The patient’s reported hallucinations are not persecutory
1. Because the patient’s reported hallucinations are not persecutory, as a clinician, what medications would you start with?
2. What treatments (pharmacological and non-pharmacological) are most effective for patients with extensive trauma history?
3. What symptoms could be co-occurring in relation to PTSD vs schizophrenia for this patient?
Sample Solution
Medications for Non-Persecutory Hallucinations
Atypical antipsychotics (AAPs) are the first-line medications for non-persecutory hallucinations. They are effective in reducing the frequency and severity of hallucinations, and they have a better side effect profile than older antipsychotics.
Examples of AAPs include:
- Quetiapine (Seroquel)
- Risperidone (Risperdal)
- Olanzapine (Zyprexa)
- Aripiprazole (Abilify)
Full Answer Section
Non-Pharmacological Treatments for Patients with Extensive Trauma History Trauma-focused therapy (TFT) is a type of psychotherapy that is specifically designed to help people who have experienced trauma. TFT can be helpful for reducing PTSD symptoms, such as flashbacks, nightmares, and hyperarousal. Examples of TFT modalities include:- Cognitive processing therapy (CPT)
- Eye movement desensitization and reprocessing (EMDR)
- Prolonged exposure (PE)
- Cognitive-behavioral therapy (CBT)
- Acceptance and commitment therapy (ACT)
- Group therapy
- Support groups
- Flashbacks
- Nightmares
- Hyperarousal
- Avoidance of trauma-related reminders
- Negative thoughts and feelings about oneself or others
- Difficulty concentrating
- Difficulty sleeping
- Hallucinations
- Delusions
- Disorganized thinking
- Disorganized behavior
- Negative symptoms, such as social withdrawal and lack of motivation