The Medications Used in Post-Traumatic Stress Disorder - Research Paper Example

of the Introduction Post-traumatic stress disorder is a mental disorder or a condition where a person experiences recurring thoughts, flashbacks after he has been through a traumatic event or even witnessing a traumatic event. The condition is worse when the person has suffered serious situations like life-threatening assaults, sexual assault, or death of a loved one. It can occur at any age, mostly above the age of ten. It is much more common in women than in men who have experienced such events. The fact that this kind of disorder is not easily treatable, it requires counseling as well as medicinal therapy. The treatment through medicines is considered to be a one-way therapy, whereas there are certain medications that have showed a positive influence on the patient. Now, the question is why there isn’t a successful medication for the treatment of PTSD. PTSD is classified as a type of anxiety disorder, which is said to be manageable after taking anti-depressants and which is merely a way to manage symptoms. But yet, no proper drug therapy is found. Background The medications used in PTSD patients include Benzodiazepines, SSRIs, and atypical Anti-depressants. These drugs are mainly used to manage the symptoms, the symptoms include: Sleep disturbances, Emotional disturbances, Hyper-arousal, Numbness, Panic attacks. These drugs are given in combination to avoid the recurrences, and to improve sleeping patterns of the patient. These signs and symptoms are not persistent. It is normal to have signs and symptoms after a traumatic event. Researchers have proved that the patients with lesser intellectual abilities are more likely to suffer from it and are usually victims of severe cases of PTSD. Most survivors or sufferers are not always the victims. It is said that the time is the most effective medicine in the treatment (Bonnano, 2004). In the case of distinct minorities, the substance abuse, depression, anxiety emerges. (Kessler, Peterson, Lucia, 1999). Most epidemiological studies suggest that the traumas like wars, killings, kidnappings are actually happening in the developed countries. With increasing disaster rates, the patients are increasing drastically and are more difficult to manage. As the medical science is going through a vast development, a number of assessment tests have come into existence, which plays a crucial part in the diagnosis at the right time and then management therapy. Supporting Evidence # 1:What is the most suitable way of treatment of PTSD? As discussed earlier, there are two ways of managing the disorder, one is by the psychological counseling and the other is by the use of anti-depressant medications. Psychotherapy is slow and is also not a successful therapy, but if it goes along with the medication, the success rate is higher. Psychotherapy includes cognitive behavioral therapy or group psychotherapy or sometimes combination of both, also includes EDMR and hypnotherapy. The psychotherapy follows a 3 phase therapy, as follows: Achieving safety of patient and reduction of symptoms, Review of traumatic memories, Consolidation. As Dr. Figley states that, “confronting human through suffering is a painful process, it should be taken wisely and may also result in the professional burnout.’’ The patients of PTSD are usually worn out and under the impression that they are left alone and there will be no one to help them. Beyond the obvious cost advantage of psychotherapy, group therapy may be particularly useful for the treatment of PTSD. (Klein, 2009) According to recent statistics, after a detailed interview of the affected, especially adult survivors (Foy et al, 2000) around 10-15 weekly sessions used to be held and session as length as 1.5 hours, including majority female victims of childhood sexual abuse, very few published male victims. Out of the victims who were taking group sessions were showing a drastic improvement in their health conditions. These patients were also taking medicines side by side with the counseling sessions. The evidence above explained proves that the medicinal therapy alone is not worth taking, while the drugs taken with psychotherapy sessions are much better way of managing the condition. In this case, it highly depends on the patient, if the patient is responsive to the drug therapy, it is much easier. But the drug therapy along with the psychotherapy is a recommended procedure. Usually, the family of the patient is supporting enough to take the patient out of the trauma and stress but in many other cases the group psychotherapy goes a long way off. Although, the time is healer especially where memories play a vital role in the recurrence of the disease, and with the time the memory fades away, which makes it easier and a favorable therapy for the patient. But if the patient is unresponsive to both, much attention is required. Supporting Evidence # 2: Prevention of PTSD, possible or not? Prevention of PTSD is directly related to the memory of the person, it is possible to alter the memory of the patient but it can also alter many other functions of the brain. The memory of a person is indirectly linked to the intellectual capacity and the patients with less intellectual capacity are usually less likely to be affected by this disorder. According to a Medical Institute, investigators researched on a receptor called OprI1, the alteration of this receptor causes prevention of PTSD in mice, thus preventing the development of this disorder. In this experiment, mice were exposed to a traumatic event, in which they were being subjected to such extent where their fears were heightened; the researchers gave mice this newly researched drug which showed great results in the prevention of PTSD. A study was published in the journal, indicating that humans with a type of OprI1 gene showed some effect on the tendency to develop this disorder. However, with the new drug, the problem can be prevented. Although, this disorder is treatable; but researchers are working on new ways to stop the development at first place. The drug that has been developed has successfully stopped the disease from progressing in laboratory animals and is expected to do the same in the human body, the drug is still stuck in clinical trials but it is anticipated in the coming years for its release. Resslersays: "There are many genes likely to develop post -traumatic stress disorder, OprI1 is said to be the one highly contributing to the risk, although larger samples as well as more studies are required to work in this." The first approach of the investigators is the linked with neuroscience, they believe by altering the neural functions, this disorder will not a problem in the future. A study published in another institute also indicated that, the increase in number of glucocorticoid hormones is also one of the factors for its development. Whereas Glucocorticoids and its family are considered to be stress hormones and these may be increased after the stress, causing the prevention of PTSD. Latest medical research supports the idea of prevention of PTSD, which has also been proved but the test results are confined to laboratories and to the R&D department. But in the near future, the therapy will be available to every patient. Support Evidence #3: Why do people suffer from PTSD? The purpose of this research is to identify that whether parents have adequate knowledge about the efficiency and effectiveness of measures that are required to be taken during PTSD. In addition to that, the study is also aimed at studying that whether parents know, that what is their proper use of the measures and to identify the level of fear and reservation related to the use in the patients. People with Post-traumatic stress disorder (PTSD) may have problems different kinds of problems which includes, they start drinking or taking drugs, they have a feeling of despair and hopelessness, they may face employment problems and other relationship problems for example violence and divorce. The reasons and causes of these problems is the trauma which has been caused by any natural disasters, accident or any unforgettable experience or event. The post-traumatic stress disorder (PTSD) cause internal deficiencies or weakness as a source of mental disorders, the patient of PTSD also suffer from other problems like they feel alone, worried, sad and they sometimes feel guilty, they had a trouble in sleeping because they see frightening nightmares, or they feel like if the event is happening again. The post-traumatic stress disorder starts at different times for different people, it might start soon after the event has happened or it starts happening after some months or years later. It can happen to anyone in any age it can also happen to children. Medicines help patients to feel less afraid and ignore tense but it might take some time for the medicines to react. Some people use to consult psychologist, and they help people to overcome their mental stress (Marsella, 1996). The psychological issues in PTSD occurs as a results of the experience of a traumatic event, which engulf the normal defense mechanisms of a person, which results in deep fear, the patient feels helplessness, and usually get a loss of self-control, and the person starts to act abnormally. This abnormal behavior of a patient cause some personality disorders, as an example of this mental functions, some of the PTSD patients experience deep emotion but they did not have a clear memory of the event in their mind; but there are others who may remember each and every detail but without emotion; but there are still other patients who may re-experience the happening of the event in flashback.   Counter Argument:How can there be a medicinal management when the disorder is considered to be purely psychological? The disorder is indeed psychological, but it is related to the memory and some hormones. The Amine theory says that, ‘’ Depression is caused by the reduction of amine in the body’’. The reduction in the amines causes the person to feel low and unhappy. These levels can be brought back to normal by enhancing the ability of the brain to release amine hormones in the body with the help of drugs. Also, PTSD is linked to the memory and intellectual impairment, in most severe cases, the patient experiences withdrawal and isolation from the world, which can be brought back to normal by two therapies, i.e psychotherapy as well as medicinal therapy. Sum up Conclusion It has been concluded that people who faces traumatic events will at some point of time suffer with post-traumatic stress disorder. Therefore, psychotherapy in such events will be helpful for such patients who are suffering from PTSD. However, people who are not sure that whether they are suffering from PTSD or not, they may benefit from taking a self-test with the help of a practitioner. Many post trauma factors are linked with the development, occurrence, and severity of PTSD symptoms. A growing body of literature supports that the extent to which an individual experiences a loss of valued resources after trauma, including material possessions, interpersonal resources (for example, time with loved ones), and intra-personal resources (for example, hope, self-esteem), is associated with risk for PTSD. Social support has also been consistently associated with PTSD risk and severity of symptoms. The coping strategies that an individual uses in managing the trauma also are clearly related to PTSD risk and severity. In particular, reliance on avoidance strategies in managing the trauma, such as dreaming (for example, imagining that the trauma had not occurred), problem avoidance, and disengagement from trauma-related thoughts and feelings, are associated with PTSD symptomatology. The extent to which an individual experiences damage to many culturally valued beliefs has also been related to PTSD development and severity after trauma. Beliefs commonly affected by the experience of trauma associated with PTSD risk include belief that the world is a safe place, belief that other people are generally good and benevolent, belief in the trustworthiness of others, belief in one’s own worth, and belief that life has meaning. So what Conclusion PTSD is a disorder that hasn’t come up with a perfect management therapy since it largely depends on the patient itself, and every person has his own capacity of thinking and intellect. PTSD doesn’t only relate to the neural disorder but also to the levels of hormones in the body. Hence, there are many factors which are considered when the drug therapy is studied and being researched on when finding the perfect cure for PTSD. Post-traumatic Stress Disorder (PTSD) is considered to have a negative effect on the life of a person as it hinder their daily performance and they are unable to perform the most basic tasks. Trauma is considered to have major impacts on the lives of people since they cannot forget the life-threatening experiences happened with them and they visualize, as if the events were still occurring. These are some factors that hold a high significance in a person’s well-being. The fact that the person’s mental health is extremely important to carry out his daily activities makes the medical science more dedicating towards the cure. Annotated Bibliography Wilson, John P., Matthew J. Friedman, and Jacob D. Lindy, eds. Treating psychological trauma and PTSD.Guilford Press, 2012. Data Retrieved from: http://books.google.com/books?hl=en&lr=&id=PeFUHiGwU_4C&oi=fnd&pg=PA1&dq=psychotherapy+in+ptsd&ots=vQVz5ovX35&sig=OFxPgI_tQGEkM2e4tOHZZccaw6M#v=onepage&q=psychotherapy%20in%20ptsd&f=false This article discusses well about the treatment and management of PTSD, including epidemiology and statistics regarding the recurrence of the disorder as well as the recognition of PTSD as a genuine psychological disorder, The article also tells us about the events seen in Iraq and surveys done on the US soldiers, where most of the soldiers were likely to suffer from PTSD. The author describes the reason about why PTSD took longer to be claimed as a psychological disorder by the APA. The above information is taken from a book called, ‘’Treating Psychological trauma and PTSD’’, written and edited by John P . Wilson, Matthew J. Friedman in 2001. John P. Wilson is a PhD and a professor of Psychology at Cleveland State University. Matthew J. Friedman MD and a PhD is an executive Director of Centre for PTSD in White River Junction, Vermont. Jacob D. Lindy is an MD and a training analyst at Cincinnati Psychoanalytic Inst. This book provides elaborative theoretical explanations on treatment and recurrences of PTSD. I analyzed the source and read the book which gave me information about the sudden emergence of PTSD as a mental disorder and acceptance of this disorder by the APA, which lead the Psychiatrists to work further on it and enhance their skills which is of highest importance in the world of Psychiatry. American Psychiatric Association. (1987). Diagnostic and statistical manual of mental health disorders (3rd ed., rev.). Washington, DC: Author. Data retrieved: http://tmt.sagepub.com/content/16/4/117.refs The article indicates the importance of psychotherapy in PTSD patients and further distinguishing between inpatient and outpatient therapy, the both programs differed from each other in number of days and number of treatments per week between these patients. After a survey, it was concluded that more number of therapies per week caused much better results. The abstract is taken from the manual of American Psychiatric Association, the manual is called, ‘’Diagnostic and statistical manual of mental health disorders’’. This manual provides the information about the current treatment procedures in the psychiatry. After a review of this article, the information about the statistics that I have added in this paper, the difference between the medicinal therapy and psychotherapy and the frequency of these therapies as well as the outcome is seen. Terr, L. C. (1991). Childhood traumas: an outline and overview. American Journal of Psychiatry, 148(1), 10-20. Data retrieved: http://www.isst-d.org/default.asp?contentID=77 In this article, the author emphasizes on the fact that PTSD might be an occurrence due to a childhood factor, due to a form of rheumatic fever, which is responsible for many other health and mental disturbances. No matter what is the diagnosis, there are certain characteristics that are related to the childhood and have chances of difficulty in the therapy. The author has divided childhood trauma in two phases, the author has given two examples in this case. The occurrence of PTSD is related to this factor. The American Journal of Psychiatry is an official journal for American Psychologists which gives equal standards to the field of psychology all over the US and other countries as well. After a thorough review of this journal, we come to know about the fact that occurrence of PTSD is highly related to childhood factors; also the examples have been highlighted related to the recurrences and treatment of PTSD. Moreau, C., & Zisook, S. (2002). Rationale for a posttraumatic stress spectrum disorder. Psychiatric Clinics of North America, 25, 775-790. Data retrieved: http://www.isst-d.org/default.asp?contentID=77 The article gives us the idea of PTSD in infancy, and the fact that PTSD was not considered as a distinct disorder until 1980. The author tells about the three different spectrum defined in the paper, with the enhancement in the survey and research skills, the diagnosis are more likely to be improved. The authors belong to the Department of Psychiatry, University of California, San Diego, Gilman Drive, very well known in the Psychiatry world. Also work as Psychiatrists in the Psychiatric Clinics of North America. This abstract of research helped in the improvement of skills that are considered as diagnostic tools. Also gives a vivid difference between the psychotherapy and medicinal therapy along with the fact that the modern medicine requires counseling as well as proper therapy. Davidson, J. R. "Long-term treatment and prevention of posttraumatic stress disorder." The Journal of clinical psychiatry 65 (2003): 44-48. Data retrieved from:http://europepmc.org/abstract/MED/14728096/reload=0;jsessionid=J8f3aZHB5sbBcNMH2bUS.0 The author presents an argument about the new advancements in the medicine that can lead to a better treatment for. E.g. long term use of SSRIs anti-depressants, the article indicates the new researches about the prevention of the PTSD which is supported by some evidences and stats. The author tells about the research about the receptor recently discovered in mice and the research on a drug that will alter the receptor. The information is taken from the abstract written by Davidson J.R, works in the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA. The contribution of this article can be seen in the paper under the idea that discusses the differences between psychotherapy and long term treatment of anti-depressants. Also the outcomes of these treatments are seen and compared. Martenyi, Ferenc, et al. "Fluoxetine v. placebo in prevention of relapse in post-traumatic stress disorder." The British Journal of Psychiatry 181.4 (2002): 315-320. Data retrieved from: http://bjp.rcpsych.org/content/181/4/315.short In this article, the author shows a support on the use of an anti-depressant drug like Fluoxetine and tells its effects on the PTSD patient. The effect of fluoxetine as a placebo drug and in the relapse of PTSD is also discussed. The drug therapy results are also discussed, the relapse which is directly related to the memory and morose, this anti-depressant drug therapy is useful for this cause. The authors Moreau C, Zisook S, work at the Department of Psychiatry, University of California, San Diego, Gilman Drive, La Jolla, the research was published in the British Journal of Psychiatry, which serves as a national as well as an international standard for Psychiatrists and professionals related to Psychiatry. The research in the article is done on the basis of medicinal therapy and its effects on long term, the placebo effect is also seen which is helpful in many therapies especially related to psychiatry. The author also indicates the need for further research in this regard. This article gave the information about drug related therapy especially anti depressants like Fluoxetine. Read More