00:01
There are medications
that we use
to help people
deal with their PTSD.
00:09
So there are some SSRIs,
antidepressants that we use.
00:14
Prozac is one
of the best medications
also known as fluoxetine.
00:21
Sertraline (Zoloft), and
Paxil, which is a paroxetine.
00:28
So, these are usually
our first go to medications,
if a person has PTSD.
00:35
It helps with the anxiety,
it helps with a depression.
00:38
It really gives them
an overall sense of capacity.
00:44
And when I am
talking about medications
medications alone are not what's
helping the person with PTSD
or any other psychiatric disorder.
00:55
Medications are an
adjunctive used with therapy
and other interventions,
whether it's milieu therapy,
whether it's group therapy,
individual therapy, family therapy,
or all of the above.
01:13
Other antidepressants are also used
to help patients who have PTSD.
01:20
Nefazodone
also known as Serzone
Venlafaxine,
which is Effexor.
01:28
Remeron
which is mirtazapine.
01:32
And also the
tricyclic antidepressants,
and MAOIs are also used.
01:40
Important to remember whenever
medications are being used
with a person with PTSD
is to do patient education
about what to expect,
when they're taking
these medication.
01:55
We know that with antidepressants,
there is usually a 7 to 10 pound
weight gain.
02:02
For some people, this alone
will make them far more depressed.
02:08
But if they know
that it is associated
with the medication
that they're taking,
and that they can adjust
their eating habits
and their exercise patterns
and keep that weight gain
to a very minimum,
they are far more likely
to be successful
both with their
medication adherence,
as well as
with their therapy.
02:32
Also, medications like Remeron
can be extremely tiring.
02:38
And so if a patient
is put on Remeron
talked to the patient about
maybe taking that at night,
rather than during the day.
02:48
Most important if your patient
is placed on MAOIs,
you want to make sure
that they know all the
food and dietary restrictions
that go along
with those medications.
03:06
To affect their reactions
to being activated
when their anxiety kicks in.
03:16
We also use beta blockers.
03:19
So we might be using prazosin
which is Minipress,
clonidine
which is Catapres,
Guanfacine which is Tenex
and propranolol.
03:32
Now, why and how did
we figure this out
to use a beta blocker
in order to deal with PTSD.
03:42
We know that prazosin (Minipres)
is incredibly effective
to help with nightmares
and flashbacks.
03:52
It helps to calm the nervous system,
it brings down the blood pressure
but it also helps that patient
to be able to sleep
and not have nightmares
and flashbacks.
04:05
Other medications that are used
to help you who have PTSD
are mood stabilizers.
04:11
Many of our mood stabilizers
are also anti-seizure drugs
like Tegretol
also with its generic name
of carbamazepine,
or Depakote
which is divalproex,
Lamictal
which is lamotrigine,
and also Topamax
which is topiramate.
04:34
Now, they are
mood stabilizers, yes,
but they also are
anti-seizure drugs.
04:41
And as anti-seizure drugs, they have
a general impact on the brain,
slowing everything down.
04:50
There is an increase in weight gain.
04:53
There's an increase in likelihood
for metabolic syndrome
at some of these medications.
04:59
And so we have to really be
looking at our patient,
the whole patient
and weighing with the team,
what is best for this person?
And what is going to help them
through to recovery from PTSD?
In some cases,
second-generation antipsychotics
are used for persons who have PTSD.
05:26
(Abilify) aripriprazol.
05:30
Now, when we're
looking at the antipsychotics,
it's also important to remember
that metabolic syndrome
come secondary to the use
of antipsychotics.
05:43
In addition to that, we might be
seeing some extrapyramidal symptoms.
05:48
and so that patient might actually
be put on other medications
prophylactically,
to prevent the
extrapyramidal symptoms,
something like Cogentin.
05:59
And so we are starting to pile up
and seeing a lot of medications
being used
for these sometimes
difficult to treat patients.
06:12
Benzodiazepines
are also used with PTSD.
06:16
Though not as frequently anymore,
due to what we have seen
with the explosion
of substance use disorders
secondary to medications that
had been previously prescribed
and over prescribed.
06:32
So, for some people,
benzodiazepine are being prescribed
and that is lorazepam
also known as Ativan,
clonazepam
which is Klonopin
alprazolam
which is Xanax,
and diazepam
which is Valium.
06:55
These should be prescribed
for short periods of time,
and not
over long periods of time
because we know that with the
benzodiazepines tolerance occurs.
07:08
The patient will start
requiring more
in order
to get the same effect,
which will then lead them into
possibly having a dependence.
07:17
And then we have a completely
different problem on our hand.
07:24
So, there are other therapies.
07:26
And as I said before,
medication alone
is not going to be our go to.
07:31
We want to be able to help
the patient towards recovery
using a combination of strategies,
medication, and therapy,
and it may be more than
one mode of therapy.
07:44
The patient might have
group therapy or family therapy.
07:50
Cognitive behavioral therapy
has been shown to be very effective
for patients who have PTSD.
07:58
Prolonged exposure therapy
is a therapy that is used
by the Veterans Administration
with extremely good results.
08:08
There is the
eye movement desensitization
and reprocessing therapy,
also known as EMDR,
which has also been demonstrated
to be effective
for persons with PTSD.
08:22
And there is sensory motor
psychotherapy.
08:25
Again, specifically for people with
trauma and attachment disorders.