What do we know about medication in kids with PTSD?

ZoloftWelcome 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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600817_10200479396001791_905419060_nConfused 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!

About Dr. G

Dr. Stephen Grcevich serves as President and Founder of Key Ministry, a non-profit organization providing free training, consultation, resources and support to help churches serve families of children with disabilities. Dr. Grcevich is a graduate of Northeastern Ohio Medical University (NEOMED), trained in General Psychiatry at the Cleveland Clinic Foundation and in Child and Adolescent Psychiatry at University Hospitals of Cleveland/Case Western Reserve University. He is a faculty member in Child and Adolescent Psychiatry at two medical schools, leads a group practice in suburban Cleveland (Family Center by the Falls), and continues to be involved in research evaluating the safety and effectiveness of medications prescribed to children for ADHD, anxiety and depression. He is a past recipient of the Exemplary Psychiatrist Award from the National Alliance on Mental Illness (NAMI). Dr. Grcevich was recently recognized by Sharecare as one of the top ten online influencers in children’s mental health. His blog for Key Ministry, www.church4everychild.org was ranked fourth among the top 100 children's ministry blogs in 2015 by Ministry to Children.
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One Response to What do we know about medication in kids with PTSD?

  1. Robin Hilsmeier says:

    Good morning!!

    So don’t leave us all hanging. . . . what do studies show is an effective method of dealing with these kids. . . so they don’t grow up to be like Arial Castrow or TJ Lane, or any of the other horrible crazy people we see in the news?

    I’d like to know I’ve done everything I can do to help Leah overcome the prison that she is in. She has been diagnosed with childhood depression, is on Zoloft, and Abilify (and as of yesterday on Intuniv as well), and appears to have an eating disorder. I seriously wanted to take her down to Karyn Purvis, thinking I as willing to try anything to help her break these chains she seems to be stuck in!

    I have two adopted kids that seem fairly well adjusted and are pretty happy about life. . . like any other kid. Then there’s Leah. . . who has really PUSHED me in my quest to reach out to other families with kids like her. . .and try to get her the mental health resources necessary. I am genuinely concerned for her future. . .just last night I was awake for a couple hours during the night – spent praying that God would work a miracle in her life.

    Thanks for posting these informative blogs – keep them coming. All of us with this type of adopted little darlings need this stuff. . . .along with positive news of what is shown to be effective treatment. Do you and your staff have any desire to do groups on social skills, how to handle feelings, etc. from a biblical background? If so. . . I’d love to try and include that in my business plan for an orphan care ministry. I also think Leah would benefit from talking with adult adoptees – because they can honestly say they “have been where she is”. Just a thought.

    Looking forward to meeting next Wednesday, Robin Hilsmeier

    robinhil@oh.rr.com http://linkedin.com/in/robinhilsmeier

    Home: 440.327.4171 Cell: 440.821.2755

    Like

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