WCA Recommendations for the Long-Term Treatment of Posttraumatic Stress Disorder

CNS Spectrums ◽  
2003 ◽  
Vol 8 (S1) ◽  
pp. 31-39 ◽  
Author(s):  
Dan J. Stein ◽  
Borwin Bandelow ◽  
Eric Hollander ◽  
David J. Nutt ◽  
Ahmed Okasha ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Stress Disorder ◽  
Traumatic Event ◽  
Term Treatment ◽  
Economic Consequences ◽  
Persistent Symptoms ◽  
Long Term Treatment

ABSTRACTPosttraumatic stress disorder (PTSD) is a common and disabling condition. In addition to combat-related PTSD, the disorder occurs in civilians exposed to severe traumatic events, with the community prevalence rate for the combined populations reaching as high as 12%. If left untreated, PTSD may continue for years after the stressor event, resulting in severe functional and emotional impairment and a dramatic reduction in quality of life, with negative economic consequences for both the sufferer and society as a whole. Although PTSD is often overlooked, diagnosis is relatively straight-forward once a triggering stressor event and the triad of persistent symptoms—reexperiencing the traumatic event, avoiding stimuli associated with the trauma, and hyperarousal—have been identified. However, comorbid conditions of anxiety and depression frequently hamper accurate diagnosis. Treatment for PTSD includes psychotherapy and pharmacotherapy. The latter includes selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and monoamine oxidase inhibitors. Only SSRls have been proven effective and safe in long-term randomized controlled trials. Current guidelines from the Expert Consensus Panel for PTSD recommend treatment of chronic PTSD for a minimum of 12–24 months.

scholarly journals Long-term treatment with paroxetine increases verbal declarative memory and hippocampal volume in posttraumatic stress disorder

2003 ◽  
Vol 54 (7) ◽  
pp. 693-702 ◽  
Author(s):  
Eric Vermetten ◽  
Meena Vythilingam ◽  
Steven M. Southwick ◽  
Dennis S. Charney ◽  
J.Douglas Bremner
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Declarative Memory ◽  
Hippocampal Volume ◽  
Term Treatment ◽  
Long Term Treatment

scholarly journals Adjunct pharmacotherapy for psychotherapy

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S166-S167
Author(s):  
Jessica Lochtenberg ◽  
Ari Kirshenbaum ◽  
Matthew Johnson
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Therapeutic Alliance ◽  
Posttraumatic Stress ◽  
Substance Dependence ◽  
Stress Disorder ◽  
Psychiatric Symptoms ◽  
Treatment Options ◽  
Term Treatment ◽  
Compulsive Disorder ◽  
Long Term Treatment

AimsA variety of pharmacotherapies have been used to assist the psychotherapy process as “adjunctive therapies.” These drugs are used in an acute, targeted fashion, such that they are explicitly delivered in the context of psychotherapy for anxiety, mood and substance-dependence disorders (SUDs). Our narrative review highlights the potential of medically-assisted psychotherapy by outlining the current state of research on few of these medications and describing the basic science that supports their use.MethodFirstly, we researched an assortment of medications that have been used off-label to enhance psychotherapy, and selected a few that have received the most empirical attention in preclinical and clinical-trial settings. Our review of clinical trials focused on three of the most common psychiatric ailments. For all studies reviewed, we identify the strengths and weaknesses of the data supporting the use of the medications for the three aforementioned disorders.ResultD-cycloserine: accelerates the process of associative emotional learning, enhancing exposure therapy in the treatment of various anxiety disorders, including obsessive-compulsive disorder and posttraumatic stress disorder. Limited studies are available on efficacy in treating SUDs.Intranasal oxytocin: accelerates memory retrieval-extinction procedures used in posttraumatic stress disorder, and promotes prosocial cognition and behaviour, facilitating a therapeutic alliance. Sufficiently powered studies and safety studies are required before strong conclusions can be made.Propranolol: interrupts the reconsolidation of memories (leading to maladaptive learned responses) involved in posttraumatic stress disorder during memory-reactivation therapy sessions, but there is little evidence that this drug can be used for depression or SUDs.Psychedelics: may effect the brain's default mode network, engendering a transformative experience that is often followed by a reduction in psychiatric symptoms. 3,4-methylenedioxymethamphetamine may additionally modulate the amygdala response in a way that allows for reprocessing of traumatic memories, and improves the therapeutic alliance. Anxiety, mood, and SUDs appear to be positively influence by traditional and non-traditional (ketamine) psychedelics.ConclusionAlthough the efficacy of the medically-assisted psychotherapies reviewed is still under investigation, we propose that these novel treatment approaches may be preferred over traditional psychopharmacological treatments due to the presence of fewer chronic side effects, as well less toxicity and abuse potential. Furthermore, these adjunctive pharmacotherapies may help to reinforce the psychotherapeutic alliance and may ultimately yield better long-term treatment outcomes. If at least some of the adjunctive pharmacotherapies outlined in this review are found to be clinically efficacious and safe, patients will benefit from having more treatment options available to them in the future.

scholarly journals Confronting Trauma's Early Aftermath and the Risk for Posttraumatic Stress Disorder

CNS Spectrums ◽  
2006 ◽  
Vol 11 (8) ◽  
pp. 585-586
Author(s):  
Ehud Klein
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Acute Stress ◽  
Traumatic Event ◽  
Acute Stress Disorder ◽  
Clinical Syndrome ◽  
Therapeutic Interventions ◽  
Psychological Resources

Posttraumatic stress disorder (PTSD) is a well-defined clinical syndrome that develops in individuals who have witnessed or been exposed to an event that involves a direct threat to life or physical and/or psychological integrity.While numerous studies indicate that PTSD will develop in 15% to 25% of trauma victims, time-limited responses develop in a larger portion of victims during the first 48–72 hours (acute stress reaction) and to a lesser extent over the first 4 weeks (acute stress disorder). Many of those who suffer from acute posttraumatic symptoms eventually recover and overcome the consequences of the traumatic event. However, ∼30% to 50% of those with acute stress disorder will eventually develop PTSD. It is obvious that some individuals are vulnerable to the adverse effects of trauma while others have neurobiological and psychological resources that make them resilient to the long-term impact of traumatic exposure. The identification of risk factors and early predictors for PTSD is thus of major importance for identifying those at risk and for initiating therapeutic interventions aimed to reduce long-term morbidity and suffering.

scholarly journals Update on the epidemiology, diagnosis, and treatment of posttraumatic stress disorder

2000 ◽  
Vol 2 (1) ◽  
pp. 37-43
Keyword(s):  
Posttraumatic Stress Disorder ◽  
General Population ◽  
Mental Disorders ◽  
Posttraumatic Stress ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Stress Disorder ◽  
Psychological Intervention ◽  
Traumatic Event ◽  
Psychological Trauma ◽  
Therapeutic Effects

Posttraumatic stress disorder (PTSD) is a maladaptive, pathological response to a traumatic event which is currently underdiagnosed and undertreated. This results in part from a lack of awareness regarding the prevalence of the disorder. It has been estimated that at least one third of the general population will be exposed to severe trauma throughout their lifetime, out of which approximately 10 % to 20 % develop PTSD. A prevalence of 3 % to 6 % of PTSD in the general population, found in several studies, corresponds well with these figures. Both the type of trauma and the personal characteristics of the individual involved are associated with the probability of developing PTSD. The Diagnostic and Statistical Manual of Mental Disorders, 4th ed (DSM-IV) gives four diagnostic criteria: (i) exposure and emotional response to a traumatic event; (ii) reexperiencing; (iii) avoidance; and (iv) increased physiological arousal, along with severe impairment in occupational, social, and interpersonal functioning. The rate of comorbidity with other mental disorders is high, particularly for major depression, anxiety disorders, and substance abuse. Different types of psychological intervention, including cognitive-behavioral therapy and a host of pharmacological interventions, have been tried. Selective serotonin reuptake inhibitors (SSRIs) are currently the most widely researched agents with consistent, though modest, therapeutic effects. Other compounds, such as tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) have also been found to be effective, although their use is limited due to side effects. PTSD is a psychobiological phenomenon in response to psychological trauma, which represents maladaptive neurobiological deregulation and psychological dysfunction, and awaits further recognition and research.

The exposure to traumatic events and symptoms of posttraumatic stress disorder among Korean journalists

Journalism ◽  
2017 ◽  
Vol 19 (9-10) ◽  
pp. 1308-1325 ◽  
Author(s):  
Mina Lee ◽  
Eun Hye Ha ◽  
Jung Kun Pae
Keyword(s):  
Social Support ◽  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Coping Strategy ◽  
Stress Disorder ◽  
Traumatic Event ◽  
Traumatic Events ◽  
Ptsd Symptoms ◽  
Negative Beliefs ◽  
Traumatic Event Exposure

This study investigated posttraumatic stress disorder (PTSD) symptoms on Korean journalists and the contributing variables. Predicting variables included the exposure to traumatic events, coping strategy, social support, optimism, negative beliefs, and the journalists’ occupational perspectives. A total of 367 Korean journalists participated in the survey. The findings revealed that, first, Korean journalists had suffered severely from PTSD symptoms according to the prevalence rate. Second, the extent of traumatic event exposure, the length of career, the use of dysfunctional coping strategy, a lack of social support, and negative beliefs were identified as significantly related variables. Finally, occupational perspectives showed meaningful associations with development of the symptoms. This study provided an empirical analysis of Korean journalists’ experiences of traumatic events and psychological stress for the first time.

scholarly journals Longitudinal Examination of Posttraumatic Stress Disorder as a Long-Term Outcome of Iraq War Deployment

2016 ◽  
Vol 184 (11) ◽  
pp. 796-805 ◽  
Author(s):  
Jennifer J. Vasterling ◽  
Mihaela Aslan ◽  
Susan P. Proctor ◽  
John Ko ◽  
Brian P. Marx ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Iraq War ◽  
Stress Disorder ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Longitudinal Examination
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