Psychopharmacology Wilkes n552
Dissociation - ANSdefense mechanism that protects a person from overwhelming anxiety by
emotionally separating
Depersonalization - ANSunreality or detachment from one's body, thoughts, feeling and actions
Derealization: - ANSunreality or detachment from one's surroundings
Body dysmorphic disorder - ANSPreoccupation with one or more perceived defects or flaws in
physical appearance
Spends significant time trying to correct perceived flaw with makeup, dermatological procedures
or plastic surgery
Txt: SSRI and or CBT
Hoarding disorder - ANSPersistent difficulty discarding possessions regardless of actual value
Results in accumulation of possessions that compromise living space or inability to function
Patients who remain resistant to psychosocial interventions, or who lack access to them, can be
provided a trial of a serotonin-reuptake inhibitor, particularly if they have a comorbid affective or
anxiety disorder;
Trichotillomania - ANSRecurrent pulling out one's hair despite repeated attempts to stop.
Txt: SSRI, Clomipramine; atypical antipsychotics, lithium
Excoriation Disorder - ANSRecurrent skin picking that results in lesions despite attempts to stop.
Cognitive-behavioral therapies may be beneficial for patients accepting psychiatric referral
Txt: SSRIS, antipsychotics, anxiolytics
Posttraumatic Stress Disorder (PTSD) - ANSRe-experiencing of an extremely traumatic event
accompanied by symptoms of increased arousal and avoidance of stimuli associate with the
trauma.
PTSD treatment - ANS1st line: SSRIS (Zoloft, Celexa) or SNRIS (Venlafaxine)
FDA approved meds: Sertraline (Zoloft) and Paroxetine (Paxil)
, Alpha-1 agonist (Prazosin)= targets flashbacks; nightmares and hypervigilance
Psychotherapy (CBC- exposure therapy etc.)
• PTSD - ANSis a potentially debilitating disorder that can occurs after a traumatic event.
Commonly described in war veterans •
Can also present in those experiencing non- war events
PTSD - ANS• Clinical syndrome is characterized by 4 clusters of symptoms:
Re-experiencing the trauma (with intrusive thoughts, nightmares, or flashbacks) •
Emotional numbing •
Avoidance behaviors •
Persistent hyperarousal and mood symptoms (depression, irritability, anger)
Difference between Acute Stress Disorder and PTSD: - ANSWhen an individual experiences a
traumatic event and displays anxiety symptoms that lasts for only a short duration, the condition
is opposed to PTSD.
For the diagnosed as ASD as condition to be diagnosed as ASD, symptoms must occur within
one month of trauma and last for not more than one month. The symptoms of ASD, however,
are similar to those observed in PTSD.
Comorbidity Assessment: PTSD - ANSIt is important to look for:
Substance use disorders (avoid benzodiazepines)
Depression
Bipolar disorder
Psychosis
Nonpharmacologic Treatment in PTSD: - ANSСВТ
Supportive Group Therapy Relaxation therapies
Eye Movement Desensitization and Reprocessing (EMDR)
***Benzodiazepines may interfere with the psychological processes needed to benefit from СВТ
Dissociation - ANSdefense mechanism that protects a person from overwhelming anxiety by
emotionally separating
Depersonalization - ANSunreality or detachment from one's body, thoughts, feeling and actions
Derealization: - ANSunreality or detachment from one's surroundings
Body dysmorphic disorder - ANSPreoccupation with one or more perceived defects or flaws in
physical appearance
Spends significant time trying to correct perceived flaw with makeup, dermatological procedures
or plastic surgery
Txt: SSRI and or CBT
Hoarding disorder - ANSPersistent difficulty discarding possessions regardless of actual value
Results in accumulation of possessions that compromise living space or inability to function
Patients who remain resistant to psychosocial interventions, or who lack access to them, can be
provided a trial of a serotonin-reuptake inhibitor, particularly if they have a comorbid affective or
anxiety disorder;
Trichotillomania - ANSRecurrent pulling out one's hair despite repeated attempts to stop.
Txt: SSRI, Clomipramine; atypical antipsychotics, lithium
Excoriation Disorder - ANSRecurrent skin picking that results in lesions despite attempts to stop.
Cognitive-behavioral therapies may be beneficial for patients accepting psychiatric referral
Txt: SSRIS, antipsychotics, anxiolytics
Posttraumatic Stress Disorder (PTSD) - ANSRe-experiencing of an extremely traumatic event
accompanied by symptoms of increased arousal and avoidance of stimuli associate with the
trauma.
PTSD treatment - ANS1st line: SSRIS (Zoloft, Celexa) or SNRIS (Venlafaxine)
FDA approved meds: Sertraline (Zoloft) and Paroxetine (Paxil)
, Alpha-1 agonist (Prazosin)= targets flashbacks; nightmares and hypervigilance
Psychotherapy (CBC- exposure therapy etc.)
• PTSD - ANSis a potentially debilitating disorder that can occurs after a traumatic event.
Commonly described in war veterans •
Can also present in those experiencing non- war events
PTSD - ANS• Clinical syndrome is characterized by 4 clusters of symptoms:
Re-experiencing the trauma (with intrusive thoughts, nightmares, or flashbacks) •
Emotional numbing •
Avoidance behaviors •
Persistent hyperarousal and mood symptoms (depression, irritability, anger)
Difference between Acute Stress Disorder and PTSD: - ANSWhen an individual experiences a
traumatic event and displays anxiety symptoms that lasts for only a short duration, the condition
is opposed to PTSD.
For the diagnosed as ASD as condition to be diagnosed as ASD, symptoms must occur within
one month of trauma and last for not more than one month. The symptoms of ASD, however,
are similar to those observed in PTSD.
Comorbidity Assessment: PTSD - ANSIt is important to look for:
Substance use disorders (avoid benzodiazepines)
Depression
Bipolar disorder
Psychosis
Nonpharmacologic Treatment in PTSD: - ANSСВТ
Supportive Group Therapy Relaxation therapies
Eye Movement Desensitization and Reprocessing (EMDR)
***Benzodiazepines may interfere with the psychological processes needed to benefit from СВТ
