Kuszmar, Thaddeus J; Short, Davis T; Barnes, Jennifer; Strehlow, Anja, (2000) Post-traumatic stress disorder: A primary care approach to diagnosis and management, Physician Assistant; November 1, Volume: 24, Number: 11, Page 21.
Post-traumatic stress disorder---cognitive and behavioral sequelae from a significant emotional event affects an estimated 1 percent to 14 percent of Americans. Post-traumatic stress disorder treatment options include individual, group, and pharmacologic therapy. Acute-phase post-traumatic stress disorder refers to post-traumatic stress disorder symptoms present for less than 3 months, while chronic post-traumatic stress disorder is defined as post-traumatic stress disorder symptoms present for 3 months or more. Delayed-onset post-traumatic stress disorder occurs at least 6 months after the offending traumatic event. With the high prevalence of Post-traumatic stress disorder in the general population, primary care and specialty clinicians are likely to encounter patients with symptoms directly and indirectly referable to post-traumatic stress disorder. The term post-Vietnam syndrome was used to describe post-traumatic stress disorder symptoms among Vietnam veterans.
Nearly 30 percent of post-traumatic stress disorder patients recover completely, 40 percent continue to suffer mild symptoms, 20 percent moderate symptoms, and 10% remain unchanged or worsen with treatment. Post-traumatic stress disorder symptoms-specially startle reflex, depression, irritability, and nightmares-often worsen with age. Post-traumatic stress disorder is treated with a combination of nondrug and drug therapy. Post-traumatic stress disorder pharmacotherapeutics include anxiolytics, anticonvulsants, and antidepressants. Acute post-traumatic stress disorder is sometimes managed by immediate treatment intervention.
The ideal outcome in Post-traumatic stress disorder treatment is permanent elimination of all Post-traumatic stress disorder symptoms, including avoidance, hyperarousal, and reexperiencing. Several anticonvulsants are also used in the treatment of Post-traumatic stress disorder. Carbamazepine (400 mg to 1600 mg/day) is also an anticonvulsant used in the treatment of Post-traumatic stress disorder. Imipramine (150 mg to 300 mg/day), another TCA, can also be used to treat panic disorders, social phobias, and avoidance behaviors.........
