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Propranolol, lithium, anticonvulsants, and buspirone may be effective and should be considered if there is no response to antidepressants. Benzodiazepines are not been effective for PTSD, except during the early, acute phase of the illness. C. Psychotherapy, behavioral therapy, support groups, and family therapy are effective adjuncts to pharmacological treatment. Acute Stress Disorder Acute stress disorder may occur as an acute reaction following exposure to extreme stress. I. DSM-IV Criteria for Acute Stress Disorder.

C. Narcissistic Personality Disorder. Narcissistic patients also lack empathy and are exploitative, but they are not as aggressive or deceitful as antisocial patients. D. Borderline Personality Disorder. These patients are also impulsive and manipulative, but they are more emotionally unstable and they are less aggressive. The manipulativeness of borderline patients is aimed at getting emotional gratification rather than aimed at financial motivations. V. Treatment of Antisocial Personality Disorder A.

Amphetamines, cocaine or caffeine can mimic panic attacks. Physiologic withdrawal from alcohol, benzodiazepines or barbiturates can also precipitate panic attacks. C. Anxiety Due to a General Medical Condition. Pheochromocytoma may mimic panic disorder and is characterized by markedly elevated blood pressure during the episodes of anxiety. It is excluded by a 24-hour urine assay for metanephrine or by serum catecholamines. Cardiac arrhythmias, hyperthyroidism, pulmonary embolism and hypoxia can present with symptoms similar to panic attacks.

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CCS Psychiatry

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