Can Smoking Marijuana Reduce PTSD Symptoms?

Topics: Cannabis | Double blind trial | PTSD

REVIEW OF: Bonn-Miller MO et al, PLoS ONE 2021;16(3):e0246990 STUDY TYPE: Randomized controlled trial More and more veterans are using cannabis to treat their PTSD symptoms, despite the lack of high-quality safety and efficacy data and the high comorbidity between PTSD and cannabis use disorder (Bryan JL et al, J Subst Abuse Treat 2021;122:108254)

Quetiapine Reconsidered

Topics: Antipsychotics | Anxiety | Bipolar Depression | Depression | Dosing | Psychopharmacology | Psychopharmacology Tips | PTSD | Quetiapine | Schizophrenia

It is the best of drugs; it is the worst of drugs. Quetiapine (Seroquel) has benefits in some disorders that are unmatched by other medications, but it is also one of the most difficult antipsychotics to tolerate. In this article, I’ll look at where this medication fits and whether its numerous off-label uses are justifiable, including PTSD, generaliz

Assessment and Treatment of PTSD in the Older Patient

Topics: clonidine | Cognitive Behavioral Therapy | cognitive processing therapy | Eye movement desensitization and reprocessing | PCL-5 | Prazosin | Prolonged exposure | PTSD | screening | Trauma | Trauma-focused psychotherapy

Your patient, Jonathan, is a 71-year-old man with a history of depression. Two months ago, he was a passenger in a car accident in which the driver was killed. Now he reports sleeping poorly due to nightmares and complains about headaches and stomachaches. He tells you he can’t stop thinking about what happened and needs convincing to get into a car,

Minimizing PTSD From Workplace Trauma

Topics: Debriefing | Nurses | post traumatic stress disorder | PTSD | Trauma | workplace

For staff on inpatient psychiatric units, the rate of posttraumatic stress disorder (PTSD) is around 9%, which is two to three times higher than the national prevalence rate of 3%–5%. Rates are higher if you work with forensic patients or if you’re a nurse. Nearly all (96%) psychiatric nurses have been directly or indirectly exposed to a critical ev

Using Equine-Assisted Psychotherapy

Topics: ADHD | Anxiety Disorder | Autism Spectrum Disorder | Equine Assisted Psychotherapy | Equine therapy | Free Articles | PTSD | Trauma

  Sylvia is 7 years old, referred for long-standing school refusal after CBT proved ineffective. You confer with her therapist about trying a different approach. When patients are not amenable to usual therapy, equine-assisted psychotherapy (EAP) might be a good option. In this article we’ll talk about working with horses as an alternative

Treating Pandemic-Associated Trauma in Children and Adolescents

Topics: COVID-19 | PTSD | ScreeninGeg | Suicidality | TFCBT | Trauma

CCPR: Tell us about your backgrounds. Dr. Steinberg: I’m the Associate Director of the National Center for Child Traumatic Stress at UCLA. Dr. Ahmadi: I’m Assistant Professor of Psychiatry at UCLA and Director of Family Trauma Distress at Olive View, and Dr. Steinberg and I worked together with colleagues to develop our UCLA Brief COVID-19 Screen

SSRIs for PTSD: Just How Effective Are They?

Topics: PTSD

Strangely enough, there are only two medications FDA-approved for PTSD--Zoloft (sertraline) and Paxil (paroxetine). This is despite the fact that PTSD is a common problem, with a lifetime prevalence of between 5 and 10%, and can be extremely debilitating. Contrary to popular opinion, Zoloft's PTSD indication is not limited to women alone. It is, in f

Therapy for PTSD: What You Should Know

Topics: PTSD

As you can see from this issue's lead article, SSRIs help alleviate core PTSD symptoms, but hardly roar by the placebo response rate in clinical trials. And anytime the placebo effect is this robust, you can predict that psychotherapy will be very effective. This is certainly true in the world of PTSD. The most well-studied therapy is exposure therap

Off-Label Nostrums for PTSD

Topics: PTSD

Let's face it, when our patients are in distress, we use whatever meds we think might be helpful, whether the FDA has given its blessing or not. Not a single one of the nostrums discussed in this article is FDA-approved for PTSD, but they are all commonly used when nothing else works. Benzodiazepines. Who among us has not tried a dusting of Klonopin

Edna Foa, Ph.D., On Therapy for PTSD

Topics: PTSD

TCR: Dr. Foa, how common is PTSD? Dr. Foa: The epidemiological studies tell us that 60% of men in the United States and over 50% of women have been traumatized at least once in their lifetime. TCR: That's a surprisingly high figure. What type of trauma are we talking about? Dr. Foa: The DSM-IV definition of a trauma, which is either being a victim

Using SSRIs For PTSD

Topics: PTSD

Laura Wolfe, M.D., is an adult psychiatrist who works for Kaiser Permanente in Santa Clara, California. Her experience treating a man with PTSD is helpful in understanding the role of SSRIs. Dr. Wolfe has disclosed that she has no significant relationships with or financial interests in any commercial companies pertaining to this educational activit

Co-Occurring Addiction and PTSD

Topics: Addiction Treatment | Co-occurring disorders | PTSD | Substance Use Disorder | Trauma

CATR: We know PTSD often co-occurs with addiction. What should clinicians pay attention to? Dr. Vojvoda: Individuals who have PTSD have a high risk of developing other disorders, including substance use disorders (SUDs). Studies have shown that both in the veteran and non-veteran populations, these numbers are high. For example, one study of the genera

Exposure Therapy Efficacious for PTSD Co-Occurring With Alcohol Use Disorder

Topics: Addiction | Addiction Treatment | Alcohol | Alcohol Use | Alcohol use disorder | Alcoholism | Co-occurring disorders | Dual diagnosis | Prolonged exposure | Psychotherapy | PTSD | Research | Research Update | Substance Use | Substance use disorders

Review of: Norman SB et al, Efficacy 2019;76(8):791–799 Patients with co-occurring posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) have worse outcomes compared to patients with either diagnosis alone. Integrated approaches, in which both diagnoses are simultaneously addressed, are viewed as best practice. Providers, however, are

Can Buprenorphine Improve PTSD Symptoms?

Topics: Addiction | Addiction Treatment | Antidepressants | Buprenorphine | Co-occurring disorders | Comorbidity | Dual diagnosis | Medication | Opioid Use Disorder | Pharmacology | PTSD | Research Update | SSRIs

Review of: Lake EP et al, Am J Addict 2019;28(2):86–91 For many years, the mainstay of treatment for PTSD has been the SSRI class of medications, but many of our patients still suffer crippling symptoms despite optimal antidepressant medication dosing. PTSD is often accompanied by opioid misuse, sometimes in an effort to self-treat the hyperarousal

MDMA-Assisted Therapy for Severe PTSD

Topics: Drug-assisted psychotherapy | MDMA | Novel drug | Psychedelics | PTSD

REVIEW OF: Mitchell JM et al, Nat Med 2021;27(6):1025–1033 STUDY TYPE: Randomized controlled trial MDMA (3,4-methylenedioxymethamphetamine, more commonly known as ecstasy or molly), is an amphetamine analog that also increases transmission of both serotonin and oxytocin. Prior to the FDA banning it from further research in 1985, MDMA had been develo

Light Therapy: Good for What Ails You?

Topics: ADHD | Alternative treatments | Antidepressant Augmentation | Bipolar Depression | Bulimia Nervosa | Complementary treatments | Complimentary Medicine | Depression | Depressive Disorder | Light and Dark Therapy | Light therapy | Lightbox | PTSD | Seasonal Affective Disorder | Sexual Dysfunction | Sleep | Sleep Disorders | Traumatic Brain Injury (TBI)

There are several lifestyle changes with broad health benefits that we often encourage in our patients. Exercise, a healthy diet, sleep hygiene, and supportive social connections are near the top of the list, and bright daytime light might be worth adding. Light therapy is a standard treatment for seasonal affective disorder, and in this article we’ll

Overdiagnosis in Psychiatry

Topics: Adult ADHD | Bipolar II | Borderline Personality Disorder | BPD | Diagnosis | DSM | PTSD | Stigma

TCPR: Which disorders are the most overdiagnosed in psychiatry? Dr. Paris: At the top of the list are major depression, PTSD, bipolar II, adult ADHD, and—this one is a recent addition because it used to be underdiagnosed—borderline personality disorder. Each of these conditions may be underdiagnosed in some settings as well, but they have also been

Turning Nightmares Into Dreams

Topics: Behavior therapy | Behavioral therapy | Brief psychotherapy | Nightmares | Psychotherapy | PTSD | Sleep Disorders | Therapy during medication appointment | Therapy with Med Management

TCPR: What is nightmare disorder? Dr. Krakow: This is a sleep disorder in DSM-5 characterized by repeated, distressing nightmares. Some patients awaken from the dreams and others do not, but either way they usually remember the dreams, sometimes vividly. These nightmares often involve themes of threat, fear, and other distressing emotions. An important

Two Negative Studies of Mirtazapine and Riluzole for PTSD in Veterans

Topics: Mirtazapine | PTSD | Randomized controlled trial | Research | Research Update | Riluzole | Trauma

Review of: Davis LL et al, J Clin Psychiatry 2020;81(6):20m13267; Spangler PT et al, J Clin Psychiatry 2020;81(6):20m13233 Type of Studies: Randomized, placebo-controlled trial; randomized controlled trial Medications for posttraumatic stress disorder (PTSD) don’t have a great track record, particularly in combat-related trauma. Prazosin, risperid

Shining a Light on PTSD

Topics: Complementary treatments | Light therapy | Lightbox | natural treatments | PTSD | Randomized controlled trial | Research | Research Update | Seasonal Affective Disorder | Trauma

Review of: Youngstedt SD et al, Mil Med 2021 (Epub ahead of print) Study type: Randomized, sham-controlled trial As stated in the previous brief, PTSD is difficult to treat, and numerous interventions for PTSD have failed with veterans. This study took a different approach; it is the first randomized controlled trial of light therapy for PTSD. Conduc