Will less medication help PTSD patients?

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War veterans coping with post-traumatic stress disorder (PTSD) often present complex conditions requiring multiple drug treatments – but new research suggests that giving them less medication might have more benefits.

The study, carried out by Gallipoli Medical Research Foundation – based at Brisbane’s Greenslopes Private Hospital – found that veterans with PTSD who are treated with multiple medications at once are at significant risk of adverse health events.

The practice, known as polypharmacy, can cause drowsiness and confusion, respiratory depression, and postural instability. 

Lead researcher Dr Rebecca Mellor investigated the prevalence of psychotropic polypharmacy: the simultaneous use of two or more medicines capable of affecting the mind, emotions, and behaviour. 

“Psychotropic medications are prescribed for the treatment of PTSD symptoms,” Dr Mellor said.

“However, we’ve illustrated how psychotropic polypharmacy increases the risk of adverse drug events and drug-drug interactions, which can contribute to falls, hospital admissions, morbidity, and mortality.

“This highlights the importance of increasing awareness of polypharmacy – especially psychotropic polypharmacy – and potentially inappropriate drug combinations, and the need for improved medication review by prescribers.”

Having reviewed the medical records of 219 veterans with PTSD who were admitted to a mental health facility over a one-year period, the researchers found that 90 percent of patients had an additional diagnosis of at least one other psychiatric condition, and 97 percent had at least one non-psychiatric medical condition. 

The study, funded by the Ramsay Hospital Research Foundation, revealed a high prevalence of psychotropic polypharmacy (80 percent), polypharmacy in general (77 percent) and sedative polypharmacy (75 percent).

It is the basis of a longer-term research plan at the Gallipoli foundation, with prescribing guidelines, awareness programs and educational resources to be developed to support prescribers through the pharmacological management of PTSD and co-morbidities, particularly in veterans. 

Dr Andrew Khoo, Director of Medical Services at Toowong Private Hospital, will also be advising on this project.

“This research is an early step in the process of improving pharmacotherapeutic treatment of PTSD and reducing unnecessary overprescribing,” Dr Mellor said. 

“We’re hoping to address and change a factor that contributes to morbidity and mortality in PTSD sufferers.”

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