Hello XXXXXXX

Welcome to Health Care Magic

I have read your query and I can understand your problem. You have been on medicines for PTSD since 2006. You were apparently normal till some time back when Flashbacks started occurring again after about 3 years. You have recently started having the problem of forgetfulness. Doctors are not taking the problem seriously.

See the forgetfulness in your case is not a true forgetfulness. It is not the forgetfulness of dementia. It has its pathological basis in your main diagnosis. In PTSD most commonly depressive symptoms are seen along with flashbacks. Due to this impairment in attention and concentration occurs. The impairment ultimately leads to decline in cognitive functions which manifest as memory loss. It is equivalent to Pseudo dementia seen in the patients of depression. Hypothyroid states further potentiate it.

Now coming to management part. Before going to treatment I would advise you to get few investigations done-
Repeat Thyroid function tests. If it is not in controlled range start or increase the dose of thyroxin.
Vitamin B12 levels. Low levels are main cause for symptoms. Supplements containing B12 will definitely help.

As you have problem of memory and poor arousal then I would recommend you to take medicines that are a little activating. Fluoxetine is best drug in this case. It causes a little arousal as well as it has been approved for use in PTSD also. Other drugs like Escitalopram, Venlafexine can also be used.
If impairment increases in severity medicines containing Piracetam will help. It is a over the counter drug and is available in most of countries. It is claimed to improve cognitive functions.

Apart from medicines try to relax yourself by doing Progressive Muscle Relaxation Exercises, Breathing Exercises, Yoga and Meditation.

For investigations specially related to memory impairment I would advise you to get some psychological evaluation. Tests as XXXXXXX Mental Status Examination (MMSE), Digit Span Test will catch your problem. More specific test for cognitive and executive function, Wincosin Card Sorting Test is also very useful.

Hope I cleared your doubt, If you have more questions you can ask again.
Wish you a good health.

Thanks
Dr. Seikhoo Bishnoi, MD
(Consultant Psychiatrist)

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Hello again
How are you XXXXXXX


The tests I have mentioned to detect over all cognitive decline. These are not exclusively meant for PTSD patients. With these tests poor concentration, attention and defect in registration and recall of memory can be easily found.

See in PTST due to mood disturbances such type of symptoms can occur. As I have already mentioned that they are not due to true memory loss. They are basically due to mood disturbances of PTSD causing cognitive decline.

Thanks
Dr. Seikhoo Bishnoi, MD

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Its my pleasure to answer your queries.
Please review if you are satisfied with my answers.

Thanks, Wish you a good health.

Dr. Seikhoo Bishnoi, MD

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