Effect of Pregabalin Augmentation in Treatment of Patients with Combat-Related Chronic Posttraumatic Stress Disorder

Baniasadi, Mehdi; Hosseini, Golkoo; Bordbar, Mohammad Reza Fayyazi; Ardanı, Amir Rezaeı; Toroghi, Hesam Mostafavi

doi:10.1097/01.pra.0000456590.12998.41

Cited by 22 publications

(15 citation statements)

References 38 publications

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“…Pregabalin (PGB), a gabapentinoid derivative of γ-aminobutyric acid, possesses the potential to positively affect neurobehavioral changes associated with PTSD. Baniasadi et al ., found that pregabalin used as an adjunct to traditional treatments, effectively reduced the severity of PTSD symptoms in patients diagnosed with chronic PTSD [19]. This study of 37 adult male patients specifically examined a post-exposure treatment model.…”

Section: Introductionmentioning

confidence: 99%

Effects of pregabalin on neurobehavior in an adult male rat model of PTSD

et al. 2018

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Posttraumatic stress disorder (PTSD) can be a very debilitating condition. Effective approaches to prevent and treat PTSD are important areas of basic science research. Pregabalin (PGB), a gabapentinoid derivative of γ-aminobutyric acid, possesses the potential to positively affect neurobehavioral changes associated with PTSD. Using a rodent model of PTSD, the aims of this study were to determine the effects of PGB as a possible prevention for the development of PTSD-like symptoms and its use as a possible treatment. A prospective, experimental, between groups design was used in conjunction with a three-day restraint/shock PTSD stress model. Sixty rats were randomly assigned between two groups, non-stressed and stressed (PTSD). Each of the main two groups was then randomly assigned into six experimental groups: control vehicle, control PGB, control naïve, PTSD vehicle, PTSD Pre-PGB (prophylactic), PTSD Post-PGB (non-prophylactic). The neurobehavioral components of PTSD were evaluated using the elevated plus maze (EPM), Morris water maze (MWM), and forced swim test (FST). Pregabalin administered 24 hours before the initial PTSD event or for 10 days following the last PTSD stress event did not statistically improve mean open arm exploration on the EPM, spatial memory, and learning in the MWM or behavioral despair measured by the FST (p > 0.05).

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Section: Introductionmentioning

confidence: 99%

Effects of pregabalin on neurobehavior in an adult male rat model of PTSD

et al. 2018

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“…Six studies assessed risperidone (Bartzokis et al, 2005;Hamner et al, 2000;Krystal et al, 2011;Monnelly et al, 2003;Reich et al, 2004;Rothbaum et al, 2008), three assessed topiramate (Akuchekian & Amanat, 2004;Batki et al, 2014;Lindley et al, 2007), and two assessed d-cycloserine (Attari et al, 2014;Heresco-Levy et al, 2002). There were single studies assessing aripiprazole (Naylor et al, 2015), baclofen (Manteghi et al, 2014), bupropion (Becker et al, 2007), eszopiclone (Pollack et al, 2011), guanfacine (Neylan et al, 2006), hydrocortisone (Ludascher et al, 2015), mirtazapine (Schneier et al, 2015), nabilone (Jetly et al, 2015), olanzapine (Stein et al, 2002), pregabalin (Baniasadi et al, 2014), sodium valproate (Hamner et al, 2009) and ziprasidone (Ramaswamy et al, 2016). The average duration of studies was 10.5 (±5.6) weeks, with an average age of 44.6 (±7.7) years and a mean sample size of 52.2 (±66.1) participants.…”

Section: Description Of Studiesmentioning

confidence: 99%

Pharmacological therapy for post-traumatic stress disorder: a systematic review and meta-analysis of monotherapy, augmentation and head-to-head approaches

Hoskins

Bridges

Sinnerton

et al. 2021

European Journal of Psychotraumatology

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Background: Pharmacological approaches are widely used for post-traumatic stress disorder (PTSD) despite uncertainty over efficacy. Objectives: To determine the efficacy of all pharmacological approaches, including monotherapy, augmentation and head-to-head approaches (drug versus drug, drug versus psychotherapy), in reducing PTSD symptom severity. Method: A systematic review and meta-analysis of randomised controlled trials were undertaken; 115 studies were included. Results: Selective serotonin reuptake inhibitors (SSRIs) were found to be statistically superior to placebo in reduction of PTSD symptoms but the effect size was small (standardised mean difference −0.28, 95% CI −0.39 to −0.17). For individual monotherapy agents compared to placebo in two or more studies, we found small statistically significant evidence for the antidepressants fluoxetine, paroxetine, sertraline, venlafaxine and the antipsychotic quetiapine. For pharmacological augmentation, we found small statistically significant evidence for prazosin and risperidone. Conclusions: Some medications have a small positive effect on reducing PTSD symptom severity and can be considered as potential monotherapy treatments; these include fluoxetine, paroxetine, sertraline, venlafaxine and quetiapine. Two medications, prazosin and risperidone, also have a small positive effect when used to augment pharmacological monotherapy. There was no evidence of superiority for one intervention over another in the small number of head-to-head comparison studies. Tratamiento farmacologico para el trastorno de estres postraumatico: una revision sistematica y metanalisis de monoterapia, potenciacion y abordajes comparativos Antecedentes: Los abordajes farmacológicos se usan ampliamente para el trastorno de estrés postraumático (TEPT) a pesar de su eficacia incierta. Objetivos: Determinar la eficacia de todos los abordajes farmacológicos, incluyendo monoterapia, potenciación y abordajes comparativos (droga versus droga, droga versus psicoterapia), en la reducción de la severidad de los síntomas de TEPT. Método: Se llevó a cabo una revisión sistemática y metanálisis de estudios controlados aleatorizados; se incluyeron 115 estudios. Resultados: Se encontró que los inhibidores selectivos de la recaptación de serotonina (ISRSs) fueron estadísticamente superiores a placebo en la reducción de los síntomas de TEPT, pero el tamaño de efecto fue pequeño (diferencia media estandarizada −0.28, IC 95% −0.39 a −0.17). Para agentes en monoterapia individuales comparados con placebo en dos o más estudios, encontramos para los antidepresivos fluoxetina, paroxetina, sertralina, venlafaxina y el antipsicótico quetiapina una evidencia estadísticamente significativa pequeña. Para la potenciación farmacológica, encontramos para prazosina y risperidona, evidencia estadísticamente significativa pequeña. Conclusiones: Algunos medicamentos tienen un efecto positivo pequeño en la reducción de la severidad de los síntomas de TEPT y pueden ser considerados como potenciales tratamientos en monoterap...

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“…Characteristics of 2,331 adult patients from published doubleblind, parallel 36 RCTs (Frank et al, 1988;Davidson et al, 1990;Kosten et al, 1991;Hertzberg et al, 2000;Stein et al, 2002;Zohar et al, 2002;Hamner et al, 2003;Monnelly et al, 2003;Akuchekian & Amanat, 2004;Chung et al, 2004;Davis et al, 2004;Bartzokis et al, 2005;Neylan et al, 2006;Friedman et al, 2007;Lindley et al, 2007;Raskind et al, 2007;Davis et al, 2008a;Davis et al, 2008b;Hamner et al, 2009;Krystal et al, 2011;Panahi et al, 2011;Germain et al, 2012;Litz et al, 2012;Baniasadi et al, 2014;Batki et al, 2014;Manteghi et al, 2014;Rothbaum et al, 2014;Naylor et al, 2015;Back et al, 2016;Petrakis et al, 2016;Rodgman et al, 2016;Villarreal et al, 2016;Ramaswamy et al, 2017;Rezaei Ardani et al, 2017;Surís et al, 2017;Raskind et al, 2018) were described in the study. Among them, three studies (Frank et al, 1988;Kosten et al, 1991;Rothbaum et al, 2014) reported active-comparator experiments.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Among them, three studies (Frank et al, 1988;Kosten et al, 1991;Rothbaum et al, 2014) reported active-comparator experiments. Our research involves a variety of drug types, including atypical antipsychotics (AASs) (Stein et al, 2002;Monnelly et al, 2003;Bartzokis et al, 2005;Hamner et al, 2009;Krystal et al, 2011;Naylor et al, 2015;Villarreal et al, 2016), corticosteroids (Surís et al, 2017), alpha blockers (Raskind et al, 2007;Germain et al, 2012;Petrakis et al, 2016;Rodgman et al, 2016;Raskind et al, 2018), anticonvulsants (Hamner et al, 2003;Akuchekian & Amanat, 2004;Lindley et al, 2007;Davis et al, 2008a;Batki et al, 2014), central muscle relaxants (Manteghi et al, 2014), D-cycloserine (Litz et al, 2012;Rothbaum et al, 2014), N-acetylcysteine (Back et al, 2016), γ-aminobutyric acid (Baniasadi et al, 2014), reversible cholinesterase inhibitor (Rezaei Ardani et al, 2017), serotonin antagonist and reuptake inhibitors (SARIs) (Davis et al, 2004); SSRIs (Hertzberg et al, 2000;Zohar et al, 2002;Friedman et al, 2007;Panahi et al, 2011;Ramaswamy et al, 2017), tricyclic antidepressants (TCAs) (Frank et al, 1988;Davidson et al, 1990;Kosten et al, 1991), α2 receptor agonist…”

Section: Study Characteristicsmentioning

confidence: 99%

Key Clinical Interest Outcomes of Pharmaceutical Administration for Veterans With Post-Traumatic Stress Disorder Based on Pooled Evidences of 36 Randomised Controlled Trials With 2,331 Adults

et al. 2020

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Background: The effects of drug treatment on veterans, who have a high risk of post-traumatic stress disorder (PTSD), are not clear, and the guidelines are different from the recommendations of the recent meta-analysis. Our goal was to find the efficacy and frequencies of complications of drugs that can treat PTSD in veterans.Method: We searched Ovid MEDLINE, Ovid Embase, The Cochrane Library and Web of Science until January 1, 2020. The outcomes were designed as the change of PTSD total scale, subsymptom score, response rate, frequencies of complications outcomes, and acceptability.Results: We included a total of 36 randomised controlled trials with a total of 2,331 adults. In terms of overall effect, drug treatment is more effective than placebo in change in total PTSD symptoms scale (SMD = −0.24, 95% CI [−0.42, −0.06]) and response (RR = 1.66, 95% CI [1.01, 2.72]). However, in terms of frequencies of complications, drugs generally had a higher withdrawal rate (RR = 1.02, 95% CI [0.86, 1.20]) and a higher frequencies of complications (RR = 1.72, 95% CI [1.20, 2.47]) than placebo. Risperidone showed a good curative effect in change in total PTSD symptoms scale (SMD = −0.22, 95% CI [−0.43, 0.00]) and acceptability (RR = 1.31, 95% CI [0.82, 2.59]). The drugs acting on 5−HT receptors, our results showed that symptoms of hyper−arousal (SMD = −0.54, 95% CI [−0.86, −0.21]), symptoms of re−experiencing (SMD = −0.62, 95% CI [−0.86, −0.39]) and symptoms of avoidance (SMD = −0.53, 95% CI [− 0.77,−0.3]), The drugs acting on dopamine receptors, our results showed that symptoms of re−experiencing (SMD = −0.35, 95% CI [−0.55, −0.16]) and the drugs acting on α2 receptor has a significant effect on reducing total PTSD symptoms scale (SMD = −0.34, 95% CI [−0.62, −0.06]).Conclusion: Drug therapy can effectively treat PTSD, but its frequencies of complications should be considered. Different from the guidelines for adult PTSD, this study supports atypical antipsychotics, selective serotonin reuptake inhibitors and receptors that act on 5-HT and dopamine for the treatment of PTSD in veterans. Based on evidence among these drugs, the risperidone is the most effective for veterans, otherwise, sertraline is used as an alternative.

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Effect of Pregabalin Augmentation in Treatment of Patients with Combat-Related Chronic Posttraumatic Stress Disorder

Abstract: Pregabalin effectively reduced the severity of PTSD symptoms but it was not effective in improving the severity of depression, anxiety, and quality of life. Further investigations are required to confirm or refute these findings.

Cited by 22 publications

References 38 publications

Effects of pregabalin on neurobehavior in an adult male rat model of PTSD

Effects of pregabalin on neurobehavior in an adult male rat model of PTSD

Pharmacological therapy for post-traumatic stress disorder: a systematic review and meta-analysis of monotherapy, augmentation and head-to-head approaches

Key Clinical Interest Outcomes of Pharmaceutical Administration for Veterans With Post-Traumatic Stress Disorder Based on Pooled Evidences of 36 Randomised Controlled Trials With 2,331 Adults

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