Abilify [aripiprazole] and Seroquel XR [quetiapine XR] are called atypical antipsychotic medications with their atypicalness relating to the fact that they increase levels of the neurotransmitters serotonin and norepinephrine as well as decreasing the neurotransmitter dopamine which the typical antipsychotics do as well. Research studies have shown that Abilify and Seroquel XR can treat bipolar and depressive mood symptoms as well as psychotic symptoms. Both Abilify and Seroquel XR have low doses available that are helpful for people with mood symptoms without psychotic symptoms as they are more likely to respond to lower doses.
I have also found that low doses of Abilify and Seroquel XR are helpful in reducing the anxiety that people with Post Traumatic Stress Disorder [PTSD] experience. PTSD is felt to be caused by someone experiencing an overwhelming event and then recalling the traumatic nature of the event by having a very sudden intense recalling of the event [a flashback], and/or avoiding situations that are likely to lead to a recollection of the event, and/or re-experiencing smells, or sounds or emotions connected to the event. It used to be thought that only people who have been in combat situations developed PTSD. It is now recognized that many types of events can lead to the development of PTSD. This is very important as in my experience, PTSD is often overlooked as people adapt to chronic stress and are reluctant to report past traumatic events as they are afraid that they will re-experience the trauma, especially as avoidance is a commonly used coping mechanism.
So, why are powerful medications with the risk of metabolic and glucose metabolism side-effects necessary to help in the treatment of PTSD? [As a side note, these side-effects are not common and if any occur the medication is stopped and the side-effects also are stopped with return of normal functioning]. When we are traumatized and we continue to react like we will be traumatized again, our brains are ever alert to any possible threat and will react instantly to alert us to possible danger. This reaction causes stress and anxiety and yet from a survival standpoint is better than not reacting and being overwhelmed and possibly going into shock. In other words, the brain seems willing to have many false positive reactions to avoid the one false negative non-reaction. It seems that our brains would rather have us react thousands of times when we don't need to in order to avoid not reacting when it is critical that we do react. Other medications can help to lower anxiety levels and reactivity but frequently do not stop the majority of the brains instantaneous anxiety reactions. To stop our brains from reacting to these perceived threats we need to have our anxiety levels lowered so that our brain's alarm system is not triggered. We can then learn ways to cope with stress that keep our anxiety levels low and then we will no longer need these medications.
Non-pharmacological treatments for PTSD include: Trauma-Focused Cognitive Behavioral Therapy [TF-CBT]. This treatment can be very helpful in reducing or even eliminating symptoms of PTSD if someone's anxiety level is low enough that they do not feel threatened with being re-traumatized. Interpersonal therapy has also been shown to be helpful in treating PTSD. In addition, mindfulness practices are also helpful and I have blogged about studies that support using these treatments for PTSD.