Abstract: This case describes the onset and exacerbation of hyperarousal, panic, insomnia, and reexperiencing symptoms of posttraumatic stress disorder with concomitant 1,3-dimethylamylamine (DMAA) ingestion in a combat veteran. DMAA is a sympathomimetic amine stimulant and is used as an ingredient in popular workout supplements marketed to promote weight loss and improve strength and performance. The patient was adherent with his selective serotonin reuptake inhibitor regimen and outpatient therapy during the observed period, so it is possible that his symptom reduction resulted entirely from engagement in treatment. However, the temporal relationship between symptom onset and initiation of the supplement and remission of symptoms with discontinuation suggests an association, although causality cannot be established.
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The participant will recognize the importance of screening for over-the-counter supplement use in psychiatric populations and will describe the potential role of stimulant use in the pathogenesis of posttraumatic stress disorder.
This program is designed for all psychiatrists in clinical practice, residents in Graduate Medical Education programs, medical students interested in psychiatry, and other physicians who wish to advance their current knowledge of clinical medicine.
Estimated Time to Complete
Duration: 1 hour
Begin Date: February 1, 2017
End Date: January 31, 2019
How to Earn Credit
In order to earn CME credit, subscribers should read through the material presented in the article. After reading the article, complete the quiz and submit your evaluation and study hours (up to 1 AMA PRA Category 1 Credit™). A score of 60% or higher is required to receive credit.
The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The APA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Faculty and Planner Disclosures
Title: Use of Stimulants and Performance Enhancers During and After Trauma Exposure in a Combat Veteran: A Possible Risk Factor for Posttraumatic Stress Symptoms
Authors: Ellen Herbst, M.D., Shannon McCaslin, Ph.D., Raj K. Kalapatapu, M.D.
Affiliations: From Mental Health Services, San Francisco VA Health Care System (E.H., R.K.K.); the Department of Psychiatry, University of California, San Francisco (E.H., R.K.K.); and the Dissemination and Training Division, National Center for PTSD, VA Palo Alto Health Care System, Calif. (S.M.C.).
Disclosures: The authors report no financial relationships with commercial interests.
Discussion of unapproved or investigational use of products*: No.
*APA policy requires disclosure by CME authors of unapproved or investigational use of products discussed in CME programs. Off-label use of medications by individual physicians is permitted and common. Decisions about off-label use can be guided by scientific literature and clinical experience.
Robert Freedman, M.D. (Editor-in-Chief, AJP); Susan K. Schultz, M.D. (Deputy Editor, AJP); Michael D. Roy (Editorial Director, AJP); Michael A. Pogachar (Online Content Manager, Journals).
Dr. Schultz has received research support from the Alzheimer’s Disease Cooperative Study for projects conducted in partnership with Toyama Chemical Company and in partnership with Eli Lilly and Company. Dr. Freedman, Mr. Roy, and Mr. Pogachar report no financial relationships with commercial interests.
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