TRAUMATIZED TROOPS How to treat combat-related PTSD
Thousands of U.S. troops are seeking mental health care after being deployed in Iraq. Among 222,000 Army and Marine Iraq veterans, 35% sought treatment in the year after returning home—many for posttraumatic stress disorder (PTSD).In a related article, we discuss the diagnosis and treatment of military sexual trauma, a form of PTSD.
The greater the intensity of an Iraq/Afghanistan veteran’s combat experiences (“firefights”), the more likely the soldier is to develop PTSD.Traumatic brain injury: Choosing medications for neurobehavioral symptoms”). Sexual trauma also may cause or exacerbate PTSD.Military sexual trauma: How to identify and treat a unique form of PTSD”).
3 domains of posttraumatic stress disorder symptoms
Avoidance and numbing
FigurePTSD screen for war veterans
Source: U.S. Department of Veterans Affairs. Afghan & Iraq Post-Deployment Screen, Attachment B. Screening for risk factors associated with development of post-traumatic stress disorder (PTSD)
Psychotherapy is the cornerstone of PTSD treatment; skilled therapists may achieve greater efficacy and more-durable results than medications do. Evidence strongly supports cognitive behavioral therapy—including exposure therapy, anxiety management, and cognitive therapy.U.S. troops returning home: Are you prepared? Current Psychiatry 2006;5(1):12-22.
- U.S. Department of Veterans Affairs. Seamless Transition Home. www.seamlesstransition.va.gov. Accessed March 13, 2006.
- American Psychiatric Association. Practice guideline for the treatment of acute stress disorder and posttraumatic stress disorder. www.psych.org/psych_pract/treatg/pg/PTSD-PG-PartsA-B-C-New.pdf.
Drug brand names
- Carbamazepine • Carbatrol
- Fluoxetine • Prozac
- Lamotrigine • Lamictal
- Lithium • Lithobid, others
- Mirtazapine • Remeron
- Paroxetine • Paxil
- Prazosin • Minipress
- Sertraline • Zoloft
- Trazodone • Desyrel
- Temazepam • Restoril
- Valproic acid • Divalproex, others
- Venlafaxine • Effexor
- Zolpidem • Ambien
The authors report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products. Drs. Lineberry, Bostwick, and Rundell served on active duty in the U.S. Air Force. Dr. Ramaswamy is staff psychiatrist, Omaha Veterans Administration. and Director of Psychopharmacology Research, Creighton University, Omaha, NE.
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