Schizophrenia and its related conditions are all too common among young adults and are prevalent in about 1% of the general population. This is a devastating disorder of thinking; if gone undetected and thus untreated it can lead to robbing an individual of his or her life's goals and aspirations as it develops. If unchecked, it can lead to either suicidal or violent behavior towards others because the affected individual may become plagued by increasing paranoia, bothersome auditory hallucinations commanding various actions, and a general withdrawal from reality. Lately some unfortunate cases of developing schizophrenia have made the news because of the tragic and deadly events they initiated. These have spurred controversial gun control debates and have brought mental illness to the forefront of these debates about government legislation nationally.
From our Public Safety blog:
Re-posted from the United States Department of Veterans Affairs: Clinician's Guide to Medications for PTSD
Posttraumatic Stress Disorder (PTSD) has biological, psychological, and social components. Medications can be used in treatment to address the biological basis for PTSD symptoms and co-morbid Axis I diagnoses. Medications may benefit psychological and social symptoms as well. While studies suggest that cognitive behavioral therapies such as prolonged exposure (PE) and cognitive processing therapy (CPT) have greater effects in improving PTSD symptoms than medications, some people may prefer medications or may benefit from receiving a medication in addition to psychotherapy.
Placebo-controlled double-blind randomized controlled trials are the gold standard for pharmacotherapy. Less strongly supported evidence includes open trials and case reports. It is important for the clinician to question the level of evidence supporting the medications prescribed in PTSD treatment. There are a variety of factors influencing prescribing, including marketing, patient preferences, and clinical custom, all of which can be inconsistent with the evidence base.
Currently, the evidence base is strongest for the selective serotonin reuptake inhibitors (SSRIs). The only two FDA approved medications for the treatment of PTSD are sertraline (Zoloft) and paroxetine (Paxil) (1, 2). All other medication uses are off label, though there are differing levels of evidence supporting their use. In addition to sertraline and paroxetine, there is strong evidence for the SSRI fluoxetine (Prozac) and for the serotonin norepinephrine reuptake inhibitor (SNRI) venlafaxine (Effexor) which are considered first-line treatments in the VA/DoD Clinical Practice Guideline for PTSD. There are a number of biological changes which have been associated with PTSD, and medications can be used to modify the resultant PTSD symptoms. Veterans whose PTSD symptoms have been present for many years pose a special challenge. Studies indicate they are more refractory to the beneficial effects of medications for PTSD symptoms (3).
What core PTSD symptoms are we trying to treat?
The three main PTSD symptom clusters are listed below:
- Re-experiencing. Examples include nightmares, unwanted thoughts of the traumatic events, and flashbacks.
- Avoidance. Examples include avoiding triggers for traumatic memories including places, conversations, or other reminders. The avoidance may generalize to other previously enjoyable activities.
- Hyperarousal. Examples include sleep problems, concentration problems, irritability, increased startle response, and hypervigilance.
February 28th will mark the sixth annual Rare Disease Day which is meant to raise awareness for rare diseases and improve access to treatment and medical representation for patients and their families. The first observance was on February 29th, 2008, and was chosen because it was a "rare day." In 2009, Rare Disease Day went global with participation from patient advocacy organizations in the United States, China, Australia, Taiwan, and Latin America. More than 60 countries and regions worldwide are now involved in planning awareness-raising activities.
Rare Disease Facts
- In the U.S., a rare disease typically affects a patient population estimated at fewer than 200,000
- There are more than 7,000 rare diseases affecting an estimated 30 million people in the U.S., and more than 300 million globally
- Almost 1 in 10 Americans is affected by a rare disease
- Approximately 80% of rare diseases are genetic
- The National Institutes of Health (NIH) estimates that 50% of the people affected by rare diseases are children
- While individual rare diseases have small patient populations, collectively the rare disease community is larger than the AIDS and Cancer communities combined
- Only 15% of rare diseases have organizations or foundations providing support or driving research
- An estimated 95% of all rare diseases do not have a single FDA approved drug treatment
The Global Genes Project
The Global Genes Project is a non-profit organization led by Team R.A.R.E and R.A.R.E. Project, and aims to raise awareness for people and families touched by rare and genetic diseases. What began as a grassroots movement has now expanded into 500 organizations worldwide.
Topics: awareness, Global health, patient education, General Medicine, genetic disease, genetic disorder, global genes project, national human genome research institute, National organization of rare disorders, rare disease day, Global Health Blog, medical, NIH, patient education
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