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August 29, 2008

The Carrot or the Stick: A Specialized "Cocktail" for PTSD?

Carrot and PTSD

Carrot of Hope is a nonprofit organization on the Web of individuals with PTSD, who are trying to pool their experiential knowledge base in order to create a better future for those with PTSD.  It's hard to figure out much from their website about what they're about, but perhaps that's just because they're a work in progress. 

However, much of the group's enthusiasm seems to center around a "PTSD cocktail," using various chemicals, that they feel -- from their members' accumulated experience with it -- has some beneficial effect on PTSD.  Apparently they are both trying to raise money to study the effects of this cocktail on PTSD, and also provide resources so that those with PTSD can take the information to their doctors and/or health care providers, and initiate a dialogue about whether this treatment might be beneficial.  Worth checking out -- especially worth sharing with your health care provider, to see if it might have promise in your particular case.

They say that they are "currently taking donations to fund a research project studying the role of the MAO-A enzyme in post-traumatic stress."  According to them, "the Monoamineoxidase-A (MAO-A) removes catecholamines (fight or flight chemicals) from the body," and that "studying MAO-A levels in PTSD patients could be a major key in curing" and possibly even "preventing PTSD in the future.

The article on their website about understanding catecholamines is linked here, and th material about the "PTSD cocktail," which contains three ingredients -- Geodon [Zeldox, Ziprasidone] (20 mg); Propranolol [Inderal] (10-20 mg); and Vistaril (25 mg) -- is linked here.  The main website is linked here.

July 21, 2008

There's a Revolution Going On: Users Rate Their Drug and Non-Drug Treatments for PTSD

IStock_000005128146XSmallWe're just about to wrap up our series here -- a cycle of blog posts about the various treatments available for PTSD from the pharmaceutical, Complementary and Alternative Medicine ("CAM"), and mind-body medicine worlds. We've talked about bodywork therapies that show promise. Heck, we've even talked about street drugs like marijuana and ecstasy that appear to have some beneficial effects as well! (Sheesh -- we're not recommending them, per se -- we're just trying to do a comprehensive look at everything reasonable that's out there, that might help sufferers.)

We started this cycle of blog posts back in the beginning of June, with one about how the military was expanding its concept of treatment options to include some "revolutionary" non-drug approaches, linked here.  (We'll add to the cycle of posts over time as the need indicates, but the bulk of it is already done on this topic. This post also builds on a previous post, which talked about how a layperson can learn more about the effects and side-effects of medications prescribed, as well as where to learn about possible warnings when used in combination with other medications.  That post is linked here.) 

One of the most interesting developments is something I get to share with you now -- that a year or so ago when I first learned about it, was not robust enough to be of much value to PTSD sufferers.  Perhaps by now it really is.  The "it" I'm talking about here is something called "Revolution Health," the brainchild of AOL co-founder and marketing genius Steve Case, a project he began in 2005, after he left AOL.

Revolution Health is a number of things, but particularly for our purposes here's it's an online "community" of other patients who give their impressions, pro and con, of the treatments they're using for various illnesses and conditions -- including PTSD -- and not just of all the popular pharmaceutical medications, but also the non-drug therapies as well.  Finally, in one place, patients can check out what other people's experiences of the same drugs or therapies they've been prescribed, along with more straightforward information about the treatments themselves, the possible side-effects.  Clearly, for something like this to work, there need to be a LOT of people checking in and providing their impressions. 

When I first checked out the site, those numbers just weren't there.  It's not so exciting, interesting, or frankly even helpful to learn what three people think of a medication or a non-drug treatment like acupuncture or craniosacral therapy -- it gets a LOT more interesting as more people participate.  Such seems to be the case these days (no pun intended) -- but act quickly -- the site has been experiencing layoffs, and with Web businesses, even those founded by geniuses like Steve Case, you never really can count on how long they'll be around.  So be sure to check out what interests you while you still can.

This is what the site said a year ago about itself, which is still good advice:

This service is in its infancy, but our philosophy is that if millions of people participate, it will emerge as a useful tool for people as they consider their treatment options. Please note that treatments include a mix of some that are designed to directly treat a condition, some that treat side effects, some that provide symptomatic relief.

While individual real-life experiences can be a valuable health resource, they must be viewed in the context of evidence-based data and are not a substitute for medical advice. You should always consult a qualified health care professional before beginning, changing or stopping a treatment.

Now let's get down to business:

Want to learn how other participants rank, rate and review the various treatments for PTSD, both drug and non-drug? (Currently there are dozens suggested!), say, Duloxetine? Click here, for a list of the various, searchable treatments. (Better yet, click herefor them ranked by users in order of effectiveness!)  Want to take a look specifically at the pharmaceutical drugs for PTSD? Click here.  How about the various non-drug treatments for PTSD?  They're there, too, by name.  (You can sort either set of results by "most helpful," "most recent," and "highest effectiveness" on any individual treatment (of the 363) or on the category as a whole.)

Note: Be aware that not everyone who's weighing in with their opinion on what treatment they're loving or hating for PTSD has combat trauma-induced PTSD.  They may have PTSD from some completely other cause.  However, as far as relatabilty goes, this is the best we're gonna get for now -- a "Revolution Health" for veterans only does not appear to be in the works.  Ahhh, but we can dream, can't we?!

To reinforce the warning, though -- given the fact that nothing's permanent on the Web, especially "revolutionary business models," get in -- get your information -- and get out -- in case the website goes away, and/or the company goes out of business.  We sincerely hope that Revolution Health sticks around, because it's performing a useful AND innovative, visionary function --  but even more than that, we want YOU to get the information you're looking for, while you still can.  Oh, and if you sign up to be a member -- I believe that it's free -- you can also contribute your ratings to the user-generated rankings.

There's a Revolution going on...in health care.  Get yours now, while it lasts.

Editor's note: The usual "yada."  Be sure to consult with a qualified health care practitioner before changing or implementing a course of treatment, to make sure that the choices you make are appropriate and best for you.  We are presenting this material as information only, and it's not to be construed as medical advice.  If we could, we would; but we can't, so we won't.  There, we've said it.

June 30, 2008

PTSD: (That's Some) Pretty Terrible Sh*t (to Have to) Deal (With), Don't You Think?

MJ Marine Editor's Note: We commemorate the otherwise momentous, historic signing of the GI bill into law today with this little snippet of what life was like for someone who served recently.  For everyone who doesn't "get" what sacrifice is, and that those who've served have earned their accolades and rewards, here's a grunt's-eye view of the experience of combat trauma, and how that relates to PTSD and various other topics in the news.  It's doubtful that any one of us would like to have changed places with him, at such a young age.  Herewith, his story, emphasis mine:

---

I'm no Vietnam vet, but a vet of Operation Iraqi Freedom. I turned 18 while in boot camp because I graduated high school at 17. I was discharged early for having "personality disorder" after I went to Iraq.

I was in the Marines, and my MOS was a ground communications electronics technician. A couple months after graduating my training for the job and going to my first unit, I was "volunteered" to join and train with another unit that was leaving soon. The new task I was given was "Mortuary Affairs".

This group was put together with a couple dozen other Marines from other sections. Our job was to go to locations where troops had been killed and not able to be retrieved by the group they were out with due to the fact they were under too much danger or whatever the case. I had no clue the effects this would have on me. It was a horrible experience.


It was not like going and picking up a corpse and that's it. For one, you were in a hot zone, where people were just killed, not just by gunfire.

Here are some brief descriptions of the missions I was a part of...
 

The first one wasn't too bad; the body was actually brought to us at the camp we were at.

 

It was a young male Marine. He was supposedly in a Hummer going somewhere and might not have been wearing his helmet. He had a silver dollar sized hole in the side of his head.

When we get the bodies back the camp we have to take off all materials on the body, and go through and bag each individual body part. It was more of a surreal experience really, I did not know how I was supposed to feel.

Once our troops invaded Fallujah was when things started to get worse. On another of the missions, a truck carrying fuel was crossing a bridge and was shot with an RPG. The truck went off the bridge and fell, the fire burning most of everything.

 

When we went out it was usually just a dozen of us with maybe 2 Hummers of security if we were lucky. For anyone who doesn't know, most the Hummers used were old and poorly maintained/equipped... almost no armor. So we get there and head down to the bottom where the truck fell and we had to pull out burnt bodies from inside of the cabin.

 

It sounds bad, but burnt bodies are almost like burnt food... so perhaps it wasn't as bad as the rest. It did not help our appetite when we had to eat in the same building we processed the bodies in. Our shop was just a medium-sized bunker, no walls or anything so yes we basically ate next to the bodies. It is obvious why some of us didn't eat the meat.

 

The worst mission I went on was when an army tank was traveling down a road and was blown up from a roadside explosive. The bomb was so powerful: you could not identify ANY part of the tank except for the tracks. It had been tossed a couple hundred feet in different directions.

 

It took us I think, about 15 hours to do this mission. There was gunfire when we first arrived but nothing more. I think we picked up a couple thousand pieces of flesh that day. Going through each one individually. They would range from small penny-sized pieces to legs, torsos, heads, feet, testicles, arms, etc.

 

There were a few more missions but we get the idea by now I'm sure. I guess it started to become noticeable that I wasn't doing well. I was taking whole boxes of NyQuil tablets and drinking bottles of medicine to get anything I could out of it at night. I smoked probably a pack of cigarettes a day, which is a lot for me because I have never really smoked more than a couple cigs a day if at all.

 

My officer had me go speak to the chaplain and from there a navy doctor who was a great person to have over there. He pulled strings and had me med-evac'd out of there a few weeks later.

 

In the meantime I had been moved out of my job until I was able to leave. I was harassed for leaving: superiors thought I was just faking to get out.

 

I had become highly depressed and my roommates noticed me screaming sometimes in my sleep.

 

From Iraq I spent a few days at an army hospital in Germany, talking to various doctors and such... going through the process.

 

I was being given pills for depression and for insomnia. Then I made it back to the US and once at my base I was seen by a psychologist. They actually gave me the option to get of the military, so I did.

 

I had been told the process takes several months to year until you finally leave. In the meantime I started drinking daily, and stopped taking the pills they gave me because they seemed to numb my mind and I could not stand it because I have always had such a wonderful and creative mind. It made me feel like a zombie, I could not even create artwork which was my biggest hobby.

 

A month down the road I started having nightmares, very detailed and morbid. A few times I would wake up with tears. I began having suicidal thoughts and crying at least a few times a day. Thank God my best friend was stationed not so far, he saved my life I think.

 

It was hard for me to wake up because of the medicine I had been taking, that’s another reason I stopped it, I was always drained. The first week I was back I never even reported back to my old unit, I didn't know what I was doing.

 

A week later they send somebody to come get me. There, I was harassed and treated like a piece of s%#t some more by my master sergeant. They had me sit in inventory room all day while I struggled to stay awake. I luckily had a very kind staff sergeant in charge of me at the time. He would let me sleep and go home early.

 

I admit I was very lucky in getting out, because it only took me about 2 months until I was officially a civilian again. I was going back home. I stayed with my older sister and her boyfriend at first, because I was not too fond of going back to my parents. My depression got worse and I started to drift further from sanity and comfort; people noticed I was a different person.

 

At this point I started smoking marijuana occasionally. Which was really the only time I felt anything, happy, able to think, speak, talk to people, feel normal.

 

Eventually I moved back with my parents and that's when things got worse for me. I had some additional problems I know was facing, I needed a job, and had people on my back constantly. I had no access to marijuana during this time.

 

My insomnia got to its peak to where I could not sleep AT ALL at night. I also began having more suicidal thoughts, nightmares got worse and I had them ANY time I could sleep which was usually from 7:00 AM to 12:00 PM, began having auditory and visual hallucinations everyday, and constant anxiety.

 

I knew I had PTSD and that the military used "personality disorder" so that they would not take the rap for it.

 

I finally couldn't take the insomnia anymore and was prescribed Ambien, which actually works extremely well and helped get my body back on schedule, only thing is I had to take it for 3 months and then no more because they said it was addictive.

 

So it became difficult without it. I did a long process of seeing doctors and filling out paperwork for the VA and was finally officially a disabled vet due to chronic Post Traumatic Stress Disorder, normally referred to as PTSD.

 

I started to be able to get a hold of marijuana again and when I had it things were more stable. My temper was not out of hand and I could sleep comfortably having less nightmares. At this point I had gone a year or more straight of having nightmares every night.

 

It has been three years now and I am much better. Time has healed me a little and I smoke marijuana as often as I can. I don't have hallucinations anymore, or rarely any nightmares. I do however still have bad anxiety, temper, and depression problems when I'm not high.

 

Another thing I forgot to mention is that PTSD has basically ruined my memory. Since I first showed symptoms until now, my memory does not work nearly as well as it should.

 

I still have major problems concentrating and working sometimes too. It makes interviews and other social activities near impossible for me, as I cannot speak or express myself as I used to. I get very nervous and my mind blanks out sometimes. I cannot say if marijuana will help all my problems, but I can say marijuana helps me feel alive.

 

Being high is the only time I feel good and happy, deep down. I can be around loved ones or any social crowd without tweaking out from anxiety, I can think and operate much more smoothly, I don't have a short temper, and it makes me want to live.

 

The past couple months have been rough on me and I have been going to the VA hospital here to try and get help. The first 4 times I went, they did the same exact thing which was to ask a series of questions, ask me if I want pills and send me home. I kept telling them I did not want pills because I have seen what they have done to people I know and what they have done to me.

 

All I wanted was someone to talk to.

 

After the fourth time of going in there feeling like I wanted to die, they finally got someone for me to talk to. We have just met once so far, but I think it will be good for me.

 

In the meantime I have not been able to smoke recently because I am trying to find another job, which is not going too well and I only have a couple weeks before my current job ends.

 

I have had a few interviews but blow them miserably because it’s getting harder and harder for me to go through the whole thing without my nerves choking me to death. It’s only been a week or two since I smoked last and my temper and depression are already busting through the door. I worry too easily and stress out to the extreme.

 

Take what you will from this story, but I know for a fact marijuana has saved my life numerous times.

 

-- One young former Marine's story, in his own words. Used with permission.


Editor's note: "Mortuary Affairs" was also the detail highly-decorated Marine ("Marine of the Year") Daniel Cotnoir worked in Iraq, before a combination of circumstances, including PTSD, triggered an event in his hometown of Lawrence, Massachusetts -- which got him arrested, and barely escaped conviction.  We have blogged about Daniel Cotnoir's case many times on this blog, going back several years, when it was current.  It's safe to opine, that even within the trauma of war, some things are harder to endure than others.  Our guess would be, mortuary affairs really qualifies for extreme hardship and exposure to things that make PTSD an occupational hazard.

June 28, 2008

"Disposable Heroes" - Washington Times and ABC News Investigates Drug Testing on Veterans

Disposable Heroes On June 16th, the Washington Times, which has been following the "Chantix harm to veterans" story doggedly, and ABC News, produced an investigative piece called "Disposable Heroes," about the drug testing that takes place on veterans, sometimes with lethal consequences.   That interactive piece is linked here. (Ironically, earlier this week, we posted an entry about veteran' similar exposure, this time from the Vietnam War, that is still coming to light.  That post is linked here.)

Here's the lead from the Washington Times' story, by Audrey Hudson:

The government is testing drugs with severe side effects like psychosis and suicidal behavior on hundred of military veterans, using small cash payments to attract patients into medical experiments that often target distressed soldiers returning from Iraq and Afghanistan...

In one such experiment involving the controversial anti-smoking drug Chantix, the Department of Veterans Affairs (VA) took three months to alert its patients about severe mental side effects.  The warning did not arrive until after one of the veterans taking the drug had suffered a psychotic episode that ended in a near lethal confrontation with police.

If you want to find other entries in the Washington Times' extensive coverage of Chantix and veterans, use this link here, which will produce a list of the articles, or go to their website, linked here, and do a search for "Chantix".  Be forewarned, however. Although the information on the website is well worth learning, the Washington Times has an especially cumbersome user interface, irrespective of browser.  Get ready to enable popups, and then, even so, only be able to pull up the stories with great difficulty.  Someone really needs to improve that...)

Going Frantic over Chantix - Anti-Smoking Drug Causes Problems for Veterans with PTSD

Chantix PTSDAn anti-smoking drug, Chantix, prescribed to veterans, including those with PTSD, has been linked to significant health problems:

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