Improved psychopharmacologic treatment of posttrau-matic stress disorder (PTSD) is needed. Accruing evidence implicates pain-conducting signals in PTSD pathophysiology.
Methods
Four combat-related PTSD patients from the wars in Iraq and Afghanistan were treated with open-label tramadol hydrochloride (HCL), an atypical analgesic with opioid and non-opioid mechanisms of anti-nociception. Tramadol also inhibits neuronal reuptake of norepinephrine and serotonin.
Results
The clinical outcomes show evidence of a positive effect of twice-daily immediate-release tramadol HCL in men with combat-related PTSD. Total daily doses were 200 to 300 mg/d, with individual doses ranging from 100 to 200 mg.
Conclusions
Given its unique mechanism of action, relatively low abuse potential, and ability to double as an analgesic for minor to moderate pain, tramadol is a promising candidate for clinical use in PTSD.
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