PTSD Carlat Reports | Carlat Publishing

Clinical Update

A Review of Medications for PTSD, With a Focus on Topiramate

From The Carlat Psychiatry Report, Problems with Generics

Topics: PTSD

A new patient comes into your office for an assessment. He tells you he cannot keep living this way. He shops at Walmart at 3 am to avoid strangers. He startles easily and suffers from nightmares and flashbacks related to a trauma he experienced in the Army. He’s tried sertraline and venlafaxine for PTSD but did not find them helpful and wants to try

Expert Q&A

Mood, Cognition, and Metabolic Health

From The Carlat Psychiatry Report, Metabolism and Mental Health

Topics: Eszopiclone | Hypnotics | PTSD | Sleep

TCPR: Your research has explored how metabolic disorders can impair mood and cognition. Can you give us an overview of that topic? Dr. Mansur: Yes. There is a direct association between metabolic health and both mood and cognitive outcomes. All of the components of the metabolic syndrome—obesity, type II diabetes, dyslipidemia, and hypertension—inc

Research Update

Uncertain Results for Eszopiclone in PTSD

From The Carlat Psychiatry Report, Metabolism and Mental Health

Topics: PTSD

Review of: Dowd SM et al, World J Psychiatry 2020;10(3):21–28 Study TYPE: Randomized, double-blind, placebo-controlled trial The idea that good sleep promotes mental health has led researchers to test whether hypnotics have psychiatric benefits beyond their effects on sleep. Eszopiclone (Lunesta) fulfilled that promise in depression and generalized

Ask The Editor

Is Paxil the Best SSRI for Anxiety?

From The Carlat Psychiatry Report, How to Talk about Medication

Dear Dr. Aiken: Your review of Paxil’s risks in the May issue failed to mention a benefit that’s unique to this drug. Isn’t it the best SSRI for anxiety? Dr. Aiken: Paroxetine’s (Paxil’s) reputation as the anti-anxiety SSRI got off to a running start. It was first launched for panic disorder in 1996, two years before its approval for depres

Research Update

Another Black Eye for Prazosin in PTSD?

From The Carlat Psychiatry Report, Side Effects Part II

Review of: McCall W et al, J Clin Psychopharmacol 2018;38(6):618–621 Study Type: Randomized single-blind controlled trial (pilot study) Prazosin has become a mainstay in the pharmacologic treatment of PTSD. A selective antagonist of the noradrenergic alpha-1 receptor, it has modest benefits in sleep and nightmares that are supported by around ha

Expert Q&A

Sleep and PTSD

From The Carlat Psychiatry Report, Sleep

Topics: PTSD | Sleep Disorders

TCPR: A lot of patients with PTSD have trouble sleeping. How does this differ from the insomnia we see in other disorders? Dr. McCarthy: Insomnia is different in PTSD. Some of that is explained by the symptoms of PTSD, such as nightmares, hyperarousal, anxiety, and physical restlessness. But there’s another thing we’re seeing that isn’t as obviou

Article

Note From the Editor-in-Chief

From The Carlat Psychiatry Report, PTSD

Topics: PTSD

My goal in publishing TCPR is to help you think differently about your clinical practice, hopefully to enhance your effectiveness as a healer. After editing this month’s issue on posttraumatic stress disorder (PTSD), I think I’ve achieved that goal in my own practice. I’ve often noticed that PTSD seems to present in two forms: clear and fuzzy.

Article

Update on Medications for PTSD

From The Carlat Psychiatry Report, PTSD

Topics: Psychopharmacology | PTSD

Every five years or so, we do an update on PTSD treatments; the most recent was our August 2011 issue of TCPR, in which we declared that psychotherapy was the gold standard for treatment. Recently, the US Veterans Health Administration (VA) and the Department of Defense made this their official position. In their just-published 2017 treatment guidelines

Expert Q&A

Assessing Complex PTSD

From The Carlat Psychiatry Report, PTSD

Topics: Free Articles | PTSD

TCPR: We’ve been hearing more the last few years about the concept of complex PTSD. I know that there are similarities with conventional PTSD—which is covered in the DSM-5—but can you explain to our readers how complex PTSD is different from conventional PTSD? Dr. Schwartz: The first thing that I would say is that complex PTSD can sometimes be

Efficacy of Quetiapine in PTSD

From The Carlat Psychiatry Report,

Topics: Psychopharmacology Tips | PTSD | Research Updates

Research Update

Efficacy of Quetiapine in PTSD

From The Carlat Psychiatry Report, Side Effects

Topics: Psychopharmacology Tips | PTSD | Research Update

Review of: Villarreal G, Hamner MB, Cañive JM, et al. Efficacy of quetiapine monotherapy in posttraumatic stress disorder: a randomized, placebo-controlled trial. JAMA Psychiatry 2016:ahead of publication. Study Type: Placebo-controlled, double-blinded clinical trial Post-traumatic stress disorder (PTSD) is arguably one of the most difficult psy

From The Carlat Psychiatry Report,

Expert Q&A

The Experience of Correctional Psychiatry

From The Carlat Psychiatry Report, Correctional Psychiatry

TCPR: Dr. Gariety, please tell us a bit about your background. Dr. Gariety: I’ve been in practice for 23 years, starting out in community mental health, followed by 13 years in the federal bureau of prisons. Currently I work for a large regional medical group in the private sector. TCPR: Tell me a bit more about the correctional setting. D

Research Update

Getting Bullied as a Kid: Not Good for Your Mental Health

From The Carlat Child Psychiatry Report, Conduct Disorder in Children and Adolescents

Topics: Child Psychiatry | Cognitive Behavioral Therapy | Depressive Disorder | PTSD

Article

Foster Care and Child Psychiatry: A Primer

From The Carlat Child Psychiatry Report, Foster Care and Child Psychiatry

In this issue of CCPR we focus on the treatment of children in foster care systems. Nearly one in three of these children have significant psychiatric problems during their time in foster care—especially those related to trauma and neglect that brought them into the system (McMillen JC et al, J Am Acad Child Adolesc Psychiatry 2005;44(1):88–95). Rec

Article

Managing Psychotropic Treatment with Foster Children

From The Carlat Child Psychiatry Report, Foster Care and Child Psychiatry

Topics: Antipsychotics | Child Psychiatry | Psychopharmacology Tips | PTSD

Janey is 5. She hits and she bites. Her third foster mother, Sandy, is thinking it’s too much to handle. I am her new psychopharmacologist. Janey arrives with a thick chart documenting in utero substance exposure, early neglect, many placements, and symptoms consistent with many DSM-5 diagnoses, including reactive attachment disorder, generalized anxi

Expert Q&A

The Politics of Medicating Children: Problems and Solutions

From The Carlat Child Psychiatry Report, Foster Care and Child Psychiatry

Topics: Child Psychiatry | Psychopharmacology Tips | PTSD

Article

Medications for Childhood PTSD: It’s All Off-Label

From The Carlat Child Psychiatry Report, Trauma

Topics: Child Psychiatry | Practice Tools and Tips | Psychopharmacology Tips | PTSD

In 2011, we wrote a review of medications for PTSD in children and found, unfortunately, that data to inform true evidence-based practice was scant. There are still no psychotropic medications that have been proven effective in randomized controlled trials for children with PTSD and there are no FDA approved medications for this population. Nonethele

Expert Q&A

Trauma Systems Therapy

From The Carlat Child Psychiatry Report, Trauma