PTSD: The Daily PANCE Blueprint
Which of the following is the preferred treatment for nightmares in patients who have post-traumatic stress disorder?
A. Melatonin
B. Prazosin
C. Zolpidem
D. Diphenhydramine
E. Lemborexant
Answer and topic summary
The answer is B. Prazosin
A traumatic event is any type of incident that causes a person some sort of harm (emotionally, physically, or psychologically). Examples include events with violence, serious injury, or death (war, shooting, rape, car crash, etc). Post-traumatic stress disorder can happen from repeated traumatic exposures over time or one traumatic event. Symptoms can occur ANY time after the event(s) and have to last a total of more than one month. Per DSM-V criteria, patients must have at least 1 symptom from each category:
- Intrusive symptoms (bad flashbacks, dreams, etc)
- Persistence avoidance of stimuli associated w/ the event
- Negative alterations in mood/thoughts associated w/ the event (diminished interest, detachment, blaming self, etc)
- Marked alterations in arousal/reactivity (angry outbursts, irritability, problems concentrating, sleep disturbance, etc)
Management includes SSRIs, psychotherapy (trauma-focused), prazosin (preferred) for those with nightmares, and anti-psychotics for those with psychotic symptoms.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Psychiatry ⇒ ⇒
Also a part of the Emergency Medicine EOR, Family Medicine, and Psychiatry PAEA Rotation EOR topic list
