of cognitive dulling. However, the panel concluded that there was insufficient evidence to make a recommendation because the potential side effects/harms for topiramate are greater than they are for SSRI antidepressants. The systematic review that served as the evidence base for the guideline development panel reported moderate strength of evidence for a medium to large magnitude effect for PTSD symptom reduction. There has been recent interest in its use for PTSD. Topiramate is in the anti-epileptic category of medications and is thought to modulate glutamate neurotransmission. Some typical dosage ranges for medications: Ensuring treatment adherence is key to successful pharmacotherapy for PTSD. Research indicates that maximum benefit from SSRI treatment depends upon adequate dosages and duration of treatment. Intolerable sexual dysfunction or gastrointestinal side effects due to the effects of increased serotonin levels in the peripheral nervous system.Įach patient varies in their response and ability to tolerate a specific medication and dosage, so medications must be tailored to individual needs.A patient with PTSD and co-occurring bipolar disorder where an antidepressant could cause mood instability that could be mitigated with a mood stabilizing medication (such as lithium or an anti-epileptic medication) before prescribing an SSRI.While SSRIs are typically the first class of medications used in PTSD treatment (Brady et al, 2000 Marshall, Beebe, Oldham & Zaninelli, 2001), exceptions may occur for patients based upon their individual histories of side effects, response, comorbidities and personal preferences. The SSRIs sertraline and paroxetine are the only medications approved by the FDA for PTSD. The activity of this neurotransmitter in both the peripheral and central nervous systems can be modulated by SSRIs. ![]() The neurotransmitter serotonin has a well-recognized role in the experience of mood and anxiety disorders.
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