25th June 2023

A 44-year-old man comes into A&E with episodes where he feels he has left his body and the world is not real

A 44-year-old man comes into A&E with episodes where he feels he has left his body and the world is not real. He recalls the entire event. Each episode lasts 30 minutes to an hour.

His wife tells you that he has been under a lot of stress recently. He was in a big car crash on the motorway 6 months ago. He sustained multiple fractures and had a traumatic brain injury. He was in ITU for several weeks having multiple operations.

He now has chronic pain in his lower back with sciatica and suffers from low mood and flashbacks. He has been put on treatment for depression and has been diagnosed with PTSD by his GP.

Which of the following options is the best treatment option for this patient?