Pharmacy, Health Sciences & Exercise Science

An Evaluation of the Appropriateness of Pharmacologic Therapy in the Treatment of PTSD: A Retrospective Medical Chart Review

Document Type

Oral Presentation

Location

Indianapolis, IN

Subject Area

Pharmacy, Health Sciences & Exercise Science

Start Date

10-4-2015 9:30 AM

End Date

10-4-2015 10:00 AM

Description

Background: Posttraumatic stress disorder (PTSD) is a diagnosis introduced in the DSM-III for a series of symptoms that can occur after a person experiences (directly or indirectly) a traumatic event. PTSD can cause significant impairment in psychological, social, and occupational functioning. Only sertraline and paroxetine have been FDA approved for treatment of PTSD. There are additional medications used off-label, but efficacy is variable. Further studies are warranted to provide evidence for the most appropriate and effective pharmacologic therapy.

Methods: This was a retrospective chart review of patients treated for PTSD (based on the ICD-9 code) between June 2009 and June 2014. Electronic medical records were examined to gather demographic data, PTSD symptoms, pharmacology treatment regimen, change in GAF score, and medication side effects.

Results: Fifty subjects were reviewed. Of those, thirty subjects had multiple GAF scores recorded. The median change in GAF was 0 (IQR: -2.25 - 5). When comparing SSRI monotherapy, combination therapy with a benzodiazepine and combination therapy without a benzodiazepine there was no statistically significant difference between the treatment groups (one-way ANOVA p-value = 0.3). 63% of patients reported no side effects with their pharmacotherapy treatment regardless of regimen.

Conclusion: These findings show no real difference between patients treated with SSRIs alone or in combination (FDA approved) and those who also take a benzodiazepine (considered inappropriate therapy). There was minimal documentation of objective assessment of PTSD symptoms completed within the Gallahue system. Further assessment in the form of a prospective survey using a likert scale may be beneficial.

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Apr 10th, 9:30 AM Apr 10th, 10:00 AM

An Evaluation of the Appropriateness of Pharmacologic Therapy in the Treatment of PTSD: A Retrospective Medical Chart Review

Indianapolis, IN

Background: Posttraumatic stress disorder (PTSD) is a diagnosis introduced in the DSM-III for a series of symptoms that can occur after a person experiences (directly or indirectly) a traumatic event. PTSD can cause significant impairment in psychological, social, and occupational functioning. Only sertraline and paroxetine have been FDA approved for treatment of PTSD. There are additional medications used off-label, but efficacy is variable. Further studies are warranted to provide evidence for the most appropriate and effective pharmacologic therapy.

Methods: This was a retrospective chart review of patients treated for PTSD (based on the ICD-9 code) between June 2009 and June 2014. Electronic medical records were examined to gather demographic data, PTSD symptoms, pharmacology treatment regimen, change in GAF score, and medication side effects.

Results: Fifty subjects were reviewed. Of those, thirty subjects had multiple GAF scores recorded. The median change in GAF was 0 (IQR: -2.25 - 5). When comparing SSRI monotherapy, combination therapy with a benzodiazepine and combination therapy without a benzodiazepine there was no statistically significant difference between the treatment groups (one-way ANOVA p-value = 0.3). 63% of patients reported no side effects with their pharmacotherapy treatment regardless of regimen.

Conclusion: These findings show no real difference between patients treated with SSRIs alone or in combination (FDA approved) and those who also take a benzodiazepine (considered inappropriate therapy). There was minimal documentation of objective assessment of PTSD symptoms completed within the Gallahue system. Further assessment in the form of a prospective survey using a likert scale may be beneficial.