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Epidemiology and Management of Alcohol Dependence in Individuals with Post-Traumatic Stress Disorder

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Abstract

Post-traumatic stress disorder (PTSD) is a chronic and disabling psychiatric disorder with an estimated lifetime prevalence of 7.8%. Co-morbid alcohol dependence is a common clinical occurrence with important clinical considerations. For example, in individuals with both PTSD and alcohol dependence, the symptoms of PTSD tend to be more severe, and there is evidence that these individuals are more prone to alcohol use relapse than non-co-morbid individuals. Co-morbidity of PTSD and alcohol dependence is also associated with a higher rate of psychosocial and medical problems and higher utilization of inpatient hospitalization than either disorder alone.

This article highlights the epidemiology of alcohol dependence in PTSD and reviews the evidence for effective treatments. Management of these individuals requires an understanding of the epidemiology and an awareness of treatment interventions, which include both psychosocial treatments (e.g. Seeking Safety, Concurrent Treatment of PTSD and Cocaine Dependence, Transcend, Trauma Recovery and Empowerment Model) and pharmacotherapy (e.g. selective serotonin reuptake inhibitors [SSRIs] and topiramate). Effective treatment of co-morbid PTSD and alcohol dependence may include a combination of these psychosocial and pharmacological interventions. The key element seems to be to ensure an adequate intervention for each disorder administered collaboratively.

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Acknowledgements

This review was prepared with the invaluable assistance with manuscript preparation of Diana Limoncelli and Jenelle Newcomb. The authors wish to acknowledge VA Connecticut Healthcare System and the VISN I Mental Illness Research and Clinical Center (MIRECC). The authors have no conflicts of interest to report and had no funding for completion of this review.

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  1. VA Connecticut Healthcare System, Newington, Connecticut, USA

    Elissa McCarthy

  2. VA Connecticut Healthcare System #116A, 950 Campbell Avenue, West Haven, Connecticut, 06510, USA

    Ismene Petrakis MD

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  1. Elissa McCarthy
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Correspondence to Ismene Petrakis MD.

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McCarthy, E., Petrakis, I. Epidemiology and Management of Alcohol Dependence in Individuals with Post-Traumatic Stress Disorder. CNS Drugs 24, 997–1007 (2010). https://doi.org/10.2165/11539710-000000000-00000

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