PTSD Patients With Stroke History May Resist Medication Regimen

The presence of a mental disorder can make treatment for any physical health concern more challenging. However, with a new focus on treating the whole person, physicians are careful to ascertain whether mental disorders exist through screenings of patients.

One reason physicians are interested in whether a mental health issue is present is the potential complications that can interrupt treatment, in addition to the need to coordinate medications and therapies.

For patients with post-traumatic stress disorder (PTSD), there are many symptoms for doctors to navigate. PTSD symptoms can differ significantly both in type and severity, with many patients experiencing flashbacks, insomnia, in addition to meeting criteria for anxiety and depression.

A recent study finds that stroke survivors who also have a diagnosis for PTSD may be less prone to follow doctors’ instructions to reduce their risk of experiencing another stroke.

Researchers at Columbia University Medical Center found that when a stroke survivor has PTSD, they are at an increased risk of failing to stick to treatment. Sixty-five percent of those who survived a stroke and also had PTSD did not follow doctors’ instructions for treatment, compared to 33 percent among those with no PTSD diagnosis.

The researchers also determined that the findings are partly supported by an overall uncertainty about medication exhibited among those with PTSD. About one out of three, or 38 percent, of those stroke survivors with a history of PTSD were concerned about their medications.

Survivors of a stroke are often put on treatment including antihypertensive agents, statins and antiplatelet, which can decrease the risk of additional strokes. Prior studies have shown a connection between the presence of PTSD, the result of a previous medical event, and a hindered recovery process.

Study author Ian M. Kronish, MD, MPH, assistant professor of medicine at Columbia University explains that adherence to the prescribed medications are one of the most important ways to reduce the risk of experiencing another stroke.

The study involved a group of 535 survivors of a stroke that were asked questions regarding symptoms associated with PTSD, They were also asked to describe their adherence to treatment regimens and their attitudes about medication. The interviews were conducted beginning in March 2010 then continued until January 2012, with participants recruited through clinical trials.

The average time elapsed between the stroke was nearly two years.

When compared to those who did not have a diagnosis or symptoms of PTSD, those with PTSD were more ambivalent in regards to medication and had more worries about long-term impact of taking the medications.

In addition, those with PTSD were more likely to have overall misgivings about the overuse of medication and the general harm of medication treatment.

The researchers believe that the findings may be interpreted as evidence that survivors of a stroke who have PTSD are more likely to see medications as a reminder that they suffered a stroke, rather than a prevention of another stroke.