Drug For PTSD - Question

[Thankful]

Hi

Not sure where to post this, but have a question to anyone who might be able to answer. I see that my sufferer is taking Citalopram for PTSD. I'm curious to understand how this exactly helps PTSD, on a more scientific level.

I have several questions around this: because there are different variables/nuances to PTSD I was curious how any one drug can truly help? And does it help heal, or just help to lessen some of the extreme feelings/responses? The latter is my guess.

I read on the internet that it helps with Seratonin levels and ultimately depression. It just seems a bit simplistic in evaluation, I know that depression is one aspect of PTSD but not the entire story, so why not just say it is a medication for depression rather than say it's to treat PTSD? There must be something I'm missing here in the equation, to fully grasp the prescription.

Not sure if my questions make sense but my main curiosity is driven by the desire to learn and understand more - about PTSD and the drug 'therapy' as well. If you can help shed some light that would be great.

thanks
Kristin

 

[cat]

Hi Special K
I used to have the same opinion as you & was very reluctant to take Citalopram because I was denying that I had PTSD and had some major hangups about taking meds.

One of my symptoms was extreme anxiety which, 8 mths ago became bad enough to be signed off work & made me house bound. Having undergone some therapy with little result I was told that I wouldn't make any improvement until I was on meds.

You're right about Citalopram helping with Serotonin levels and so lifts depression but it is also, as in my case prescribed to reduce anxiety. I didn't think it would make any difference but here I am 7wks later, anxiety reduced & my PTSD symptoms at a manageable level, I also have weekly apps with a psychologist.

Is your sufferer also having therapy. Recovery is about us reprocessing our traumas & learning to manage our symptoms with all the help we can get.

Cat

 

[Thankful]

Thanks for the info Cat! My sufferer is getting therapy - not sure how much they are working to process trauma, sometimes I get the impression it is just simple talk therapy with not a lot of depth to it. But at least he is talking with someone, this is good! :)

 

[Gunchief]

Thanks for posting this, I was given a prescription for the same meds by my MD for PTSD related anxiety. It still sits inched from me untaken. I'm on the fence about taking it and I'm not sure why. I have never taken any meds in a LONG time and now I'm being told I nrrd to take this.
What is serotonin and what do the levels do?
Dave

 

[trapped]

I hesitated to respond, because I often want to respond to so many topics, but am worried I'm not really qualified... I do research in neuroscience, specifically drug addiction pathways, which means I know a fair amount about neurotransmitters and the brain and such... though I'm still a student and still learning, but have always found the mechanisms of how drugs work to be fascinating, and began reading textbooks on the subject sometime in jr high (I was a strange kid).

I'll try to answer at a basic level, and can go in to more detail if anyone wants me to.... yes, Citalopram is actually an antidepressant. But, it can be perscribed even when the person is not depressed, for things like PTSD or anxiety (when it's used like this, it's referred to as "off label" use). You are right that no one drug can truely help. And while there may be one drug that will work for some people, certainly there is no "fix all" drug that will work for everyone. That is why there are so many antidepressants out there- because no one drug works for everyone. Sometimes drugs are given not for the specific disorder, but for other factors that go along with the disorder... for example, xanax (which is a benzo... it's to reduce anxiety), may be given to someone with PTSD if anxiety is going along with it. But, it's going to treat that one aspect of the PTSD (the anxiety) not the whole thing. Sometimes depression can go hand in hand with PTSD. Anxiety often does, and benzos are addictive so most doctors would rather try antidepressants. Some antidepressants can also help with sleep, etc.

There are different classes of antidepressants. Citalopram is an SSRI. This means it causes serotonin to sit around in the synapses in the brain longer. Normally, when serotonin gets released into the synapse (the space between neurons in the brain), it gets sucked back up. SSRI's cause serotonin to sit in your synapse for longer. One hypothesis of depression is the serotonin hypothesis, which is what SSRI's are basaed on, and I can go more into detail with that if you want. The pathways of the drug also affect some of the same pathways as those involved in anxiety reactions... it gets pretty complex (but interesting) and I'm not sure how much information you're looking for, but I'd be more than happy to try to answer questions if you're interested, and I can always ask my adviser at the research lab if I don't know the answer, since he's done quite a bit of work with the serotonin model (I focus more on the dopaminergic pathways).

 

[trapped]

What is serotonin and what do the levels do?
Dave

Oh, and to give a quick answer as to what serotonin is- it's a neurotransmitter (chemical in your brain, but is also found in other parts of your body). It's responsible for helping to transmit nerve impulses. It contributes to things like mood, appetite, sleep, etc... Too much of it can be toxic and dangerously fatal, but too little can cause problems with motivation, mood regulation, etc. That goes for most of your neurotransmitters- too much is bad, too little is bad, so the goal of psychotropic medications is so balance out the levels to a normal range. It's hard to describe the specifics of serotonin without going into detail, but it affects a majority of your body's cells. Think of taking psychotropic medications, like SSRI's, as equivalent to a diabetic taking medication, or even someone wearing glasses. The diabetic needs the medication to help insulin levels stay within a normal range to help their body function properly. The person who wears glasses needs them to help their vision be closer to "normal" to help them see clearly and thus function better. Psychotropic meds can have pretty much the same principle applied.

 

[cat]

Hi Gunchief

I did reply to you post but I don't think I posted it!

I now realise that taking Citalopram was the right thing to do & regret not taking the advise given by my GP & Psychologist. If I had I could have saved myself three months of hell! Sometimes its difficult to accept that others know what's best for you, taking the decision to take it needs to be at the right time for you psychologically.

My advice to you, if & when you feel ready to take it, give it a go. Watch out for the side effects which are a nuisance but the reward of feeling less anxious is worth it.
I've just got home from a meeting at school, for the first time in a year I didn't have to leave after 10 minutes.

 

[Gunchief]

Thank you all for the info.
Dave

 

[harrywgtn]

I have been on these tablets for 3 months now and to me they are a god send.
I have PTSD from childhood abuse and I will say they dont solve all my problems but are helping me to lead a semi normal life.
I never wanted to take any meds and tried a few before these tablets and i feel alot better
Funny thing is if a forget to take them i start to feel on edge and my lips go numb, very weird.

 

[Thankful]

Cat - you mentioned the side effects and that they can be a nuisance; what are the side effects you speak of?

 

[cat]

Hi SpecialK

Everyone reacts differently to taking medication so you may take it & have none at all.
My GP warned me that I would get some because I was starting on 20mg instead of the usual 10mg which is increased to 20 after a few weeks.
all seemed to be going ok until day 3 when I felt nauseous, headaches, dry mouth & fatigued - muscle & joint aches & extremely tired. I found the best thing to do was just to rest & let it happen, drinking plenty of water helped & sleep as much as you can. This continued for about 6days then gradually eased off, followed by a few days of feeling irritable & depressed but it had taken the edge of my anxiety. My GP explained this is normal for that stage & it passed in a few days. It took around 5 wks for my to really feel some benefit & I feel so much more relaxed & I don't dwell on things like I used to but this is also due to the Eye movement psychotherapy I'm having.
Hope that's a help but as I say it does affect everyone differently.