Propranolol, post-traumatic stress disorder, and intensive care: incorporating new advances in psychiatry into the ICUReport as inadecuate




Propranolol, post-traumatic stress disorder, and intensive care: incorporating new advances in psychiatry into the ICU - Download this document for free, or read online. Document in PDF available to download.

Critical Care

, 18:698

First Online: 19 December 2014

Abstract

Post-traumatic stress disorder PTSD is a common complication of an ICU admission. Rarely is there a continuation of care, which is aimed at screening for and treating this debilitating disease. Current treatment options for PTSD are held back by inconsistent efficacy, poor evidence, and a lack of understanding of its psychopathology. Without ‘gold standard’ assessment techniques to diagnose PTSD after an ICU admission, the development of care pathways is hindered. This paper advocates for two interwoven advances in psychiatric care specifically for PTSD after ICU: 1 incorporate the monitoring and treating of psychiatric co-morbidities during extended patient follow-up, and 2 rapidly adopting the latest research to maximize its benefit. The discovery that memories were not fixed, but malleable to change, set off a sequence of experiments that have revolutionized the approach to treating PTSD. It is hoped that the phenomenon of reconsolidation can be exploited therapeutically. In the act of remembering and re-storing traumatic memories, propranolol can act to dissociate the state of sympathetic arousal from their recollection. Often, ICU patients have multiple physical co-morbidities that may be exacerbated, or their treatment disrupted, by such a pervasive psychological condition. The rapid uptake of new techniques, aimed at reducing PTSD after ICU admission, is necessary to maximize the quality of care given to patients. Increasingly, the realization that the role of intensive care specialists may extend beyond the ICU is changing clinical practice. As this field advances, intensivists and psychiatrists alike must collaborate by using the latest psychopharmacology to treat their patients and combat the psychological consequences of experiencing the extremes of physiological existence.

AbbreviationsDSMDiagnostic and Statistical Manual of Mental Disorders

HPAHypothalamic-pituitary-adrenal

ICD-10International Classification of Disease 10

IESImpact of Event Scale

IES-RImpact of Event Scale-Revised

LTPLong-term potentiation

PTSDPost-traumatic stress disorder

SSRISelective serotonin reuptake inhibitor

Electronic supplementary materialThe online version of this article doi:10.1186-s13054-014-0698-3 contains supplementary material, which is available to authorized users.

Download fulltext PDF



Author: Andrew John Gardner - John Griffiths

Source: https://link.springer.com/







Related documents