Post Traumatic Stress Disorder ( Ptsd ) - 928 Words

PHM302: Neuropsychiatry Evidence-Based Clinical Question Report Submitted by: Ryan Co Student #: 999388522 CASE JD is a 30-year-old male diagnosed with post-traumatic stress disorder (PTSD). He was involved in active combat during his 10 year career with the military and he is haunted by incidents that replay in his mind. He finds that scenes from battle run through his mind and disrupt his day-to-day functioning. He finds himself avoiding socializing with his military buddies, as this frequently triggers his PTSD. JD has been on several antidepressants with limited success and is not currently taking any medications. He is feeling hopeless and he has gone to see his psychiatrist for help. His†¦show more content†¦SEARCH METHOD A PubMed search was used with the terms â€Å"ketamine† and â€Å"chronic PTSD† in order to find studies relating to the topic. SELECTION OF LITERATURE The article â€Å"Efficacy of Intravenous Ketamine for Treatment of Chronic Posttraumatic Stress Disorder† was selected out of all the papers found. The patient fits the inclusion criteria for the trial and the purpose of the trial answers the clinician’s question. ANALYSIS OF LITERATURE The trial was performed to compare the efficacy of ketamine against anxiolytic medications in patients with chronic PTSD. The study was a randomized, double-blind crossover trial – patients were around 25-45 years of age and suffer from chronic PTSD for years with moderate to severe symptoms. Some participants also previously received antidepressants with partial or no response. Trial results showed that 24 hours after the ketamine infusion, the patient’s IES-R (impact of event scale – revised) score was significantly improved compared to when patients were on midazolam. (mean difference = 12.7, P = 0.02) In addition, patients who were on ketamine first retained symptom reduction when switched over to midazolam. Secondary outcomes studied looked at the effects of the medications on the patient’s CAPS and QIDS-SR scores, but these did not differ significantly. The study also looked at the effects of ketamine on depression in this population and showed that it was