Mental Health Clinician Volume 2: Issue 7

Select Issue

Surviving post traumatic stress disorder

PharmD, BCPP

The treatment of post traumatic stress disorder (PTSD) has often frustrated practitioners, as it is difficult to achieve the goals of treatment, primarily restoration of functioning. Far too often patients are treated unsuccessfully with prescription medications and turn to illicit drugs and alcohol to attempt to self-medicate. There is an ever-present need for more effective agents with fewer side effects. Clearly, there is a significant place for pharmacists in assuring appropriate treatment and monitoring is provided for patients suffering from PTSD.

Understanding the epidemic of PTSD, especially that which is combat-related, is the focus of January's issue of the Mental

Download PDF

Post traumatic stress disorder toolbox

PharmD, BCPP

DOI: 10.9740/mhc.n132154

This toolbox contains several helpful references to assist in choosing optimal treatments for the treatment of PTSD. The resources in this toolbox include three sections:

PTSD Pharmacotherapy: Charts of medications commonly used for the treatment of patients with PTSD
PTSD Rating Scales
Medication Treatment Guidelines Summary for Post Traumatic Stress Disorder (PTSD)

PTSD PHARMACOTHERAPY

PTSD RATING SCALES

Download PDF

Practice site interview with Jennifer Kelly

PharmD, MS, MBA

DOI: 10.9740/mhc.n130703

What drew you to psychiatric pharmacy?

While in pharmacy school, I was always interested in research and psychiatric topics that we studied. I was drawn to the area of psychiatric pharmacy because it is not a “one-size fits all” approach. It is one of the gray areas of pharmacy, where each patient responds to therapies differently, has different needs and goals for treatment.

Describe your role as a psychiatric pharmacist. What did you need to change after starting your practice to make it work the way it does now?

Currently, my practice area in the VA hospital has been established

Download PDF

A review of atypical antipsychotics and their utility in post-traumatic stress disorder

PharmD,

PharmD, and

PharmD, BCPS, BCPP, CGP

DOI: 10.9740/mhc.n131049

Post traumatic stress disorder (PTSD) is a chronic and debilitating mental illness. Atypical antipsychotics are often utilized for treatment of PTSD despite the limited data. The purpose of this article is to review published clinical trials of atypical antipsychotics used in the treatment of PTSD. Certain patients may benefit from therapy with an atypical antipsychotic, particularly for those with hyper-arousal or re-experiencing symptom clusters. At this time, guidelines suggest against the use of risperidone as augmentation therapy in patients with PTSD. Data are only available for olanzapine, quetiapine, and aripiprazole; however, data were conflicting, not very robust, and studies had limited sample sizes and narrow demographics. It is important to provide proper patient education and weigh the risks versus benefits of therapy with an atypical antipsychotic as metabolic side effects are well documented.

Download PDF

Pharmacy considerations in tobacco cessation for patients suffering from posttraumatic stress disorder

PharmD, BCPP and

PharmD, BCPS

DOI: 10.9740/mhc.n131050

Multiple studies have associated post traumatic stress disorder (PTSD) with variable and high rates of smoking documented in different populations. This article will cover the neurobiology behind tobacco use, and its implications in those with PTSD. Discussion on cessation programs (e.g., effectiveness, drug interactions), and controversy over the use of varenicline will also be discussed.

Download PDF

Prazosin treatment of nightmares related to post-traumatic stress disorder

PharmD, BCPP,

CRNP, and

DO, MPH

DOI: 10.9740/mhc.n131051

This case demonstrates the efficacy of prazosin in treating civilian post traumatic stress disorder (PTSD)-related nightmares. Although its mechanism is not fully elucidated, it is clear that prazosin decreases nightmares. Tolerability may limit one's ability to titrate to an effective dose.

Download PDF

The role of propranolol for post-exposure chemoprophylaxis of posttraumatic stress disorder and acute stress disorder

PharmD Candidate and

PharmD, BCPP, FASHP

DOI: 10.9740/mhc.n131052

Post traumatic stress disorder may be due to excessive adrenergic activation immediately following trauma leading to over-consolidation of traumatic memories. Based on this premise, propranolol has been studied as a means of post-exposure prophylaxis of posttraumatic stress disorder and acute stress disorder. Published trials include a retrospective chart review, a prospective cohort study, and a number of randomized clinical trials. Current data suggest ineffectiveness of propranolol for this indication, but larger, randomized, placebo-controlled trials that include more diverse types of traumas are needed in order to provide more definitive evidence.

Download PDF

The role of prepulse inhibition in medication management of PTSD: A case report

PharmD,

PharmD, and

PharmD

DOI: 10.9740/mhc.n131057

Post traumatic stress disorder (PTSD) is defined as an anxiety disorder that can appear after exposure to a traumatic experience. This article will review a patient's history of PTSD, and course of treatment. A discussion on the available agents to properly treat this case will also be discussed.

Download PDF

Established and emerging PTSD treatments

LMSW BCCH EFT-Adv

DOI: 10.9740/mhc.n131766

Identifying and describing the numerous types of interventions to treat post-traumatic stress disorder (PTSD) can be a daunting task especially with the numerous therapeutic models and techniques with published case study support. This article will explore the physiology and neurobiology of PTSD. Additionally, it will discuss some of the most common categories of interventions and examples of each (e.g., prolonged exposure therapy, cognitive processing therapy, emotional freedom techniques, reprocessing therapy). Data on d-cycloserine, nabotulinumtoxin A, and methylenedioxymethamphetamine will also be elucidated.

Download PDF

Book Review: Clinician's guide to post-traumatic stress disorder

PharmD, BCPP

DOI: 10.9740/mhc.n130768

CPNP members maintain a suggested reading list to provide information on peer recommended resources and convenient access to the highest quality neuropsychopharmacology publications. A reminder that if you shop with CPNP, by following the links below to Amazon, a small commission will be paid to CPNP which helps to financially support our mission to improve the minds and lives of individuals with psychiatric and/or neurologic disorders.

You can help grow this list of resources by suggesting a book.

Book: Clinician's Guide to Post-Traumatic Stress Disorder

From the publisher

Clinician's Guide to Posttraumatic Stress Disorder

Download PDF

PTSD related sleep disorders to be presented by Dr. Murray Raskind at the 2013 Annual Meeting

DOI: 10.9740/mhc.n132258

Dr. Murray Raskind, Director of the VA Northwest Network Mental Illness Research Education and Clinical Center, has focused much of his career on PTSD and brain noradrenergic abnormalities. He has been extensively involved in studies related to prazosin and treatment of PTSD symptoms. Dr. Raskind will share his knowledge of prazosin's effects on PTSD. His presentation will review prazosin's effect on CNS noradrenergic activity and how it has affected PTSD in clinical situations.

This Q & A article will provide a glimpse into the session attendees will enjoy at the CPNP Annual Meeting. Register now to take advantage

Download PDF

An exciting new year ahead!

DOI: 10.9740/mhc.n132185

Happy New Year to all!!

Now that we seemed have dodged the “fiscal cliff” – at least for a while, we can return our attention to other important tasks and issues. In thinking about “cliffs”, I always picture looking downward and seeing a dangerous fall. In contrast, there is a great deal on the horizon for the coming year that has many of us looking upward and forward. I wanted to take this opportunity to emphasize some of the exciting things that are coming up in the next few months within CPNP.

First, there is continuing activity in the push

Download PDF

CPNP Announcements

DOI: 10.9740/mhc.n132022

INITIAL CPNP FOUNDATION PROJECT SUCCESSFUL

Glen L. Stimmel, PharmD, BCPP

CPNP Foundation Board Member and Project Lead

The first project initiated by the CPNP Foundation has been successfully completed and it will lead us to further efforts to ensure that individuals with mental health conditions will have access to a pharmacist with the knowledge and skills to improve their care (see full survey report).

The overall goal of this initiative was to inquire if community pharmacists consistently treat patients with understanding and respect, provide effective counseling about their psychiatric medication, and ask if patients encounter any bias, stereotyping,

Download PDF

Surviving post traumatic stress disorder

Post traumatic stress disorder toolbox

PTSD PHARMACOTHERAPY

PTSD RATING SCALES

Practice site interview with Jennifer Kelly

What drew you to psychiatric pharmacy?

Describe your role as a psychiatric pharmacist. What did you need to change after starting your practice to make it work the way it does now?

A review of atypical antipsychotics and their utility in post-traumatic stress disorder

Pharmacy considerations in tobacco cessation for patients suffering from posttraumatic stress disorder

Prazosin treatment of nightmares related to post-traumatic stress disorder

The role of propranolol for post-exposure chemoprophylaxis of posttraumatic stress disorder and acute stress disorder

The role of prepulse inhibition in medication management of PTSD: A case report

Established and emerging PTSD treatments

Book Review: Clinician's guide to post-traumatic stress disorder

From the publisher

PTSD related sleep disorders to be presented by Dr. Murray Raskind at the 2013 Annual Meeting

An exciting new year ahead!

CPNP Announcements

INITIAL CPNP FOUNDATION PROJECT SUCCESSFUL

Pharmacist administration of long-acting injectable medications for substance use disorders: A scoping review

Transitions of care: Assessment of adherence to long-acting injectable antipsychotic treatment following discharge from inpatient psychiatry

Use of atypical antipsychotics in individuals with anorexia nervosa

Potential changes impacting psychiatric pharmacy by 2030

A model for timely dissemination of critical information: Clozapine toxicity during the COVID pandemic