Post-traumatic stress disorder medication

Umbricht A, Hoover DR, Tucker MJ, et al Opioid detoxification with buprenorphine, clonidine, or methadone in hospitalized heroin-dependent patients with HIV infection. Drug Alcohol Depend 69 263-272, 2003 Villagomez RE, Meyer TJ, Lin MM, et al Post-traumatic stress disorder among inner city methadone maintenance patients. Subst Abuse Treat 12 253—257, 1995 Mining E, Kosten TR, Kleber H Clinical utility of rapid clonidine-naltrexone detoxification for opioid abusers. Br J Addict 83 567-575, 1988 Washton AM, Pottash AC, Gold MS Naltrexone in addicted business executives and physicians. J Clin Psychiatry 45 39 1, 1984 Wesson DR Revival of medical maintenance in the treatment of heroin dependence (editorial). JAMA 259 3314-3315, 1988... 

In June of 2005, DHEC mailed a follow-up questionnaire to 280 people who were interviewed. Of the 94 respondents 23 percent had been hospitalized, 83 percent still were experiencing symptoms they felt related to the chlorine spill, 52 percent were taking medication for problems they felt were related to chlorine exposure, 51 percent were under a doctor s care for problems they felt were related to chlorine exposure, and 48 percent screened positive for post-traumatic stress disorder. 

The mood disorders were once called affective disorders and are grouped into two main categories unipolar and bipolar. The unipolar depressive disorders include major depressive disorder and dysthymic disorder the bipolar disorders include bipolar 1, bipolar II, bipolar not otherwise specified, and cyclothymic disorder. Other mood disorders are substance-induced mood disorders and mood disorders due to a general medical condition. In addition, mood disturbance commonly occurs as a symptom in other psychiatric disorders including dementia, post-traumatic stress disorder, substance abuse disorders, and schizophrenia. 

The differential diagnosis of depression is organized along both symptomatic and causative lines. Symptomatically, major depression is differentiated from other disorders by its clinical presentation or its long-term history. This is, of course, the primary means of distinguishing psychiatric disorders in DSM-1V. The symptomatic differential of major depression includes other mood disorders such as dysthymic disorder and bipolar disorder, other disorders that frequently manifest depressed mood including schizoaffective disorder, schizophrenia, dementia, adjustment disorder, and post-traumatic stress disorder, and, finally, other nonpsychiatric conditions that resemble depression such as bereavement and medical illnesses like cancer or AIDS. 

Although we are focusing on the primary sleep disorders, sleep disturbance quite often occurs as a symptom of another illness. Depression, anxiety, and substance abuse can impair the quality of sleep, though in the setting of chronic insomnia, other psychiatric disorders account for less than 50% of cases. Nightmares are a frequent complication of post-traumatic stress disorder (PTSD), and pain, endocrine conditions, and a host of medical illnesses can produce sleep problems. Thus, when discussing insomnia or hypersomnia, we are well advised to remember that these can be either a symptom of a psychiatric syndrome, a medical illness, or a sleep disorder. 

Bryant, R.A. and Friedman, MBc. (2001) Medication and nonmedication treatments of post-traumatic stress disorder. Current Opinion in Psychiatry 14 119-123. 

Pediatric patients who develop psychiatric syndromes following acute medical illness or injury or invasive procedures (e.g., a child who develops post-traumatic stress disorder [PTSD] following a motor vehicle accident and trauma a child who develops PTSD following stem cell transplantation)... 

Studies are currently underway in Spain and Israel to assess MDMA s effectiveness in the treatment of post traumatic stress disorder (PTSD). On November 2, 2001, the Food and Drug Administration (FDA) approved the first clinical trial of MDMA as a treatment for PTSD in the United States. The study is currently awaiting approval from the research review board at the Medical University of South Carolina. 

Irritable aggression and intrusive thoughts in post-traumatic stress disorder are reduced by low-dose risperidone as adjunctive therapy, according to the results of a double-blind, randomized trial in 16 male combat veterans, who took either risperidone (n = 7 mean age 49 years) or placebo (n = 8 mean age 54 years) for 6 weeks one subject taking risperidone dropped out because of urinary retention (45). Concurrent antidepressant medication and anxiolytic drugs were allowed in both groups. 

As her story unfolded, it became clear that she was experiencing symptoms of a serious, delayed-onset post-traumatic stress disorder. In prior treatments, her therapists had never explored her circumstances beyond observing her feelings of panic, depersonalization, and confusion. They were quick to medicate her and seal over her distress. 

The mood and anxiety disorders in their various permutations constitute a major source of personal suffering and impaired ability to engage in productive Avork and interpersonal relationships. Between 5 and 9% of women and between 2 and 3% of men meet the diagnostic criteria for major depression at any time 10-25% of all women suffer major depression sometime in their lives, while 5-10% of men will develop major depressive disorder (American Psychiatric Association, 1994). The anxiety disorders obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), panic disorder, and generalized anxiety disorder (GAD) show lifetime prevalence rates of approximately 2.5%, 7%, 2.5%, and 5% respectively. Between 3 and 13% of individuals in community samples are regarded to meet the diagnostic criteria for social phobia. Mood and anxiety disorders are common comorbidities (American Psychiatric Association, 1994) and the most common antidepressant medications including the serotonin reuptake inhibitors, the mixed serotonin-catecholamine reuptake inhibitors, the tricyclic antidepressants, and the monoamine oxidase inhibitors, are all effective treatments for anxiety and panic attacks. 

THC is a new miracle medication, used to treat sleep disorders, inflammatory diseases, auto immune disorders, migraines, addictions, post traumatic stress disorder, etc. The discoYery of its endogenous ligand, anandamide (a fatty acid amide) has revolutionized the investigation of this new neurotransmitter system. Fatty acid amides are easily prepared from commonly available grocery store oils. 

Interpretable medical records and accounts only commence from the middle of the 19th Century, but from then onwards the literature does contain clinical descriptions of ex-servicemen (and it is always men) with conditions that do show considerable similarities to the Gulf narratives (Hyams et al, 1996). These condition have received many different labels - Soldier s Heart , later termed Effort Syndrome , owes its provenance to the Crimean and American Civil Wars. Shell shock and neurasthenia dominate the writings of World War I, while Agent Orange Syndrome and Post-Traumatic Stress Disorder emerged after Vietnam. 

Since its introduction as a formal diagnosis in 1980, post-traumatic stress disorder (PTSD) has been shown to have a lifetime prevalence of about 8% in the USA, with a much higher prevalence in countries affected by civil war, genocide, forced migration, and terrorism. Furthermore, evidence continues to accumulate indicating that, in addition to its public health significance as a prevalent psychiatric disorder, PTSD is a risk factor for many medical illnesses. 

Post-traumatic stress disorder is a term that is bandied about fairly indiscriminately, and a word of caution is needed about its use. Properly conceived, it is a formal psychiatric diagnosis with strict, specific criteria. We have no idea how many people suffer from the full syndrome after medical treatment but the number is probably small. However, the incidence of some of the symptoms is probably very much greater. Many injured patients suffer from nightmares about their treatment and time in hospital, from persistent and intrusive recollections of their care and other problems, but nevertheless not from the full constellation of symptoms that makes up post-traumatic stress disorder. Depression appears to be a more common long-term response to the chronic problems of medical injury (Vincent and Coulter, 2002), although there is little research in this area. Whether people actually become depressed and to what degree will depend on the severity of their injury, the support they have from family, friends and health professionals and a variety of other faaors (Kessler, 1997). 

Summerfield, D. (2001) The invention of post-traumatic stress disorder and the social useMness of a psychiatric category, British Medical Journal, 322 (7278), 95-98. 

A 23-year-old army veteran with severe post-traumatic stress disorder had undergone multiple drug trials, and residential rehabilitation, all without success. Following a 24h medication washout, he received 30 mg propofol and 35 mg ketamine IV over 20 min. There was no loss of consciousness and the only reported side effect was mild... 

The book concludes with Chapter 13 and Chapter 14 on disorders that require separate consideration. The first group includes Panic, Obsessive-Compulsive, Post-Traumatic Stress, Somatoform, and Dissociative disorders. Although traditionally these are classified as anxiety disorders, their symptoms and varied treatment responsivity require a separate series of discussions. Finally, certain groups of patients are considered in light of their specialized needs when contemplating psychotropic drug therapy. They include the pregnant patient, children and adolescents, the elderly, the personality disordered, as well as patients whose conditions are complicated by medical problems (e.g., the alcoholic patient the HIV-infected patient). 

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