Some Veterans Not Getting Best Drug for PTSD

Mental health clinicians in the Veterans Health Administration too often prescribe medications for posttraumatic stress disorder (PTSD) that are not supported by guidelines, report researchers from the U.S. Department of Veterans Affairs (VA). The guidelines jointly used by the VA and the Department of Defense recommend use of selective serotonin–norepinephrine reuptake inhibitors (SSRI/SNRIs) for veterans with PTSD. They also recommend against routine use of benzodiazepines or second-generation antipsychotics.

After examining 2009 data on 356,958 veterans with PTSD, the researchers found that 66 percent were prescribed SSRI/SNRIs. However, 26 percent were prescribed second-generation antipsychotics, and 37 percent were prescribed benzodiazepines. Between 70% and 80% of these prescriptions were written by mental health clinicians, wrote Thad Abrams, M.D., M.S., and colleagues in the February Psychiatric Services.

Many factors contribute to the misalignment between guidelines and actual practice, said the authors. These might include “service providers’ attitudes, lack of organizational leadership, and insufficient resources dedicated to practitioner education and clinical staff development.”

To read more about guidelines for treating PTSD, see Psychiatric News here. Also see Clinical Manual for Management of PTSD from American Psychiatric Publishing.
 

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