Post-Traumatic Stress Disorder

By Dr. Steven Reichbach

Post-Traumatic Stress Disorder, known as PTSD, is a psychiatric disorder that can occur following the experience, or witnessing, of a life-threatening or traumatic event such as military combat, natural disasters, terrorist attacks, serious accidents, physical or sexual assaults in childhood or adulthood.

The Department of Veterans Affairs estimates that 31% of Vietnam veterans, 10% of Gulf War veterans and 11% of veterans of the War in Afghanistan suffer from PTSD. An estimated 5% of American men can be expected to experience PTSD during their lives.

There are 3 main symptoms of PTSD. The first is a re-experiencing of the traumatic event. This can be exhibited by flashbacks, nightmares, as well as feelings of distress or intense physical reactions when reminded of the event i.e. sweating, nausea, state of high anxiety, etc. The second symptom could be avoiding reminders of the trauma. One may avoid activities, places or thoughts that can remind you of the trauma or cause you to remember aspects of the event. Third, one may experience increased anxiety. Many patients have trouble sleeping, experience irritability or outbursts of anger, difficulty concentrating or feel hypervigilant. Other common symptoms include severe depression (including suicidal thoughts), substance abuse as well as feeling of guilt or shame.

There are certain things patients can do to improve their symptoms, mood and outlook. Daily exercise is very valuable by allowing one to focus on how their body feels instead of focusing on their thoughts. Release of endorphins can also improve overall well-being. PTSD can leave patients feeling vulnerable and powerless over their symptoms. By learning that one can change their arousal symptoms and calm themselves down when feeling overwhelmed, one can get back a feeling of control. Mindful breathing is a good way to put this into practice. It allows one to calm oneself and regain control. Connecting with loved ones and others who you feel safe with is an important way to stay grounded as well.

Professional treatment with a doctor or therapist is often necessary to assist patients in dealing with the difficulties that PTSD presents. In addition to trauma focused/behavioral therapy, and family therapy, medications can be prescribed to patients with PTSD.

These medications help relieve secondary symptoms of depression and anxiety. Some medications often prescribed include anti-depressives such as Prozac, Zoloft and Paxil. Medications that help decrease the physical symptoms of PTSD including Clonidine and Prazosin can also be used. When anxiety is a prominent symptom in these patients, benzodiazepines such as Valium, Klonopin and Xanax are often effective.

For patients with PTSD who suffer from major depression, severe anxiety and suicidal ideations and who have not responded adequately to previously mentioned medications, intravenous Ketamine infusions can be extremely effective and potentially life-
saving. In the right patient population, IV Ketamine can improve symptoms of depression and anxiety 75-80% of the time. That percentage increases in patients who are expressing suicidal ideations. Ketamine is an NMDA receptor antagonist which affects glutamate levels in the brain. One of the most appealing aspects of its use is the rapidity with which it works. Typically, “responders” can begin observing changes in their symptoms within hours. For patients who are suicidal, this can “buy time”, and allow mental healthcare professionals to intervene and potentially save lives. The relatively rapid effects of IV Ketamine contrasts the antidepressants commonly taken by patients which can sometimes take six weeks or longer to work, if they work at all.

At the Gulf Coast Ketamine Center, we have treated many patients who have suffered from PTSD in one form or another. Most of these patients had complaints of severe depression and anxiety. These patients had not responded to antidepressants, anxiolytics and other modalities of treatment commonly used. Many describe their goals of Ketamine treatment to be “getting my life back”. This means something different to each patient. It may mean being able to work again, get a full night’s sleep, joining a friend for lunch, or even something as simple as the ability to read a book. Enjoying these things, as simple as they may be, brings back joy back into their lives.

For more information on PTSD or other mental health issues and to find out if IV Ketamine may be the best option for you, contact our office to set up a free consultation with Dr. Reichbach. Infuse your life with hope!

Steven Reichbach, MD
Board-Certified Anesthesiologist
President and Founder,
Gulf Coast Ketamine Center

Lolita Borges, RN
Clinical Director, Gulf Coast
Ketamine Center
2415 University Parkway, Building #3,
Suite 215, Sarasota, FL 34243
941-213-4444 | www.findpainrelief.com