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 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A group of 24 Dutch World War II Resistance veterans with a documented traumatic war history and a (partially) positive diagnosis of current posttraumatic stress disorder (PTSD) was studied. This special group of war victims is characterised by chronicity, suffering from intractable posttraumatic complaints for decades. They were treated with fluvoxamine (Fevarin), a selective serotonin reuptake inhibitor with antidepressive and anxiolytic properties. The study was designed as an open-ended, outpatient pilot study, with a treatment period of 12 weeks. Results of clinical examination, and questionnaires investigating PTSD, depression, sleeping problems, anxiety, and vital exhaustion indicate that a significant number of the subjects improved with respect to their PTSD symptomatology, and their symptoms of anxiety and vital exhaustion. However, at the end of the study, quantitative improvement was modest. The results indicate that treatment with fluvoxamine may offer alleviation of chronic PTSD symptoms, in particular insomnia, nightmares, anxiety, intrusive recollections, guilt feelings and tiredness.
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PMID:Fluvoxamine treatment for chronic PTSD: a pilot study. 141 Jan 91

Three patients with a DSM-III-R diagnosis of posttraumatic stress disorder were successfully treated with buspirone in final maximum dosages ranging from 35-60 mg daily. The onset of clinical efficacy ranged from 5-29 days. Symptoms that improved included anxiety, insomnia, flashbacks, and depressed mood. Patients experienced no side effects. Serotonin partial agonist effects are a possible mechanism underlying buspirone's efficacy.
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PMID:Buspirone in the treatment of posttraumatic stress disorder. 192 17

In spite of the difficulties inherent in the study of traumatic stress in disaster victims, the benefit of obtaining more knowledge on the subject is potentially great, especially considering the numbers of individuals affected. Recent estimates of the frequency of world-wide traumatic events have determined that almost two million households annually experience damages and/or injuries from fire, floods, hurricanes, tornadoes, and earthquakes alone. The population that is at risk is expected to grow exponentially with our expanding technology, making it even more vital to acquire knowledge to help the growing number of future disaster victims. Additionally, disaster research can contribute to a better understanding of PTSD and human coping processes that can be generalized to more ordinary stress situations. In the meantime, survivors of major catastrophes who experience acute symptoms of PTSD such as insomnia, nightmares, and jumpiness should be observed for nonresolution of symptoms over time, especially if there is a premorbid history of psychopathology or character problems. Otherwise, survivors may benefit from reassurance that PTSD symptoms are common in the short-term postdisaster period and that they can usually be expected to dissipate with time.
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PMID:Post-traumatic stress disorder in disaster survivors. 207

The spectrum ranges from fearful concerns about illness to clinical anxiety disorders, such as phobias, panic attacks, generalized anxiety, post-traumatic stress disorder and adjustment disorder. Anxiety and fear are often associated with hospitalization, heart disease, insomnia, and somatopsychic syndromes. Determining the cause of the anxiety may help the physician plan the treatment approach. In selected cases, benzodiazepines are useful adjuncts to therapy.
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PMID:The spectrum of anxiety disorders in family practice. 368 77

Traumatized combat veterans frequently attempt to escape the chronic anxiety, insomnia and nightmares characteristic of post-traumatic stress disorder by self-medicating with alcohol and drugs. The elimination of alcohol and drugs through chemical-dependency treatment, therefore, might be expected to precipitate an exacerbation of stress symptoms and predispose veterans to new cycles of abuse. The relationship between combat and post-treatment substance abuse has not been subjected to empirical study. This paper examines treatment-completion and post-treatment abstinence rates (treatment efficacy) as a function of level of combat when combat veterans are provided trauma-oriented therapy concurrently with treatment for chemical dependency. The experimental results suggest that, under these conditions, treatment efficacy does not vary with level of combat. The absence of combat-level effects is explained in terms of the interactive dynamics of chemical-dependency and post-traumatic stress disorder.
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PMID:Efficacy of chemical dependency treatment as a function of combat in Vietnam. 380 32

Traumatic neurosis from Viet Nam combat or other sources includes many symptoms that can be effectively self-medicated with alcohol, at least initially. These symptoms include chronic anxiety and restlessness, insomnia, and recurrent frightening dreams. Repeated self-medication with alcohol results in tolerance and a need to increase the amount consumed. Attempts to decrease consumption or to abstain can lead to alcohol withdrawal symptoms similar to and exacerbating the initial symptoms of traumatic neurosis. Continuing alcohol use, with the establishment of a vicious circle, can follow. The authors present three case examples. They note that treatment of alcoholism under the conditions described requires specific attention to the underlying traumatic neurosis.
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PMID:Traumatic neurosis in the etiology of alcoholism: Viet Nam combat and other trauma. 741 1

A 10-week open-label trial of fluvoxamine was conducted for male Vietnam combat veterans with chronic PTSD. Subjects were excluded if they met full current criteria for panic disorder or agoraphobia, and lifetime criteria for psychosis, bipolar disorder, or organic mental syndrome. Repeated MANOVA was performed to determine change over time. Fluvoxamine was well tolerated; side effects were observed primarily early in treatment with headache, insomnia, sedation, and gastrointestinal distress being most frequent. Fluvoxamine was effective for treating the core intrusion, avoidance, and arousal symptoms of PTSD. Large treatment effects were seen by 4-6 weeks, and maintained at 10 weeks. The magnitude of change was greater than has been previously reported for antidepressant treatment of male Vietnam combat veterans with PTSD.
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PMID:Open trial of fluvoxamine treatment for combat-related posttraumatic stress disorder. 869 84

Beginning in 1990, the Department of Psychiatry. Tripler Army Medical Center developed a formal treatment program for post-traumatic stress disorder (PTSD). Between 1990 and 1996, 632 patients, the vast majority of whom suffered from combat-related PTSD, were treated. Historically, many PTSD patients were treated with benzodiazepines, often in high dosages. The risks attendant to benzodiazepine management of PTSD, coupled with poor clinical outcome, prompted the staff to explore treatment alternatives. This paper describes the role of pharmacotherapy in the management of PTSD. The medications described in this paper have other primary uses in clinical practice (e.g., hypertension, insomnia, seizure control, depression, and anxiety). Medications were selected for use based on the putative modes of action and the degree of symptom relief. The therapeutic rationale was to decrease hyperarousal and sleep disturbance to permit the patients to engage in other psychotherapeutic efforts.
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PMID:Pharmacological management of post-traumatic stress disorder: clinical summary of a five-year retrospective study, 1990-1995. 929 Feb 98

Cognitive arousal has been associated with disrupted sleep in individuals with insomnia and may be one mechanism underlying sleep disturbances in depression. We evaluated the relationship of sleep to bereavement-related intrusive thoughts and avoidance behaviors in 40 men and women with major depression consequent to bereavement. Mean subject age was 65 years, 25% of the same was male, and median time since loss was 7.4 months. Levels of intrusive thoughts and avoidance behaviors were similar to samples seeking treatment for stress response syndromes, including post-traumatic stress disorder. After controlling for the effects of age, time since loss, and depression severity, greater frequency of bereavement-related intrusive thoughts and avoidance behaviors was associated with longer sleep latency and lower delta sleep ratio (P values < .01). Intrusive thoughts and avoidance behaviors were not strongly related to gender, time since loss, depression severity, or subjective sleep quality. These results suggest that intrusive thoughts and avoidance behaviors affect sleep in bereavement-related depression and may therefore be related to the clinical course of depression.
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PMID:Intrusive thoughts and avoidance behaviors are associated with sleep disturbances in bereavement-related depression. 944 84

Intraoperative awakening and recall of specific events is a rare complication (0.2 to 1.3%) of surgery. The possibility of developing serious psychiatric complications, such as posttraumatic stress disorder (PTSD) makes the prevention and detection of intraoperative awareness a subject of special interest. We describe our experience with three patients in whom awareness was detected during emergency surgery under general anesthesia. We conducted two structured interviews with the patients three months after surgery in order to detect the possible development of psychiatric complications. One patient suffered insomnia and reexperience of the event during the first two weeks after surgery. Improvement was spontaneous. None of the patients suffered PTSD. Efforts to decrease the incidence of episodes of intraoperative awakening with specific recall must be based on clinical observation and exhaustive monitoring of the patient, including anesthetic gases, given that no ideal method of monitoring depth of anesthesia exists. Cases should be detected in the first few days after surgery by means of a specific test. Likewise, possible causes for the episode should be explained to the patient, who should be followed for six months so that early diagnosis of PTSD or other psychiatric complications can be made.
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PMID:[The incidence of intraoperative conciousness in emergency surgery and its possible relation to the post-traumatic stress syndrome. Presentation of three cases]. 961 29


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