Posted by hyperfocus on February 3, 2013, at 21:18:17
In reply to Prazosin - SLS need advice and info *please*!!!, posted by ChicagoKat on January 31, 2013, at 10:17:09
Atenolol is generally superior to propranolol for PTSD because of less side-effects and one-time dosing and because it doesn't cross the blood-brain barrier. I don't know about the significance of the last one because for me atenolol definitely interacted with the other meds I was taking. Atenolol also elevates blood glucose levels and significantly increases your risk of developing type 2 diabetes. The alpha-blockers like prazosin have more clinical evidence of effacy for PTSD than beta-blockers but beta-blockers also have been shown to reduce intrusive thoughts and nightmares and physical symptoms of anxiety.
Atenolol was effective for me in treating my overall anxiety -- almost as good as benzos and sometimes superior. It didn't seen to treat much of my dissociation and intrusive thoughts apart from its general anxiety-reducing effects. It also made me drowsy and increased somnolence when I took it with amitriptyline and Lyrica.
There doesn't seem to be a lot of evidence for effective med treatment of dissociation and PTSD. For me I find cognitive and behavioral techniques and a long-term living framework to be a lot more sustainable and consistent in treating my C-PTSD. Like I said in a previous post the helplessness and hopelessness PTSD engenders is centered in the loss of control of our inner experience -- intrusive thoughts and memories, emotional dysregulation, loss of executive control, destruction of systems of meaning -- the causes and ramifications of these things go a lot deeper than depression and anxiety. Any improvement from meds alone just transfers the locus of control to another external factor, which just trades one set of helplessness and hopelessness for another in my opinion.
I'm concerned about your reliance on Ritalin -- not wrt potential for dependence but as an unrealistic benchmark for other longer-acting meds. The emotional state we experience with short-term dopamine-enhancing drugs can't really be sustained long-term and can lead to unrealistic treatment expectations. There may not be any perfect med combo for any of us. Meds that improve long-term depression and executive control and focus will probably worsen anxiety and other symptoms. I think it's necessary to figure out what you value the most and gives you the most fulfillment in your day-to-day life that conventional meds can help and work on treating that, and try CBT and other theraputic approaches for the other things. It will not be possible to recover everything in your life the way you thought of it before. You will be a different person after recovery but this is not a bad thing. Right now I think the important thing for you is to find a way to re-establish some measure of control over your inner-experience: even if it means enduring predictable levels of depression and anxiety. You can't set full remission as your immediate treatment target with PTSD -- your mind just doesn't heal so simply.
The mind is an extremely complex thing. I think one thing you need to do is drop any objective measurement of how much depression or pain or anxiety meds cause or reduce. You might find yourself able to tolerate levels of anxiety and depression that are way above your baseline, but still able to function consistently in your day-to-day activities. Set attainable short- and medium- term goals and don't try to hit a home-run and sustain what short-acting drugs like Ritalin give you.
C-PTSD: social phobia, major depression, dissociation. 20 yrs duration.
Asperger's Syndrome.
Currently: 150mg amitriptyline single dose at night. 75mg Lyrica occasionally.
Significantly improving.
poster:hyperfocus
thread:1036953
URL: http://www.dr-bob.org/babble/20130124/msgs/1037289.html