PTSD Treatment Literature: Old and Fresh Approaches

Steven G. Koven
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Abstract

PTSD is a brain disorder that exacts large costs to individuals, families, and society in general. Direct monetary costs that are associated with PTSD symptoms of U.S. military veterans have been increasing steadily. Less direct indicators of PTSD costs to society include the externalities of lower economic productivity, family dysfunction, PTSD comorbidities, drug, and alcohol addictions. Veteran awards linked to PTSD are conferred with the tacit assumption that “cures” for PTSD do not exist. Veterans Administration policies adopt the pharmacological strategy of dispensing drugs that have not been approved for PTSD usage by the U.S. Food and Drug Administration. Despite the existing government policies regarding PTSD treatment of veterans, emerging literature indicates that innovative PTSD treatments are available, that they deserve further scrutiny, and that they may present better alternatives to status quo options. In particular, noteworthy research regarding the use of stellate ganglion block or SGB appears to be promising. In addition to SGB research, literature has shown that approaches to PTSD such as physical activity, meditation, wilderness therapy, and self-help hold promise as treatments. Two treatment drugs, the selective serotonin reuptake inhibitor (SSRI) medications sertraline (Zoloft) and paroxetine (Paxil) have been approved by the Food and Drug Administration (FDA) for relieving symptom of PTSD. However, the U.S. Food and Drug Administration warned that these drugs are accompanied with the risk of suicidal thoughts, hostility, and agitation. Equally, if not more troubling, the literature indicates that physicians commonly prescribe benzodiazepine tranquilizers (such as Valium and Xanax) to veterans even though Veterans Administration guidelines advise against their use for PTSD. The Veterans Administration dispensed these drugs to almost a third of veterans being treated for PTSD even though they recognized the need to exercise caution in their use. A review of the literature indicates that PTSD is a growing societal problem; that existing treatments show signs of being problematic, and that innovative treatment strategies deserve greater attention.
创伤后应激障碍治疗文献:新旧方法
创伤后应激障碍是一种脑部疾病,对个人、家庭和社会造成巨大损失。与美国退伍军人创伤后应激障碍症状相关的直接货币成本一直在稳步上升。创伤后应激障碍对社会造成的损失的不太直接的指标包括经济生产率降低、家庭功能障碍、创伤后应激障碍合并症、药物和酒精成瘾等外部性。与创伤后应激障碍有关的退伍军人奖励是在默认的假设下授予的,即创伤后应激障碍的“治疗方法”不存在。退伍军人管理局的政策采用药理学策略,分配未被美国食品和药物管理局批准用于PTSD的药物。尽管现有的政府政策对退伍军人的创伤后应激障碍的治疗,新出现的文献表明,创新的创伤后应激障碍治疗是可行的,他们值得进一步的审查,他们可能提供更好的替代现状的选择。特别是,关于使用星状神经节阻滞或SGB的值得注意的研究似乎很有希望。除了SGB研究,文献表明,治疗创伤后应激障碍的方法,如体育活动、冥想、野外治疗和自助,都有希望成为治疗方法。两种治疗药物,选择性血清素再摄取抑制剂(SSRI)药物舍曲林(Zoloft)和帕罗西汀(Paxil)已被美国食品和药物管理局(FDA)批准用于缓解PTSD症状。然而,美国食品和药物管理局警告说,这些药物伴随着自杀念头、敌意和躁动的风险。同样,如果不是更麻烦的话,文献表明医生通常会给退伍军人开苯二氮平类镇静剂(如安定和阿普唑仑),尽管退伍军人管理局的指导方针建议不要将其用于治疗创伤后应激障碍。退伍军人管理局给将近三分之一接受创伤后应激障碍治疗的退伍军人配发了这些药物,尽管他们认识到在使用这些药物时需要谨慎。文献综述表明,PTSD是一个日益严重的社会问题;现有的治疗方法显示出问题的迹象,创新的治疗策略值得更多的关注。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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