Antidepressants: A New Hope
After Horror - Prozac For Kosovo?
By Adam Pasick
NEW YORK - For war-torn refugees in Kosovo, Prozac may be just what the doctor ordered to counter the effects of post-traumatic stress disorder.
The debilitating condition " which affects veterans, sexual assault victims, survivors of natural disasters and others who have suffered large-scale trauma " can leave sufferers with memories "impossible to forget yet sometimes also impossible to recall," according to the Veterans Administration's National Center for PTSD.
Now, a new study in the July British Journal of Psychiatry found the antidepressant Prozac is as effective in civilians with PTSD as it is for veterans, a group long treated for the disorder through the U.S. Veterans Administration.
Symptoms of PTSD include nightmares, intrusive waking memories, emotional numbness and frequent bouts of panic and anxiety. The disorder can also lead to a compromised immune system, an increased risk of heart disease and a predisposition to drug and alcohol abuse.
PTSD can be especially difficult for refugees from countries with traditional, conservative cultures, said Dr. Matthew Friedman, executive director of the VA center.
"Trauma doesn't happen in a vacuum," he said, noting that societal and cultural pressures can make it even harder to come to grips with horrific memories.
Therapies in the Works
But even before the release of the latest research, Prozac and other drugs such as Zoloft " known as selective serotonin re-uptake inhibitors " were already on their way to becoming indispensable by enabling other therapies, experts say.
If PTSD symptoms are reduced or eliminated through pharmaceuticals, patients "can participate more in psychotherapy and in dealing with enormous social issues," said Dr. Jim Jaranson, medical director of the Center for Victims of Torture in Minnesota.
Although not specifically approved for that use by the U.S. Food and Drug Administration, physicians are allowed to prescribe the drug to patients they think might benefit " especially since many PTSD sufferers are dual-diagnosed with clinical depression.
"We aggressively try to treat the symptoms of our patients and we've found that SSRIs, especially in combination with other therapies, can be effective," said Dr. Allen Keller, director of the Bellevue/New York University Program for Survivors of Torture.
More research needs to be done on this disorder, which is still relatively new in the medical world. But even as researchers develop a more nuanced knowledge of PTSD it seems clear that Prozac and other antidepressants will play a key role in providing those who have lived through horrible circumstances with the opportunity to move on.
"SSRIs are the first line of treatment at this point " anywhere," Jaranson said.