PTSD Treatments Need Further Study

Oct. 18, 2007 -- Most posttraumatic stress disorder (PTSD) treatments lack strong evidence on their effectiveness, according to a report released today by the Institute of Medicine.

But "patients should continue to seek care and discuss treatment options with their providers," Alfred Berg, MD, MPH, told reporters in a news conference today.

"This report was not intended to give advice to clinicians or patients," says Berg, who chaired the committee that wrote the report.

The committee reviewed 90 PTSD treatment studies and found "inadequate" evidence for the effectiveness of most psychotherapies and all medications for treating PTSD.

There was one exception: Exposure therapy had "sufficient" evidence supporting its effectiveness, according to the report.

In exposure therapy, PTSD patients are exposed to a real or surrogate threat in a safe environment to help them overcome their fears.

More PTSD Research Needed

The committee's report doesn't mean that PTSD treatments don't work.

"Our assessment of inadequate evidence does not mean that the treatments are ineffective," says Berg.

"It may well be that some of the treatments are extremely effective, more effective than the exposure therapies where we did find the strongest evidence," he adds.

The committee found flaws with many of the studies.

For instance, a high proportion of PTSD patients quit several studies. The committee also voiced concern that most of the drug studies were funded by the drugs' makers, and that there wasn’t enough research on certain groups, such as minorities, veterans with head injuries, and depressed or addicted PTSD patients.

"Our main message is that more high-quality research is needed to determine whether the specific treatments are effective and then which treatments work better than others and for which populations of patients. Our report is the first step in that process," says Berg.

An estimated 12-20 million people in the U.S. suffer from PTSD at some point in their lives, according to Berg.

The report was commissioned by the U.S. Department of Veterans Affairs.

The findings apply to the estimated 12-20 million people in the U.S. who have PTSD at some point in their lives, most of whom aren't veterans, Berg notes.