Jones & Bartlett Learning Medicine Blog

    Clinician's Guide to Medications for PTSD

    Posted by Jennifer Sharp on Jun 4, 2013 3:35:28 AM

    Re-posted from the United States Department of Veterans Affairs: Clinician's Guide to Medications for PTSD

    Overview

    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.
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    Topics: awareness, patient education, mental health, psychiatry, General Medicine, PTSD, Pyschiatry & Mental Health, veterans, posttraumatic stress disorders

    New Asthma Treatment May Help Patients Breathe a Bit Easier

    Posted by Jennifer Sharp on May 29, 2013 1:00:04 AM
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    Topics: pharma, medicine, patient education, primary care, allergy, Dupilumab, General Medicine, Sanofi, allergies, asthma, Global Health Blog, pharmaceuticals, Regeneron, Sally Wenzel, trial study

    New From JBL: The Jones & Bartlett Author's Corner

    Posted by Jennifer Sharp on May 17, 2013 12:00:46 PM

    Jones & Bartlett is pleased to announce the launch of  the Jones & Bartlett Learning Author’s Corner, a resource for prospective and new authors. The site contains the most up-to-date, general information on art development, manuscript submission, the publishing process, and editorial contacts. It also houses pertinent documents including: author information forms, marketing questionnaires, and proposal guidelines.

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    Topics: allied health, education, health, Author, Contest, Jones & Bartlett, medicine, oncology, patient education, primary care, General Medicine, Authors, Prescribing, publication, Pyschiatry & Mental Health, Cardiology, Global Health Blog, Hospital Medicine Blog, Infectious Disease, text

    National Autism Awareness Month

    Posted by Jennifer Sharp on Apr 14, 2013 12:44:28 PM

    April marks the annual observance of National Autism Awareness Month.

    Autism is a complex developmental disability that typically appears during the first three years of life and affects a person’s ability to communicate and interact with others. Autism is defined by a certain set of behaviors and is a "spectrum disorder" that affects individuals differently and to varying degrees. There is no known single cause of autism, but increased awareness and funding can help families today.

    In March 2012, the Centers for Disease Control and Prevention issued their ADDM autism prevalence report. The report concluded that the prevalence of autism had risen to 1 in every 88 births in the United States and almost 1 in 54 boys.  The spotlight shown on autism as a result of the prevalence increase opens opportunities for the nation to consider how to serve these families facing a lifetime of supports for their children.

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    Topics: Centers for Disease Control, medicine, patient education, primary care, caregiver, Family Medicine, General Medicine, national autism month, spectrum disorder, autism, patient education

    Better Than Google: New Search Engine Helps Doctors Diagnose Rare Diseases

    Posted by Jennifer Sharp on Mar 20, 2013 11:48:51 AM

    Rare diseases are notoriously difficult to diagnose.  According to the FDA, one-third of people with a rare disease will wait one to five years before receiving a correct diagnosis. A new search engine created by researchers at the Technical University of Denmark, FindZebra, is aiming to change that.

    "Zebra" is a medical slang term for a surprising diagnosis. The term derives from the aphorism "When you hear hoofbeats behind you, don't expect to see a zebra", which was coined by a professor at the University of Maryland School of Medicine to describe unexpected diagnoses. This term is widely used in medical communities, and refers to diseases occurring in less than 1 in 2000 of the population.

    The FindZebra website states that it aims to "[address] the task of searching for relevant rare diseases given a query of patient data. The patient data is given as free text, which means that the queries do not have to use a controlled vocabulary or specific query language restrictions as in conventional diagnostic assistance systems. The patient data submitted as a query to the information retrieval (IR) system could consist of patient age, gender, demographic information, symptoms, evidence of diseases, test results, previous diagnoses, and other information that a clinician might find relevant in the differential diagnosis."

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    Topics: physicians, patient education, Diagnosis, findzebra, General Medicine, rare disease, Technical University of Denmark, zebras, Hospital Medicine Blog, hospital medicine, patient education, search engine for rare disease

    February 28th is Rare Disease Day

    Posted by Jennifer Sharp on Feb 20, 2013 5:08:18 PM

    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.

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    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

    October is Breast Cancer Awareness Month

    Posted by Jean Oneil on Oct 3, 2012 10:00:35 AM

    October is Breast Cancer Awareness Month, an annual campaign to increase awareness of the disease. While most people are aware of breast cancer, many forget to take the steps to have a plan to detect the disease in its early stages and encourage others to do the same.

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    Topics: oncology, patient education, Breast Cancer, Disease, Early Detection Plan, lung cancer, National Breast Cancer Foundation, Breast Cancer Awareness Month, breast exams, mammograms, patient education

    Celebrating NYU Cancer Institute’s New Research System

    Posted by admin on Sep 5, 2012 12:46:43 PM

    Re-posted from Yahoo News:

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    Topics: oncology, patient education, cardiothoracic surgery, Authors, metabolic disease, NanoString Technologies, nCounter Analysis System, NYU Langone Medical Center, NYU School of Medicine, Belluck & Fox, Cancer Institute, Cardiology, Dr. Harvey Pass, Infectious Disease, infectious disease, patient education

    Celebrate Men's Health This June

    Posted by Jean Oneil on Jun 4, 2012 10:36:35 AM

    Anchored by a Congressional health education program, each June, Men’s Health Month is celebrated across the country with screenings, health fairs, media appearances, and other health education and outreach activities.

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    Topics: patient education, Health care, cholesterol, Dr. David Gremillon, medical reference, men's health month, prostate cancer, PSA, wear blue, blood pressure, Men's Health Network, patient education

    Moustaches for Men's Health

    Posted by admin on Nov 4, 2011 1:18:58 PM

    With the help of the Prostate Cancer Foundation, LiveStrong and the Movember Foundation, November marks the 5th annual, Movember.  Movember is an annual, Global event that takes place each November, involving the growing of moustaches, also known as “Mos,” to help raise funds and awareness for prostate cancer and other cancers that affect men.

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    Topics: patient education, men's health, movember, prostate cancer, moustache, patient education

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