Avoid Benzodiazepines As PTSD, Trauma Treatment

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Benzodiazepine drugs are ineffective for treating post-traumatic stress disorder (PTSD), and may even worsen the condition, according to a study published in the Journal of Psychiatric Practice.

Although benzodiazepines are commonly used to treat PTSD, their use is controversial. Some clinicians believe the drugs can reduce insomnia, anxiety, and irritability in PTSD, while others argue that the drugs worsen these symptoms.

The researchers performed a systematic review of 18 studies that included more than 5,200 patients with PTSD or recent trauma. Types of trauma included physical injuries, life-threatening medical conditions, combat-related trauma, sexual trauma, and disaster-related trauma.

Evidence from these studies indicated that benzodiazepines were associated with no improvement or worsening of overall severity, psychotherapy outcomes, aggression, depression, and substance abuse in patients with PTSD.

Using 12 of these studies, the researchers also performed a meta-analysis. The results suggested that benzodiazepines do not improve PTSD outcomes, and using the drugs in patients who had recently experienced trauma may result in worse outcomes.

"Benzodiazepines might be effective if they selectively inhibited the stress and anxiety centers of the brain that are often hyperactive in PTSD," researcher Jeffrey Guina, MD, Wright State University, Dayton, Ohio, said in a statement. "Instead, they indiscriminately target the entire brain – including areas that are already hypoactive in PTSD, such as the cognitive and memory centers."

The results of their analyses indicate show that benzodiazepines are “relatively contraindicated” for patients with PTSD. The researchers recommend using evidence-based PTSD treatments, such as psychotherapy and antidepressants, before considering benzodiazepines.

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Benzodiazepines are associated with no improvement or even worsening of PTSD symptoms.

Benzodiazepine drugs are widely used in patients with post-traumatic stress disorder (PTSD), but available evidence suggests that they are not effective — and may even be harmful, concludes a systematic review and meta-analysis in the July Journal of Psychiatric Practice.

The researchers performed a systematic review to identify clinical trials or observational studies concerning the use of benzodiazepines in patients with PTSD, or in patients with recent trauma evaluated for possible PTSD. The study was the first comprehensive review and meta-analysis (pooled data analysis) to focus on this issue.

Benzodiazepines are a "common and controversial" treatment for PTSD. Some mental health professionals argue that benzodiazepines can reduce anxiety, insomnia, and irritability associated with PTSD. Others suggest that benzodiazepines may actually prolong and worsen the disorder.

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