Today in my Irvine clinic I had two patients who were suffering from Post Traumatic Stress Disorder (PTSD). One was unfortunately physically and verbally abused by her boss and the second was involved in a very traumatic car accident where he lost one of his best friends. Both of these patients experienced a combination of difficulty sleeping, recurring nightmares, avoidance and depression.
The first step in their recovery process involved psychotherapy which both were receiving. One of them had started group therapy as well. These two treatment modalities are pretty standard for patients who suffer from PTSD.
At this point many of you reading this may be wondering why and how they ended up in my office? The reason is because each was started on 4 medications and for one a 5th was added. One stated that they “felt like a zombie” and the others emotions “were completely dulled”. Here is the list of medications that they brought in.
1) Trazodone: is an anti-depressant which affects the serotonin levels in your brain: in these cases it was being used to assist with insomnia.
2) Ambien: is a drug used to induce sleep as well. It works similar to benzodiazepines in that it binds to the GABA receptors in the brain. Patients often are worried about the addiction potential and complain of feeling very groggy upon awakening with daytime drowsiness that can affect work performance.
3) Lorazepam (Ativan): is a drug used to treat acute anxiety and insomnia. Is a benzodiazepine and affects the GABA receptors in the brain. Patients often worry about its addiction potential and increasing tolerance and dependence.
4) Prozac (Fluoxetine): is a drug most commonly used to treat depression. It affects the serotonin receptors in the brain. Many patients complain about it’s side effects. Specifically, it can affect a patients sex drive and sexual performance.
5) Seroquel (quetiapine): is a drug often used to treat schizophrenia and bipolar disorder. Often I have seen patients prescribed this to assist with insomnia as well.
The problem that these patients had with their psychiatrists treatment plan is the amount of medications that they were taking throughout the day. They literally felt like walking zombies; out of touch with their personal relationships. They also experience unwanted side effects. This is a very common theme that I hear from patients.
So where does cannabis come into play? For one I think the goal is to get these patients off there medications used to treat the anxiety and insomnia. For these patients the goal was to eliminate the need for the Ambien, Ativan and Trazodone IMMEDIATELY.
I encourage them to continue the prozac if it is helping with their mood. As long as the side effects are not too bad I think this is a reasonable medication for them to stay on until the therapy allows them to cope without any medications.
Many times the goal for my patients is to substitute cannabis for one or more of the medications that they currently take. Cannabis, if used appropriately, can replace many varieties of medication. It can assist with falling asleep, decreasing anxiety, improving mood, stimulating appetite and also decreasing patients use of other drugs such as alcohol.
I will follow up with them in a few weeks and blog about how they are doing. Stay tuned!
If you would like more information on seeing if cannabis can improve the quality of your life please feel free to call my staff and schedule an appointment to come in. I would be happy to take care of you.
Visit us at www.mcsocal.com or call 877-721-0047