David Kopacz, MD
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  Academic Presentations

Nefazodone, Visual Trails, and Mistrust in a Viet Nam Veteran

Poster presentation by Kopacz, D., Bencomo, L., and Gabel, T.
at the International Society for Traumatic Stress Studies
Annual Meeting
Washington D.C. | November 1998

Abstract: This case illustrates psychodynamic and psychopharmacological issues pertinent to the treatment of Viet Nam veterans with PTSD. Issues of mistrust were activated during a veteran's participation in an open trial of nefazodone for PTSD.  After experiencing an adverse effect of visual trails, the veteran concluded that the “government” was experimenting on him and giving him “strychnine.” This case is unusual for the onset of visual trails secondary to nefazodone within the first two days of treatment. Questions are raised whether visual trails could be more common in patients with a diagnosis of PTSD or with a history of hallucinogen abuse.

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