pharmacologic agents for PTSD - med tx is focused on diminishing intrusive
thoughts, hyperarousal, and avoidance, with some success and mixed
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PTSD frequent comorbidity - depressive disorder, anxiety disorders, and
behavioral problems associated with ______________
sertraline and paroxetine - that __________and ______________ are approved by
the Food and Drug Administration (FDA) in the treatment of PTSD in adults, there
is scant evidence to support its use for the core symptoms of PTSD in youth
Risperidone and aripiprazole - FDA approval for use in children and adolescents
with aggression, severe behavioral dyscontrol, and severe psychiatric disorders
Antiadrenergic agents - treat dysregulation of the noradrenergic system in adults
and youth with PTSD
clonidine and guanfacine - Alpha2-agonists examples
Alpha2 agonists - decrease norepinephrine release, such as, are
propranolol - centrally acting β-antagonists example
prazosin - α-1-antagonists example
propranolol use - hypothesized to improve hyperarousal and intrusive thoughts
through attenuation of norepinephrine postsynaptically
prazosin use - nightmares associated with trauma
Modify PTSD sx - Off-label medications including antidepressants, atypical
antipsychotics, adrenergic modulators/sympatholytics, and anticonvulsants/mood
stabilizers
clonidine and propanolol - nightmares and exaggerated startle response: some
evidence in adults, but children case report onlyguanfacine and clonidine - __________ may reduce nightmares in children with
PTSD and ____________may diminish symptoms of reenactment of traumatic
events in children
Mood-stabilizing agents - divalproex, carbamazepine, topiramate, and gabapentin
have been utilized for adults with PTSD with modest improvement; some
clonidine with dosage ranges of 0.05 to 0.1 mg twice daily - may provide some
relief for the symptoms of hyperarousal, impulsivity, and agitation in young
children with PTSD; in children some evidence
benzodiazepines - no controlled trials supporting use in children
Trauma-Focused CBT - 10-16 treatment sessions, including 9 components
itemized in the acronym PRACTICE
PRACTICE elements - Psychoeducation on typical reactions to PTSD.
Parenting skills- praise, time-out, reinforcement
Relaxation- muscle, breathing, cognitive tech
Affective Expression and Modulation- ID feelings
Cognitive Coping and Processing Cognitive Triangle
Trauma Narrative:developed over time by child,
In Vivo Exposure and Mastery of Trauma Reminders- how to deal with reminders
Conjoint Child-Parent Sessions- this component may involve several sessions in
which the child and parent share their understanding
Enhancing future safety-family changes
EMDR - exposure and cognitive reprocessing interventions are paired with
directed eye movements, alternating tones or tapping
CBITS - Cognitive Behavioral Interventions for Trauma in Schools
CBITS description - intervention that administers treatment in the school setting
for children who screen positive for PTSD and whose parents agree to treatment in
school. [Show Less]