Veterans Affairs And Defense Department Guidelines Updated
The VA/DoD clinical practice guidelines originally recommended off-label risperidone, olanzapine, or quetiapine for the adjunctive treatment of patients with PTSD.1 However, in view of the disappointing results from the recent VA-sanctioned study of risperidone in PTSD,44 the guidelines have been revised to recommend against the use of risperidone as adjunctive therapy.52 The revised guidelines further state that there is insufficient evidence to recommend for or against the use of any other atypical antipsychotic as an adjunctive therapy for the treatment of PTSD.
Table 2 depicts the VA/DoDs current assessment of the drugs used to treat PTSD .52
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Positive Outcomes For Our Patients Is The Most Important Thing We Do
All testimonials on this page were unsolicited, have been anonymised and can be verified on request
I am very grateful for my time at Khiron House. I have learnt so much and am more in touch in with my body – thank you to everyone for looking after me.
Janet, 21, Portsmouth
Ive really appreciated all youve done.
Charles, 28, Bradford
I am sincerely grateful for your support, guidance and time these past 7 months.
Ethan, 39, Bath
Your positive energy and hard work are much appreciated.
Tracy, 39, Swansea
What a great job you all do I am looking forward to seeing the continued growth and transformation of KH and the residents which so much depends on you all.
Elizabeth, 32, York
I will continue to be curious and to explore my willingness.
Daniel, 41, Winchester
Thank you for always being so caring
Robert, 37, Southampton
Thank you so much for all you have done for me.
Laura, 33, Birmingham
Thanks very much for your generosity and kindness over the past two months.
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Thank you so so much for everything you are truly amazing and gifted guide and teacher.
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You have all contributed greatly to my recovery and healing journey this year.
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In just over 2 weeks that |I spent at KH I did manage to gain some helpful experiences and tips so thank you for those.
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Aerobic Exercise Augments Ptsd Therapy
Batya Swift Yasgur, MA, LSW
A brief aerobic exercise intervention can augment the benefits of exposure therapy for posttraumatic stress disorder , new research suggests.
Investigators randomly assigned individuals with PTSD to receive either exposure therapy with aerobic exercise or exposure therapy with passive stretching for 9 weeks. At 6 months post-intervention, participants in the aerobic exercise group showed greater reductions in PTSD severity, compared with those in the stretching group.
“There is a critical need to improve outcomes for treating people with PTSD, and this finding points to one potentially cheap and ready-to-use strategy that all clinicians could employ with most patients,” lead author Richard Bryant, MPsych, PhD, DSc, director of the Traumatic Stress Clinic and Scientia Professor of Psychology at the University of New South Wales, Sydney, Australia, told Medscape Medical News.
The study was November 24 in Lancet Psychiatry.
Side Effects And Risks
People should not take venlafaxine with MAOIs. They should let their doctor know about any other medications or supplements they take, including tryptophan, St. Johns wort, or any recreational drugs.
If a person is taking venlafaxine and is awaiting surgery, they should let the surgeon know they are taking this medication.
Venlafaxine may cause drowsiness. Alcohol may exacerbate the effects. People taking this medication need to be cautious about driving or operating machinery while starting this medication.
Venlafaxine can cause high blood pressure. People should have their blood pressure monitored regularly.
Side effects may include:
all the following for at least 1 month to receive a PTSD diagnosis:
- at least one re-experiencing symptom
- at least one avoidance symptom
- at least two arousal and reactivity symptoms
- at least two cognition and mood symptoms
Symptoms of re-experiencing might include flashbacks, bad dreams, or scary thoughts. These may disrupt sleep or a persons daily routine.
Avoidance symptoms might include avoiding people, places, or events that are reminders of the trauma. Alternatively, the person might try to ignore or look past thoughts and feelings that occur about the trauma.
Arousal and reactivity symptoms are feelings of stress and anxiety. They might include:
- feeling startled
- problems sleeping
There may be other ways these symptoms manifest. Cognition and mood symptoms can present in many ways. A few examples include:
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How Do Medications Help Regulate Biological Responses In Ptsd
The medications prescribed for treating PTSD symptoms broadly act upon neurotransmitters affecting the fear and anxiety circuitry of the brain including serotonin, norepinephrine, gamma-aminobutyric acid , the excitatory amino acid glutamate and dopamine, among many others. Note that there are a number of different glutamatergic receptors, including NMDA , AMPA , kainate and metabotropic, all of which are potential targets for different medications. There is great need to develop agents with novel and more specific mechanisms of action than are currently available to target the PTSD symptoms described earlier while also minimizing potential side effects.
Studies show that a number of medications are helpful in minimizing PTSD symptoms. Most of the time, medications do not entirely eliminate symptoms, but provide symptom reduction, while trauma-focused psychotherapy such as CPT, PE and EMDR are strongly recommended as the most effective treatments .
Side Effects Of Alpha
While Prazosin is generally well-tolerated, it may cause some side effects, some of which may be particularly dangerous for older patients.
Some of the side effects caused by alpha-1 blockers are:5
It is important that patients discuss any side effects with their primary care providers. Patients should contact 911 or report to their nearest ER if they have very low blood pressure or experience a fall.
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Will Weed Lower High Blood Pressure
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A Drug Widely Used To Treat Ptsd Symptoms Has Failed A Rigorous Trial
The medication is currently prescribed for many veterans
Thousands of people with post-traumatic stress disorder have taken the drug prazosin to ease the nightmares and disturbances that stalk their sleep.
Numerous studies have shown the drug to be effective at controlling those episodes. But a team of researchers from the Department of Veterans Affairs, seeking to collect more evidence, set out to study the sustained effectiveness of the treatment. They organized a large, lengthy, multisite trialthe most rigorous type of trial.
The drug was no better than a placebo.
The trial seemed like a good idea, but you know, live and learn, said Dr. Murray Raskind, a lead researcher on the trial, which was described Wednesday in the New England Journal of Medicine.
Some researchers not involved with the study were quick to say that clinicians should still prescribe prazosin for some patients Raskind, director of the VA Northwest Network Mental Illness Research, Education, and Clinical Center, agreed. There are few other treatment options and there is evidence supporting the use of the drug, a generic that was originally approved to treat high blood pressure but is prescribed off label to control nightmares and improve sleep quality in patients with PTSD.
For some people with PTSD, the trouble isnt so much getting to sleep, its staying that way. Nightmares and other disturbances are common symptoms.
Clinician’s Guide To Medications For Ptsd
Matt Jeffreys, MD
The 2017 VA/DoD Clinical Practice Guideline for PTSD recommends trauma-focused psychotherapy as the first-line treatment for PTSD over pharmacotherapy . For patients who prefer pharmacotherapy or who do not have access to trauma-focused psychotherapy, medications remain a treatment option. PTSD also carries high levels of psychiatric comorbidities which may be treated with medications.
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How Can Other People Be Supportive
This page is for friends and family who would like to support someone who is experiencing a mental health problem.
Under 18? We have information for you on how to support a friend or partner who’s struggling
It can be very difficult to see someone who you care about becoming unwell, but you don’t need to be an expert on mental health to offer support. Often small, everyday actions can make the biggest difference.
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Class Discussion: Weighing Approval Of A New Miracle Drug
Teachers should read the following two paragraphs aloud before splitting the classroom into two groups:
A new pill has been made that helps people lose five pounds every time they take it. The weight loss community is going crazy about this new miracle drugbegging for the FDA to finally approve it so that people can lose weight instantly and feel more confident.
But there are drawbackstaking the drug increases the risk of many diseases, including heart disease. The drug also makes you age faster. Lastly, the drug takes away all appetite, so much so that it is difficult for a person taking the drug to get their daily nutrients from food.
Split the classroom into two groups. Half the class will act as lawyers arguing for the drugs approval, and the other half will serve as the FDA listening and responding with concerns. Whose arguments will be stronger?
This brief was written by Bella Ratner as part of the 2017 Summer Internship Program at NYU Langones Division of Medical Ethics.
Potential Side Effects Of Medication
Every medication has possible side effects, but these will vary between the antidepressant and the person taking the medication. Side effects should improve within a few days or weeks of treatment: always consult your doctor before you stop taking the medication.
The particular side effects of SSRIs can include the following:
- feeling nauseous and/or vomiting
- indigestion and stomach cramps, or loss of appetite
- sexual problems
- gastrointestinal bleeding
You should consult your doctor if you are experiencing side effects that bother you, have further questions about the usages of the medication, or if you feel you arent getting any results from it.
Its important to note, that while choosing your PTSD recovery path you need to address both the symptoms and the underlying condition. NICE guidance updated in 2018 recommends the use of trauma focused psychological treatments for Post Traumatic Stress Disorder in adults, specifically the use of Eye Movement Desensitisation Reprocessing and trauma focused cognitive behavioural therapy .
Please remember, these arent meant to be medical recommendations, but theyre tactics that have worked for others and might work for you, too. Be sure to work with a professional to find the best methods for you.
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Don’t Just Talk About Mental Health
Keep in mind that having a mental health problem is just one aspect of your friend or family member’s life. Most people don’t want to be defined by their mental health problem, so keep talking about the things you’ve always talked about together.
“For me, it is good to have them there to talk to me about other things, and take my mind off negative thoughts.”
What Medications Treat Ptsd And Which Is Right For Me
Post-traumatic stress disorder is a type of anxiety disorder that can occur after trauma, a threat, or a life threatening event. There are several medications that can help relieve the symptoms of PTSD.
Fear is a normal response to a shocking or traumatic situation. Some people may continue to experience anxiety or fear following the event. The anxiety or fear may alter their behavior, even after the perceived threat has passed. Sometimes these symptoms arise months or even years after the event.
A medical or mental health professional can diagnose PTSD. A person must experience symptoms for at least 1 month for a PTSD diagnosis to be made. Medications and talk therapy are first-line treatments.
There are four kinds of medications that treat PTSD. However, only two of them currently have approval from the Food and Drug Administration specifically to treat the condition. All four medications are antidepressants that act on the levels of neurotransmitters in the brain.
The FDA-approved medications for PTSD are sertraline and paroxetine . The other two medications are fluoxetine and venlafaxine .
A doctor or psychiatrist can determine which medication is the best option and make adjustments based on the bodys response.
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