Eye movement desensitization and reprocessing therapy in a patient with alcohol use disorder and posttraumatic stress disorder
Description
Post-traumatic stress disorder (PTSD) is a disorder characterized by involuntary, distressing and repetitive memories of the traumatic event and various symptoms associated with it. Eye movement desensitization and reprocessing (EMDR) therapy is an effective treatment for PTSD. In this case report, the application of EMDR therapy in a patient, with flashback episodes manifested by the somatic symptoms of the traumatic experience, who has been treated for alcohol use disorder will be discussed.
Case presentation:
A 50-year-old male patient was admitted to our clinic with symptoms of alcohol use disorder(AUD). For the last 10 years, the patient received about 16 standard drinks per day. In psychiatric examination; he had depressed mood and tremors. In 2001, the patient had had a work accident by a high-voltage line and had required intensive medical treatment. In addition to the classical symptoms of PTSD, his body had begun to shake, aimless running and tingling sensation in the body. The patient had many traumatic experiences before and after this event. His complaints increased after an in-car traffic accident that resulted in the death of his child and started to drink alcohol every day. In order to overcome body tremors and to be able to work, he started to use alcohol continuously and increase his amount. After the accident, he used various antidepressant medications for the acute stress disorder and later diagnosis of anxiety disorder. In addition, he tried to be treated for addiction but no significant improvement was observed in his complaints after the treatments. He was accepted in the trauma-focused therapy program in addition to standard AUD treatment after being admitted to our Alcohol and Substance Addiction Treatment Center. In the clinical interviews, it was learned that the patient experienced a re-experience flashback of electric shocks during the current shaking and running-tingling attacks. A total of 5 sessions of 30-minute trauma-focused standard EMDR were performed. EMDR sessions were performed by decreasing the duration and amount of sessions as the patient could not comply with standard EMDR therapy. As a result of pharmacotherapy and EMDR treatments, current tremors and running-tingling attacks completely regressed. The patient’s Hamilton anxiety scale (78.5%), depression scale (70%) and BPRS scores (93%) improved after the treatment. Up to 40–50% of patients with AUD have comorbid PTSD. As it is common for addictive patients to focus on alcohol use in order to overcome the traumatic experiences (self-treatment), trauma focused therapies can effectively reduce addiction symptoms in this patient group. In this study, it can be predicted that trauma oriented approaches will affect the prognosis positively in the addicted patients. In our case, the patient with PTSD symptoms had a significant decrease in his symptoms with EMDR treatment. The number of studies examining the effect of traumaoriented treatment approaches such as EMDR in patients with AUD is very small, these methods should be used more frequently and further investigation should be made on the EMDR effect. EMDR can be effective treatment choice for patient with PTSD and comorbid AUD.
Case presentation:
A 50-year-old male patient was admitted to our clinic with symptoms of alcohol use disorder(AUD). For the last 10 years, the patient received about 16 standard drinks per day. In psychiatric examination; he had depressed mood and tremors. In 2001, the patient had had a work accident by a high-voltage line and had required intensive medical treatment. In addition to the classical symptoms of PTSD, his body had begun to shake, aimless running and tingling sensation in the body. The patient had many traumatic experiences before and after this event. His complaints increased after an in-car traffic accident that resulted in the death of his child and started to drink alcohol every day. In order to overcome body tremors and to be able to work, he started to use alcohol continuously and increase his amount. After the accident, he used various antidepressant medications for the acute stress disorder and later diagnosis of anxiety disorder. In addition, he tried to be treated for addiction but no significant improvement was observed in his complaints after the treatments. He was accepted in the trauma-focused therapy program in addition to standard AUD treatment after being admitted to our Alcohol and Substance Addiction Treatment Center. In the clinical interviews, it was learned that the patient experienced a re-experience flashback of electric shocks during the current shaking and running-tingling attacks. A total of 5 sessions of 30-minute trauma-focused standard EMDR were performed. EMDR sessions were performed by decreasing the duration and amount of sessions as the patient could not comply with standard EMDR therapy. As a result of pharmacotherapy and EMDR treatments, current tremors and running-tingling attacks completely regressed. The patient’s Hamilton anxiety scale (78.5%), depression scale (70%) and BPRS scores (93%) improved after the treatment. Up to 40–50% of patients with AUD have comorbid PTSD. As it is common for addictive patients to focus on alcohol use in order to overcome the traumatic experiences (self-treatment), trauma focused therapies can effectively reduce addiction symptoms in this patient group. In this study, it can be predicted that trauma oriented approaches will affect the prognosis positively in the addicted patients. In our case, the patient with PTSD symptoms had a significant decrease in his symptoms with EMDR treatment. The number of studies examining the effect of traumaoriented treatment approaches such as EMDR in patients with AUD is very small, these methods should be used more frequently and further investigation should be made on the EMDR effect. EMDR can be effective treatment choice for patient with PTSD and comorbid AUD.
Format
Conference
Language
English
Original Work Citation
Mercandagi, E., Yazici, A. B., & Yazici. E. (2019). Eye movement desensitization and reprocessing therapy in a patient with alcohol use disorder and posttraumatic stress disorder. Oral Presentation at the 11th International Congress on Psychopharmacology & 7th International Symposium on Child and Adolescent Psychopharmacology. Online Table of Contents, Psychiatry and Clinical Psychopharmacology, 29:sup1, i-xxvi. doi: 10.1080/24750573.2019.1648733
Citation
“Eye movement desensitization and reprocessing therapy in a patient with alcohol use disorder and posttraumatic stress disorder,” Francine Shapiro Library, accessed May 17, 2024, https://francineshapirolibrary.omeka.net/items/show/26204.