The guidelines from the New York State Workers Compensation Board provide general principles for the use of anticonvulsant and antipsychotic medications. These directives aim to assist healthcare professionals in determining appropriate strategies for prescribing these classes of drugs as part of a comprehensive treatment plan.
Healthcare practitioners specializing in anticonvulsants and antipsychotics can rely on the guidance from the Workers Compensation Board to make well-informed decisions about the most suitable approaches for utilizing these medications in the care of their patients.
It is crucial to emphasize that these guidelines are not intended to replace clinical judgment or professional expertise. The ultimate decision regarding the use of anticonvulsants and antipsychotics should involve collaboration between the patient and their healthcare provider.
Anticonvulsants
Gabapentin isn’t advised for treating patients with PTSD
Lamotrigine isn’t recommended for patients with PTSD
Topiramate is not recommended for treating patients with PTSD, and there’s evidence against its use
Valproic Acid is not recommended for patients with PTSD, and there’s evidence against its use .
Tiagabine is not recommended for treating patients with PTSD
Antipsychotics
Aripiprazole isn’t suggested for treating patients with PTSD.
Quetiapine is not recommended for the treatment of patients with PTSD. There’s evidence against its use (I.8.b).
Risperidone is not recommended for patients with PTSD, and there’s evidence against its use (I.8.c).
Olanzapine, however, is recommended for select patients with PTSD who experience flashbacks and nightmares. It might be suggested after trying first-line PTSD psychotherapies or other pharmacotherapies and finding them ineffective or intolerable. Nevertheless, due to potential adverse effects, it’s generally advised to explore other medications before considering Olanzapine.
Discontinuation should be considered if there’s a lack of efficacy, adverse effects, non-compliance, or if the resolution of PTSD reaches a point where medication isn’t needed anymore. There is evidence supporting the use of Olanzapine in this context.
