Posted on 08/04/2011 5:30:02 PM PDT by neverdem
Drugs widely prescribed to treat severe post-traumatic stress symptoms for veterans are no more effective than placebos and come with serious side effects, including weight gain and fatigue, researchers reported on Tuesday.
The surprising finding, from the largest study of its kind in veterans, challenges current treatment standards so directly that it could alter practice soon, some experts said.
Ten percent to 20 percent of those who see heavy combat develop lasting symptoms of post-traumatic stress disorder, and about a fifth of those who get treatment receive a prescription for a so-called antipsychotic medication, according to government numbers.
The new study, published in The Journal of the American Medical Association, focused on one medication, Risperdal. But experts said that its results most likely extend to the entire class, including drugs like Seroquel, Geodon and Abilify.
“I think it’s a very important study” given how frequently the drugs have been prescribed, said Dr. Charles Hoge, a senior scientist at the Walter Reed Army Institute of Research, who was not involved in the study but wrote an editorial accompanying it. He added, “It definitely calls into question the use of antipsychotics in general for PTSD.”
The use of such drugs has grown sharply over the past decade, as thousands of returning soldiers and Marines have found that their post-traumatic stress symptoms do not respond to antidepressants, the only drugs backed by scientific evidence for the disorder. Doctors have turned to antipsychotics, which strongly affect mood, to augment treatment, based almost entirely on their experience with them and how they expect them to work.
To test those assumptions, a team of researchers affiliated with the Veterans Affairs medical system had 123 veterans with the disorder begin a regimen that added Risperdal to their treatment. Some of the patients served in Vietnam, others in...
(Excerpt) Read more at nytimes.com ...
Well we know that's crap! 40 plus years has not reset.
Were you around loud artillery? Yea stupid question maybe but important. The startle reflex may be pointing to Vestibular {Inner Ear} and Sensory Processing damage. No indeed those type of meds will not help in some cases because it is neurological damage involved which can be compounded by stress. It is damage most doctors are simply not checking for. If it isn't ruled out then in some cases like what I went through their text book protocol meds can do more damage because they are not treating the actual problem.
People might scream bloody murder for what I'm about to say but I know this beast real well. Medications like Xanax taken at a low dosage of say .5mg four times a day gives major relief. Antidepressants can make what I am describng far worse and I have seen what the worse can do. Antidepressants to some persons with sensory damage can be as bad as LSD. I've seen it. I've seen doctors miss it too.
Try to tell a shrink about Vestibular related sensory processing damage causing anxiety and a bad startle reflex and they'll likely say rubbish. A few won't but most will. Look up Anxiety +Vestibular Disorders. The Vestibular researchers like Harold Levinson made that connection back in the 1970's. The last thing needed is sensory enhancement as the sensory processing system is already overtaxed and the anxiety is the direct result of that. Xanax slows down the sensory processing too a manageable level so the brain and Vestibular sytem can handle it and somewhat function again.
I still reach a point where I have violent spasms hitting my upper torso from the shoulder blades up sometimes an involuntary jerking and yell. These spasms usually last a second or two and can be as many as several a minute. These are actually seizures and not spasms. The technical name Myoclonic Seizures caused by sensory stimulation. The wrong noise or certain visual stimulation sets it off. It can be auditory, visual, or both triggering it. Things like loud noises can cause the initial damage to the processing system. Add stress and it can really work on you. The way too deal with it so you can function also goes against the textbook protocol for PTSD. I control my sensory enviroment as much as possible. I get out and do things but I do it at times least likely too set me off. This includes even the hours I shop in stores.
I was born with what lead too most of it. But I was also in a Howitzer Battery in the guards and had a fully battery fire mission {155's} go off about 50 feet from my truck while I was asleep. I've had this since 1994 {10 years after my gaurd hitch} and I got hit with PTSD at the same time over non service related traumatic events happening in my life over a 10 year time frame. The PTSD requires therapy. Really that is the best long term answer for PTSD but from what you are saying it sounds like there is more too it than simple PTSD going on.
If this sounds like whats going on drop me FR Mail. Once you understand it you can learn to live with it although as far as working it can be disabling. I had to retire at age 34. There is no cure for what I am describing but you can get some relief if you can find a doctor who thinks outside the box.
Xanax taken correctly in low dosages can be safely taken for over two decades. My wife has been on it for 26 years and I have for 17 years. But you and your doctor must go with low but consistent level in the blood stream dosage.
You hang in there! I am married to Vietnam Vet with PTSD. I know it never goes away, but I pray that you can find a way to live with it. Be kind to yourself. It should get less intense. Learn what triggers you and try to distract your mind during those times. I know what triggers my husband and it helps to know what to expect.
I am glad that you don’t have issues. But I assure you this has nothing to do with courage or the lack there of.
I think persons who have other undetected neurological problems are far more prone to PTSD. The problems seem to start when the the persons brain gets overloaded with events and believe it or not they don't all have too be bad events. Good events that still cause stress like a wanted promotion with more responsibilities can add too it.
When PTSD hit me I had done been through all the bad events. My job was turning around too decent pay and a position I had worked 5 years too get. But my brain was overtaxed from compensating for neurological issues and the traumatic events weren't being resolved while at the same time stress increased.
It's not just vets who can get it. You can go to the hospital for an operation and the stress of the operation and possibly some minimal damage from being put under is also known to trigger what they call Panic Attacks which can lead to Agoraphobia. For most persons it is short lived. For some the underlying neurological issues must be found and treated and that is where a lot of the falling through the cracks is happening in PTSD patients. PTSD and Anxiety Attacks very often co-exist with another or even one or several neurological things going wrong in the body. Those things can also feed the PTSD.
I totally agree with everything you have said. I have had panic attacks and never been in combat. I totally understand the “feelimg”.
24 months for the average person going through a traumatic experience. PTSD occurs with car accidents, rape, abuse, etc. Those who experience more than one traumatic event have a proportionately higher chance of experiencing PTSD without recovering on their own. That reminds me, my sister-in-law’s mother lived through the Blitzkrieg and she might get help with the neuro/biofeedback therapy.
What about Wally World? Does he usually just want the heck out of there becoming a little confused maybe even irratiable especially in busy hours where they are paging every minute at full volume? What about TV? Not being able to watch high action shows but shows formatted in the 70's and earlier are more tolorable? How about watching someone lets say climb a ladder? Is he scared of heights? If so that is classic Vestibular. It is a self preservation mechanism in the brain doing it and it is not an actual phobia. The brain is saying hey you have a balance issue stay off the darn ladder. But they brain doesn't want Joe acros the street on it either.
Any altered hearing? By that I mean the dripping faccet type problems. Where he is almost asleep and any small noise sounds much louder than it is? This is a filtering issue between the Inner Ear and the brain. All of this can trigger anxiety.
Don't be too shocked if you have to go pick him up while he's out sometime because he went into what I call brain fog. Scarey as hell but it's harmless. In a major attack the brain like a computer will start shutting down programs. IOW he may be driving on a street he drives say once a week. All of the sudden sense of where you are at, how you got there, where you were going, etc is gone. It won't kill you but first several times I thought I had major things wrong like a tumor.
Everyone is different bu have any of my post on this thread sounded like what is going on? How about ringing in the ears? Chronic ear infections as a child? Tubes in the ears as a kid? Sinus allergies? Partial deafness? I'm over 50% now. Poor balance? These are some things that can point too what I'm saying that doctors overlook and never consider when treating anxiety. Yet any of us over 50 can remember when persons had what was called Middle Ear infections and how they acted till it passed.
I did respond to your post in public but want to send the links I posted. Please read them all, it sounds very promising.
http://www.datehookup.com/Thread-151368.htm
http://www.eeginfo.com/newsletter/?p=317
http://www.healthnews.org/news/2010/11/biofeedback-helps-veterans-battling-ptsd-and-tbi
http://www.prweb.com/releases/2010/11/prweb4178094.htm
As for brain fog. Yes this has happened. He forgets what he was saying or doing. But it's not an old age thing. He sleep walks and appears totally lucid when he does it, except that the situation is inappropriate for the middle of the night.
Thank You. I will I will try anything to help him. He is a bit more stubborn! I am sure you know what I mean.
Cognitive Aspects of Vestibular Disorders
Panic disorder: the role of the balance system
I also think this needs to be said. To anyone experiencing PTSD you and your family need to look up Serotonin Syndrome. I say this because it might someday save someones life.
Sometimes when persons have underlying neurological issues which are the actual cause of the anxiety and they do not get addressed the wrong medications might be given. In those cases it is important that family and doctor catch this in it's early onset. It is an adverse medication reaction.
This is not Tin Foil Junk Science I have been a witness too it in my wife and almost myself. My wife has serious neurological damage that left her a quadriplegic. She has PTSD. A doctor gave her Trazadone and Zoloft. It ended up having the same effect as LSD would and she nearly died. Six doctors ignored medical history and were too busy having her take SSRI's. Xanax likely saved her life as she was also on it. When a person becomes a quad the first thing they must regain besides limb usages is their Inner Ear and balance.
I have an extensive sensory processing medical history almost from birth the shrinks ignored while insisting I take Paxil and other Meds. I got lucky in the fact I found a book that helped be understand what was wrong. It's called Phobia Free and anyone with a Vestibular medical history should read it. I also later on found a doctor who had seen what I have although there is still no name for it as such as it is several things combined.
Don't get me wrong. Stay on your meds never go cold turkey on any med either but also look at your life long medical history and do some basic detective work. If your doctor doesn't want too listen then find another. I fired 5.
It really sounds like he is a Vestibular patient. You can do the searches with a search engine Vestibular disorders +anxiety. There is a lot more information out there than what I had in 1994.
I also very highly recommend the book "Phobia Free" by Harold Levinson. Don't let the title throw you off. In that book he puts the Vestibular triggering anxiety puzzle together. He is a Neurologist and Pyschratistist and was decades ahead of his time.
BTW I bet he can wear out a good pair of shoes pretty fast huh? Breaks over the sides unless he wears corrective insoles? That's due to walking of balance it makes the ankles turn in real bad. Concrete floors are the worse. I also have to use a cane now.
BTW at the bottom of the page of the first link is a link for Cognitive Aspects of Vestibular Disorders. You really need to read it as well. If this links here’s part 2 http://sci.tech-archive.net/Archive/sci.med.diseases.lyme/2005-08/msg00134.html
Thanks for the link I am going to look into it. I will say that sense he has been taking the anti-anxiety med he is much better.
bookmark
Benzodiazepines such as Xanax, Valium, Librium, and Klonopin work pretty good. Of those four Klonopin is the easiest to get a doctor to write for long term and should work as long as no seizure activity is involved. If seizure activity is involved then Xanax is the best IMO. The trick is a maintenance level of the lowest dosage of Xanax that works. That is usually .5mg for most persons. If a doctor writes it for lets say 1-2 mg twice per day that is a disaster waiting to happen and will eventually make things worse. But a 2mg pill split into four doseages a day usually every 6-8 hours will work.
Benzo's have a bad reputation mainly due to ignorance on the part of prescribing doctor writing too strong a dosage and too far apart or writing it too those who drink alcohol in excess. The doctor and patient have to understand how too take it. Yes there is a risk for dependency. On the other hand on some days I've gone up too 12 hours without it others I have too have all four doses that day.
The thing that burns me is persons with anxiety attacks and PTSD need help now. Antidepressants can take up too a month too fully work and usually no relief at all for the first week. A Benzo starts working in a few minutes or in the case of Xanax within 5 minutes when placed under the tongue. If there is an adverse reaction it takes the antidepressants up too several weeks to leave the body. The adverse reaction in a male can mean bladder blockage which is also very dangerous and requires imediate medical attention or you will go into shock. Been there done that too. A Benzo is usually gone within 12 hours at max. Benzo's also do not have the Serotonin Syndrome risk as they are actually the antidote for it.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.