Category Archives: Psychiatric Medications

Birth trauma? Maternal PTSD?


The August 5, 2008 Wall Street Journal ran a short article on a new postpartum illness akin to PTSD. The author, Rachel Zimmerman, reports that though”PTSD is commonly associated  with combat veterans and victims of violent crimes, but medical experts say it also can be brought on by a very painful or complicated labor and delivery in which a woman believes she or her baby might die.”

While Postpartum depression has received more attention of late (the paper reports the NIH statisticof 15% of mothers affected), there is some speculation that as many as 9% meet criteria for PTSD, and most of these who have given birth to children with serious and immediately life-threatening health issues. These find themselves re-experiencing the traumatic birth, avoidance of places that bring these flashbacks up, and persistent symptoms of increases arousal and hyper-vigilance. Per the article more states are now trying to screen and/or education new moms to this problem. NJ requires all mothers to be screened for depression prior to discharge.

As an adoptive father, I recall well the anxiety and hyper-vigilance of bringing home our first child when he was 4 days old. I didn’t sleep for days, or so it seemed. I worried about his breathing. I felt like I had lost my independence for the rest of my life (I was the stay-at-home dad at the time). It was an overwhelming time for us. And we were healthy, he was healthy, and we were not recovering from the trauma of even a normal birth.

So, I can well assume that if you add all of the normal birth trauma plus medical crises, helplessness, etc. that these experiences can result in symptoms like PTSD. I would suspect, however, that for most people these symptoms would dissipate quickly, especially if the medical crises passes in a day or two. So, we should be careful not to overreact to transitory symptoms and medicate everyone with a struggle. If it is PTSD, then the symptoms should persist for more than a month.

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Filed under Anxiety, Depression, Post-Traumatic Stress Disorder, Psychiatric Medications, Psychology

Science Monday: Easing the suffering in schizophrenia


While few outpatient, private practice therapists deal much with those diagnosed with schizophrenia, there are things therapists can do to ease the suffering of both client and family. Kim Mueser, a professor at Dartmouth Medical School has published a number of helpful research and popular writings designed to increase social and cognitive functioning and decrease family distress in people with schizophrenia. Click here for an Amazon.com list of his writings. His Complete Family Guide (#1 on the list) is probably the best though several other texts may be just as useful depending on the reader’s focus. And while medications are important in the treatment of schizophrenia, it is quite clear that when families and client learn to minimize family distress and conflict, they also reduce active psychotic episodes

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There are a number of interesting research angles on the pathways of Schizophrenia. One such hypothesis is that the croticostriatal loops do not work correctly in such patients. In lay terms this means that information doesn’t flow normally from the frontal lobe of the brain to some of the mid-brain structures and then back again. This seems to be part of the cause of apathy and lack of volition and/or planning. One wonders whether the longer time it takes for information to flow properly in order to make a decision or interpretation increases the likelihood of making random assumptions about the world. I know that when my children get stuck in a math problem, they are more likely to begin wild guessing to complete the task.  

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Filed under conflicts, counseling science, counseling skills, Psychiatric Medications, Psychology

Science Monday: New Treatment for Mania?


The Harvard Mental Health Letter (v. 24:8, Feb. 2008) has a short blurb about a new medication being researched for the treatment of active mania.

Tamoxifen. Yes, the drug best known for treating and inhibiting the growth of estrogen sensitive breast cancers. Apparently it also inhibits an enzyme (protein kinase C or PKC) which may contribute to mania. The study lasted only 3 weeks and on a tiny sample of people (both males and females). But, there are positive signs that it stops active bipolar symptoms. 63% of those taking the drug improved, many within five days. Only 13% of those taking a placebo improved.

Side effects include hot flashes, increased risks for stroke and blood clots (known from its study in breast cancer patients). We will have to wait to see if it is useful just in bringing mania under control or also in long-term maintenance. Actually, we’ll have to wait a long time to see if it is ever used at all with manic individuals.

I do wonder about the back-story. How did this drug get targeted as a possibility. Was it in the lab or did doctors report that their actively manic breast cancer patients seemed to get better. That is how many of these discoveries get made. Viagra, for example, was first used to reduce hypertension. Turns out it was not particularly good at doing that. But, the men in the studies reported some other surprising and very desirable side effects.  Oh, if you can believe wikipedia, it also helps reduce plant wilting in cut flowers. Sorry, couldn’t help but add that little factoid.  

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Filed under counseling science, Psychiatric Medications

Miracle cure for addiction?


60 minutes ran a piece last Sunday about a new drug treatment for certain addictions. Three drugs have been combined and called, Prometa, and are being touted for their efficacy with alcoholism, cocaine and meth.

Always be suspicious of folks hawking treatments that just can’t wait until the research is done because their treatment is so fantastic and a miracle cure–especially if the guy doing the hawking is a former junk bond salesman. Wikipedia includes a quote from the show I saw Sunday night:

Prometa is “being promoted by Terren Peizer, a former junk bond salesman whose business is business, not medicine. He skipped the usual medical research and government approvals to rush Prometa to market. Why the shortcuts? Peizer, who stands to make millions, says there’s no way he can sit on Prometa when he believes it’s the miracle treatment that millions are dying for.”

Check out this newspaper article for a more balanced view: http://www.thenewstribune.com/news/local/story/200936.html

Also Wikipedia reminds us what a controlled trial consists of: http://en.wikipedia.org/wiki/Prometa

There may well be something valuable for meth addicts here. But, lets do the research first before hawking to those most vulnerable to false hopes.

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Filed under Psychiatric Medications

Science Monday: Meds for kids and the counselor’s role


Recently read a NY Times article on the issue of giving children multiple psychiatric medications to manage mood, behavior, and concentration. You can read the article here. The article states that 1.6 million children (280,000 under the age of 10) were given multiple psychiatric meds last year. There is a little graphic that lists the number of people (ages 0 to 19) taking each class of medication in 2005 (with the percentage in parenthesis of those taking that class who ALSO take another class of psychiatric medication):

Stimulants

3,600,000

28%
Anticonvulsants

830,000

62%
Antidepressants

1,980,000

56%
Antipsychotics

540,000

86%
Anxiolytics

475,000

36%
Sleeping aids

190,000

45%

As you read the article and the parents’ stories of trying and suffering with and without the medications, you have to feel their pain. No parent wants to have to put their kids on medications but some feel they will lose their children if they do not. Continue reading

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Filed under biblical counseling, christian psychology, counseling science, Psychiatric Medications