What is the gold standard diagnostic tool for PTSD
CAPS-5
Intrusion symptoms of PTSD
Recurrent, intrusive distressing memories of the trauma
Avoidance symptoms of PTSD
Avoidance of conversations, thoughts, people, places, or activities that are reminders of the event
Persistent negative alterations in thinking and mood symptoms of PTSD
Anhedonia
Negative mood state
Estrangement from others
Hyperarousal symptoms of PTSD
Decreased concentration
Easily startled
Hypervigilance
Insomnia
Dissociative symptoms of PTSD
Depersonalization or derealization
How long should therapy be maintained for PTSD
At least ONE year
How long should SSRI treatment for PTSD be treated for
8-12 weeks
What augmentation agent is used for sleep difficulties/nightmares
Prazosin
What augmentation agent is used for anger
Lamotrigine (anticonvulsants)
What augmentation agent is used for intrusive thoughts and hypervigilance
Risperidone and quetiapine (antipsychotics)
Which SSRI is FDA approved for long-term management of PTSD
Sertraline
Which two TCAs can be used in the treatment of PTSD
Amitriptyline
Imipramine (Tofranil)
Which agent used for PTSD is associated with QT prolongation
Mirtazapine
If psychotic symptoms are part of the PTSD how should a pt be treated
SSRIs
If psychotic symptoms are comorbid with PTSD how should a pt be treated
Risperidone (SGA)
OCD is characterized by what two things
Intrusive obsessive thoughts
Compulsive ritualistic behaviors
What treatment should be used for mild OCD
CBT alone
What treatment should be used for severe OCD
SSRI +/- CBT
Obsessions associated with OCD
Contamination, sexual, religious, aggression, lack of self-control, doubt/completeness, etc.
Compulsion associated with OCD
Hand washing, cleaning rituals, avoiding situations, asking forgiveness, avoiding being around others
If a pt with OCD is unsuccessful with an SSRI, another SSRI should be tried before augmenting therapy? T/F
True
How many adequate trials with anti-depressant must be completed before augmenting with another drug
Three
One trial must have been with clomipramine
What is the first line therapy for children with OCD
ERP
Which SSRI is not altered in patients with significant renal impairment
Sertraline
Typical antipsychotics are recommended for OCD
False- Use aripiprazole, risperidone, or haloperidol
Second line therapy for OCD
SSRIs
Antipsychotics