Sedatives still used for PTSD treatment despite warnings

Sedatives still used for PTSD treatment despite warnings
By Wyatt Olson
Stars and Stripes
Published: April 8, 2013

Department of Veterans Affairs doctors are continuing to prescribe tranquilizers such as Valium and Xanax to veterans diagnosed with post-traumatic stress disorder — despite VA guidelines advising against their use for the condition.

Almost a third of veterans being treated for PTSD are prescribed benzodiazepines, a class of sedatives commonly used to treat insomnia, anxiety, seizures and other conditions, according Dr. Nancy Bernardy, a clinical psychologist with the VA’s National Center for PTSD.

Benzodiazepine prescriptions by VA doctors for PTSD patients declined from 37 percent to 30 percent between 1999 and 2009, Bernardy and fellow researchers found in an earlier study. But it remained at 30 percent through 2012, Bernardy said, citing data that will be published soon.

The current clinical practice guidelines for managing PTSD, co-authored by the VA and Department of Defense, caution medical providers against using benzodiazepines “due to lack of efficacy data and growing evidence for the potential risk of harm,” Bernardy wrote in the PTSD center’s current newsletter.
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Despite warnings against using drugs for PTSD, they did it anyway

VA GIVES TRANQUILIZERS TO 30 PERCENT OF PTSD PATIENTS, DESPITE WARNINGS
Nextgov
By Bob Brewin
March 18, 2013

In September 2011, the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury almost shouted its warning against benzodiazepines, emphasizing the guidance in bold-face type on its website: “There is evidence against the use of benzodiazepines in PTSD management as it may cause HARM. Strongly recommend against the use of benzodiazepines for treatment of PTSD.”

The Veterans Affairs Department treats more than 30 percent of veterans diagnosed with post-traumatic stress disorder with tranquilizers such as Xanax and Valium, despite clinical practice guidelines issued in 2010 warning against their use, VA’s National Center for PTSD reported.

The 2010 PTSD clinical practice guidelines, which also apply to the Defense Department, cautioned providers against using benzodiazepines to manage PTSD due to “the lack of efficacy data and growing evidence for the potential risk of harm,” the PTSD center said in in the March edition of its research quarterly publication.

Research shows that treatment of PTSD with benzodiazepine drugs “may interfere with the extinction of fear conditioning or potentiate the acquisition of fear responses, actually worsening recovery from trauma,” the center reported. This, in turn, may interfere with “first line” treatment such as exposure therapy, in which a trained therapist helps a veteran relive traumatic events.

More than 50 percent of combat veterans diagnosed with PTSD also suffer from alcoholism or substance abuse, and treatment with benzodiazepines can lead to addiction, the center said.
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