<h2>Medications in Our Treatment of PTSD</h2>

One pill makes you larger

And one pill makes you small,

And the ones that mother gives you

Don't do anything at all.

-White Rabbit, Jefferson Airplane 1967

I awoke this morning with a list of items I needed to tackle today. The real trick for me is trying to balance all my work around my family and husband. Today's list consists of running to the post office to mail off many candles, make some phone calls for FRG and our upcoming Family Day, write an article for our unit newsletter, and get my husband's medications in order. So armed with my extra large cup of coffee and my Vietnam Era music playing in the background, I hit the ground running. I had to buy my husband one of those seven day a week pill reminder boxes, or as we lovingly refer to it as, the Old Man Pill Box. Once a week I must refill it for twice to three times a day, and then double check myself as I can be forgetful sometimes. Once completed, I must then go through and double check all the original bottles they came in just to make sure he has plenty in supply or begin the refill process. I wondered how many others are on the same meds and what do all these do for my husband? Thought the White Rabbit song reference really played well with my blog this morning!

Citalpram

• (Commonly known as Celexa, Cipramil) Anti-depressant used to treat major depression, social anxiety disorder, panic disorder and OCD. My husband takes 40mg twice a day. Side effects: fatigue, drowsiness, dry mouth, increased sweating (hyperhidrosis), trembling, headache, dizziness, excessive yawning, sleep disturbances, insomnia, cardiac arrhythmia, bruxism, hallucinations, blood pressure changes, nausea and/or vomiting, diarrhea, heightened anorgasmia in females, impotence and ejaculatory problems in males. In rare cases (around over 1% of cases), some allergic reactions, convulsions, mood swings, anxiety and confusion have been reported. Also sedation may be present during treatment of citalopram. I can vouch for the sweating, headaches (which has worsened because he has TBI in which he also suffers headaches from), Impotence, and the rest? Well, where does one begin and separate from PTSD symptoms he already suffered from? This is the primary cause of impotence in Veteran's or so we were told by his physician. Her take was be crazy, or no sex...."I'll take No Sex Life Alex, for 500".

Magnesium Dietary Mineral

• Taken at 400 mg per day, this was prescribed by his primary care physician, who is really really into holistic medicine practices, if you remember my past reference to her with the fish oils and vitamins to make him poop. Now supposedly, this is to help with his headaches. If it does, I can't tell. It is "being investigated" for the treatment of migraine headaches.

Ativan

• Commonly known as Lorazepam (We call it the crazy pill). My husband has to take 0.5 three times a day, and then two more at night. It is used for the management of anxiety disorders, the short-term relief of symptoms of anxiety or anxiety associated with depression. The effectiveness of lorazepam and other benzodiazepines has not been adequately studied for treatment beyond 4 months. (nice as my husband has been taking this for three years now) Lorazepam can cause physical dependence (even better). The most common side effects associated with lorazepam are sedation, dizziness, weakness, and unsteadiness. Other side effects include a feeling of depression, loss of orientation, headache, and sleep disturbance. Now the thing that disturbs me, is he already had depression and headaches. So they give him this one, which causes more depression and more headaches. Kind of fighting a losing battle here between medications.

Trazadone

• AKA Zombie Maker. 100 mg at night. It is another anti-depressant used to treat Panic Disorders, Diabetic Neuropathy, Bulimia, OCD, Alcohol Withdrawal, Schizophrenia, other psychoses and Complex Regional Pain Syndrome. Last but not least, Control of nightmares or other sleep disturbances. The most common adverse reactions encountered are drowsiness, nausea/vomiting, headache and dry mouth. (Here we go again with the headaches) Now this is the medicine he takes at night for nightmares, sleepwalking, and night terrors. This is literally a zombie maker as the world could blow up around him and he would sleep right through it. The only problem I have with this medicine is that it leaves him groggy and irritable the rest of the day but does knock him out and we can all rest.

Gabapentin

• Also known as Neurontin. This is taken 3 times a day at 300mg. It was originally developed for the treatment of epilepsy, and currently, Gabapentin is widely used to relieve pain, especially neuropathic pain. This was prescribed for my husband's back and knee pain which is leftover from injuries which occurred from an IED explosion in Iraq. Gabapentin is widely believed to help patients with post-operative chronic pain. So far, we haven't seen any difference in him on this medication. Most common side effects in adult patients include dizziness, drowsiness, and (swelling of extremities); these mainly occur at higher doses, in the elderly. Also, children 3–12 years of age were observed to be susceptible to mild-to-moderate mood swings, hostility, concentration problems, and hyperactivity.

Tylenol with Codeine

• Prescribed 1-2 tablets every four hours for severe pain. He doesn't take this one every day but only on a need to need basis. This is for pain he feels in his lower back, both knees and for severe migraine headaches.


Omeprazole

• Commonly known as Prilosec and prescribed to my husband for gastric/stomach problems such as severe heartburn and indigestion which has been causes from all the other medications. Taken at 20mg twice a day. Hell, if I had to take this much, I would have stomach problems too!


Tizanidine

• Commonly known as Zanaflex. Prescribed to my husband for severe muscular spasms. As need basis, he takes 4 mg (2 tabs) three times a day. It is used to treat the spasms, cramping, and tightness of muscles caused by medical problems such as multiple sclerosis, spastic diplegia, back pain, or certain other injuries to the spine or central nervous system. It is also prescribed off-label for migraine headaches, as a sleep aid, and as an anticonvulsant. It is also prescribed for some symptoms of fibromyalgia. This one really knocks him on his butt too.



So which one is best for him, and which one makes him worse? I look over all these and an overwhelming sadness fills me. My husband was one who never took anything! I think in the past ten years, I can remember him being sick once. His cure for the common cold was hot tea with a shot of moonshine (hey, we are from Tennessee-Moonshine cures all that ails ya!). Occasionally he might get a headache and I would literally have to force some tylenol or Goody's powder down him! Who would have thought my husband, after war, would come home and require so much maintenance and medications! Now as we are awaiting his appointment for the TBI doctor (Traumatic Brain Injury), I am curious to see if they will add yet another pill to his repertoire of many. I can't really complain as his mood, his anger, and triggered episodes are a lot more dulled, but in the same sense he is a walking zombie all the time. This has caused our sex life to disappear, makes him sleep hard and for long hours at a time, and his mood more irritable (although more tolerable with the meds). Is there really ever going to be a happy medium in

PTSD?