Clinical Practice Guideline Updated for Management of PTSD, Acute Stress

34 recommendations developed in five topic areas, including assessment and diagnosis, prevention, and treatment

By Elana Gotkine HealthDay Reporter

MONDAY, Feb. 26, 2024 (HealthDay News) — In a synopsis of the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline (CPG), published online Feb. 27 in the Annals of Internal Medicine, updated recommendations are presented for the management of posttraumatic stress disorder (PTSD) and acute stress disorder.

Paula P. Schnurr, Ph.D., from the National Center for PTSD in White River Junction, Vermont, and colleagues summarize the 2023 CPG and its development process for management of PTSD and acute stress disorder. Twelve key questions were developed and reviewed; recommendations were made after evaluation of the evidence.

Thirty-four recommendations in five topic areas were included in the revised CPG: assessment and diagnosis, prevention, treatment, treatment of nightmares, and treatment of PTSD with co-occurring conditions. The researchers found that the six recommendations on PTSD treatment were rated as strong. Use of specific manualized psychotherapies is recommended over pharmacotherapy; other recommendations include prolonged exposure, cognitive processing therapy, or eye movement desensitization and reprocessing psychotherapy; paroxetine, sertraline, or venlafaxine; and secure video teleconferencing to deliver recommended psychotherapy when other options are unavailable and the therapy has been validated for use with video teleconferencing. There were recommendations against benzodiazepines, cannabis, and cannabis-derived product use.

“We suggest that providers use this guideline to support communication to improve the quality of care and enhance clinical outcomes for their patients,” the authors write.