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Serious post-traumatic stress: improvement often occurs without drug treatment

In cases of stress as a reaction to a serious trauma, listening, moral support and, for some patients, psychotherapy, are the main measures to take.

Stress as a response to a serious trauma, also known as "post-traumatic stress disorder", is defined as persistent psychological distress following a serious traumatic event (accident, rape, disaster, war etc.).

The evolution of post-traumatic stress is generally positive. Listening to and supporting the patient is the first step to be envisaged, especially if there is no assistance from family or friends.

In some cases, cognitive and behavioural psychotherapy can be helpful. There is no proof that emergency psychotherapy treatment does any good, on balance. Drugs known as "psychotropic drugs", including antidepressants, are sometimes prescribed, but they have little or even no effect and can cause unpleasant adverse effects.

Paroxetine is an antidepressant whose indications in France now include post-traumatic stress. The clinical trials show that its effectiveness is limited but that it has frequent, sometimes major, adverse effects (neuropsychic and digestive disorders in particular), and it can be addictive, leading to withdrawal syndrome if the treatment is halted abruptly. It is best avoided.

©Prescrire November 2006

Source: "Paroxetine (Deroxat° ou autres). Stress post-traumatique : soutien psychologique d'abord" Rev Prescrire 2006 ; 26 (277) : 730.

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