An overview of the differences in the pharmacological management of post-traumatic stress disorder between women and men

ABSTRACT

Introduction

Post-traumatic stress disorder (PTSD) is a disabling psychiatric condition with a worldwide prevalence between 6% and 9%, and more common in the female than in the male sex. The aim of this paper is to review and comment on the different factors that might explain the discrepancies in the pharmacological management of women and men.

Areas covered

The available literature shows that there exists a vulnerability of women to develop PTSD that may depend on neurobiological as well as environmental/cultural factors. These variables might influence the clinical picture, the outcome and the response to specific treatments, given their consequences on the pharmacokinetics of commonly prescribed drugs. Women suffering from PTSD are more prone to consult and receive more prescriptions of psychotropic drugs than men. However, it is evident that the particular stages of a women’s life such as pregnancy or breastfeeding might require a specific evaluation and care.

Expert opinion

It is necessary to explore the pharmacokinetics of compounds highlighting sex-related differences, and their safety during pregnancy and lactation. Taking care of differences between women and men should represent a main focus of research, while being a primary target towards a really tailored pharmacological treatment of PTSD.

KEYWORDS:

• Post-traumatic stress disorder
• pharmacological treatment
• gender
• neurobiology
• psychotropic drugs
• pregnancy
• lactation
• gender-related differences

Article highlights

• Post-traumatic stress disorder (PTSD) is a common psychiatric condition with a complex and heterogeneous clinical picture.

• PTSD is more prevalent in women than in men.

• Gender is a major factor that might influence treatment choices and response, as well as pharmacokinetics of the different drugs.

• The pharmacological treatment of PTSD is mainly empirical and symptom-based for the limited information available regarding its pathophysiology.

• There is a certain degree of dimorphism in the treatment of PTSD, with women requiring and receiving more psychotropic drug treatment than men.

• A deeper knowledge of sex-related difference in the treatment of PTSD is essential for its appropriate management.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.