PTSD GL

Question 1

1st line PTSD

Answer 1

sertraline
paroxetine
venlafaxine
fluoxetine (replace with escitalopram for GAD list)

Question 2

2nd Line PTSD

Answer 2

Fluvoxamine
Mirtazapine
Moclobemide
Phenelzine
Adj Risp, Olanz
Luv, Mirth, ROMP

Question 3

3rd line PTSD

Answer 3

amitryptaline
imipramine
escitalopram
adj: carbamazepine, gabapentine, lamotrigine,valproate, tiagabine, topiramate, quetiapine, conidine, trazodone, buspirone, buproprione, prazosin, citalopram, fluphenazine, naltrexone.

Question 4

NR in PTSD

Answer 4

desipramine
cyproheptadine
mono:
alprazolam
clonazepam
olanzapine

CODAC

Question 5

PTSD notes from Dr.Ianni

Answer 5

effect size of therapy (1.4) larger than meds (0.4)
chochrane: not enough evidence to routinely combine?

CBT > EMDR
EMDR=fluoxetine butEMDR less relapse after6 months

Some positive studies for beta blockers reducing physiologic response to reminders

PTSD response rate to meds: 60%
Remission: 30%
Treat for 1-2 yrs.
Maintenance meds decreased relapse from 50% to 25% around

Question 6

prazocin for PTSD?

Answer 6

Level 1 recommendation by American Association of Sleep. treats adrenergic dysfunction in REM. watch for hypotention
it’s 3rd line (in general) as is clonidine and naltrexone and many other things

Question 7

mirtazapine is 2nd line in?

3rd line in?

Answer 7

2nd: PTSD, panic, OCD

3rd in: SAD and GAD