Posttraumatic Stress Disorder

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Overview

Most traumatic events do not result in PTSD, however community practitioners may have seen an increasing number of patients with PTSD over the last several years due to the Iraq and Afghanistan wars, making understanding and awareness of this illness imperative. PTSD is often a chronic disorder linked with suicidal behaviors and high rates of coexisting conditions. While all classes of psychoactive medications have been studied, the largest body of evidence supports the use of selective serotonin reuptake inhibitors (SSRIs); sertraline and paroxetine are FDA approved for the treatment of PTSD. Non-SSRI antidepressants may be considered for patients who do not respond to SSRIs. Combinations of medications may be needed to adequately control symptoms. Anticonvulsants, antipsychotics, and adrenergic agents may be useful as add-on agents depending on which targeted symptoms are most prevalent in an individual.

This issue reviews all aspects of PTSD treatment including psychotherapy, targeting symptom clusters with medications, prevention/treatment of coexisting conditions, prevention of relapse, medication side effects and interactions, and considerations for an improved quality of life.

Publication Date: Oct-1-10
Expiration Date: Oct-1-13
CE Credit: 1.5 (.15 CEU)
Type of activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.

Authors

Christine Johnston, Pharm.D., Mental Health Clinical Pharmacist, Department of Veterans Affairs Northern California Health Care System.

Disclosure Statement

Dr. Johnston reports no financial or personal relationship with any commercial interest producing, marketing, reselling, or distributing a product or service that appears in this issue.

Guest Editorial Advisor

Julie A. Dopheide, Pharm.D., BCPP

Editorial and Review Board

Editor and CE Administrator Terry M. Baker, PharmD Associate Editor and CE Coordinator Tracy Farnen, PharmD Associate Editors James Chan, PharmD, PhD Pharmacy Quality and Outcomes Coordinator Kaiser Permanente Oakland, CA Associate Clinical Professor School of Pharmacy University of California San Francisco San Francisco, CA Ron Finley, RPh Lecturer Department of Clinical Pharmacy University of California San Francisco San Francisco, CA Associate Member of the UCSF Memory and Aging Center Alzheimer's Research Center Consultant Pharmacist to the Institute on Aging-On Lok Senior Health Institute on Aging Alzheimer's Day Care Center Angie S. Graham, PharmD Drug Information Coordinator Stanford Hospital and Clinics Stanford University Medical Center Stanford, CA Julio R. Lopez, PharmD, FCSHP Chief of Pharmacy Service VA Northern California Health Care System Adjunct Clinical Professor College of Pharmacy Touro University Vallejo, CA Assistant Clinical Professor School of Pharmacy University of California, San Francisco San Francisco, CA

Adjunct Professor Thomas J. Long School of Pharmacy University of the Pacific Stockton, CA Visiting Associate Professor and Lecturer Nursing School Samuel Merritt University Oakland, CA Pamela Mausner, MD Joshua J. Neumiller, PharmD, CDE, CGP, FASCP Assistant Professor Department of Pharmacotherapy College of Pharmacy Washington State University And Elder Services of Spokane Spokane, WA Candy Tsourounis, PharmD Professor of Clinical Pharmacy Medication Outcomes Center Department of Clinical Pharmacy School of Pharmacy University of California, San Francisco San Francisco, CA Senior Editorial Advisor Gerard Hatheway, PharmD, PhD Editorial Advisors Jocelyn Chan, PharmD Belinda M. Danielson, RPh Christopher M. DeSoto, PharmD Cynthia Chan Huang, PharmD, MBA Fred Plageman, PharmD Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners Emily K. Meuleman, RN, C, MS

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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Target Audience

This accredited program is targeted to pharmacists and nurses.

Exam and Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Educational Goals and Objectives

At the conclusion of this program, participants will be able to:

1. Describe the clinical presentation of posttraumatic stress disorder, the diagnostic criteria, and the clinical course of disorder.
2. Explain the limitations of the evidence in support of pharmacologic treatment strategies in order to best counsel patients.
3. Identify drug and non-drug treatment options for the patient with PTSD. Individualize treatment based on guideline recommendations, individual patient presentation, predominant symptom clusters, presence of coexisting disorders, and potential for side effects.