Welcome to the tenth installment of our Fall 2013 blog series: Trauma and Kids…A Primer for Pastors, Church Staff and Parents. Today, we’ll look at the available data examining the use of medication for kids and teens with Post-Traumatic Stress Disorder (PTSD).

There’s no magic pill to help relieve symptoms of post-traumatic stress in children and teens.

Two serotonin reuptake inhibitors…sertraline (Zoloft) and paroxetine (Paxil) are FDA-approved for the treatment of PTSD in adults. There are no medications specifically approved to treat PTSD in kids. There have been three small double-blind, randomized controlled trials of selective serotonin reuptake inhibitors (SSRIs) and one controlled trial of imipramine in children and adolescents with PTSD or acute stress disorder. One study showed no benefit to medication. One compared trauma-focused CBT plus medication to trauma-focused CBT plus placebo in 24 kids who experienced sexual trauma in which no clear benefit was evident from medication, even though 60% of the kids in the study were diagnosed with depression in addition to PTSD. Another randomized study in 26 children who experienced PTSD following traumatic burn injuries showed benefit on parent, but not child-reported PTSD symptoms following treatment with sertraline.

There have been small, uncontrolled studies of risperidone, clonidine, propranolol and guanfacine showing positive results to medication for PTSD symptoms…again, none of these studies employed a placebo-control group.

Quoting a review article from clinicians at the University of Cincinnati…

The extant data do not support the use of SSRIs as first-line treatments for PTSD in children and adolescents. There is limited evidence that the brief use of antiadrenergic agents, second-generation antipsychotics, and several mood stabilizers may attenuate some PTSD symptoms in youth. However, controlled trials of these agents in children and adolescents with PTSD are needed.

Given what we know about the presence of other mental health conditions among kids who have experienced trauma, it’s not unreasonable for prescribers to take the limited available data about medication and PTSD into consideration when kids require treatment for other conditions. At the same time, there’s no evidence that medication should be considered as an initial treatment for kids with PTSD, especially in light of the data supporting other demonstrably effective psychotherapeutic treatments.

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Confused about all the changes in diagnostic terminology for kids with mental heath disorders? Key Ministry has a resource page summarizing our recent blog series examining the impact of the DSM-5 on kids with mental health disorders. Click this link for summary articles describing the changes in diagnostic criteria for conditions common among children and teens, along with links to other helpful resources!