Pharmacological interventions for preventing post-traumatic stress disorder (PTSD)

Amos, Taryn; Stein, Dan J.; Ipser, Jonathan

doi:10.1002/14651858.cd006239.pub2

Cited by 112 publications

(81 citation statements)

References 77 publications

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“…These effects of cytokines on GR function have been shown to be mediated by p38 MAPK that, as noted above, can also affect serotonin transporter expression (Wang et al, 2004). Studies have been conducted and are underway using both adrenergic antagonists and synthetic glucocorticoids in the context of acute trauma to prevent development of PTSD (Amos et al, 2014). Nevertheless, although increased inflammatory markers including CRP have been shown to predict the subsequent development of PTSD (Eraly et al, 2014;Michopoulos et al, 2015), no studies have determined whether those individuals with increased inflammatory markers are the ones who might be most likely to respond to adrenergic or glucocorticoid agonists.…”

Section: Reviewmentioning

confidence: 98%

Therapeutic Implications of Brain–Immune Interactions: Treatment in Translation

Miller

Haroon

Felger

2016

Neuropsychopharmacol

118

124

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A wealth of data has been amassed that details a complex, yet accessible, series of pathways by which the immune system, notably inflammation, can influence the brain and behavior. These data have opened the window to a diverse array of novel targets whose potential efficacy is tied to specific neurotransmitters and neurocircuits as well as specific behaviors. What is clear is that the impact of inflammation on the brain cuts across psychiatric disorders and engages dopaminergic and glutamatergic pathways that regulate motivation and motor activity as well as the sensitivity to threat. Given the ability to identify patient populations with increased inflammation, the precision of interventions can be further tuned, in conjunction with the ability to establish target engagement in the brain through the use of multiple neuroimaging strategies. After a brief overview of the mechanisms by which inflammation affects the brain and behavior, this review examines the extant literature on the efficacy of anti-inflammatory treatments, while forging guidelines for future intelligent clinical trial design. An examination of the most promising therapeutic strategies is also provided, along with some of the most exciting clinical trials that are currently being planned or underway.

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Section: Reviewmentioning

confidence: 98%

Therapeutic Implications of Brain–Immune Interactions: Treatment in Translation

Miller

Haroon

Felger

2016

Neuropsychopharmacol

118

124

View full text Add to dashboard Cite

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“…19 A Cochrane review of pharmacological interventions for preventing PTSD concluded that there is moderate quality evidence for the efficacy of hydrocortisone for the prevention of PTSD development in adults. 20 They found no evidence to support the efficacy of propranolol, escitalopram, temazepam and gabapentin in preventing PTSD onset. The findings, however, were based on a few small studies with multiple limitations.…”

Section: Case Presentationmentioning

confidence: 99%

Resolution of flashbacks of PTSD with propranolol: a case report

Chandavarkar¹,

Sangha²,

Khalil³

2016

Prog Neurol Psychiatry

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An individual suffering from post-traumatic stress disorder (PTSD) can continue to re-experience the traumatic incident, which can involve a sense of extreme fear. In this article, the authors describe the case of a 36-year-old gentleman in whom the use of propranolol for the management of these persistent PTSD symptoms proved beneficial and led to the resolution of his flashback symptoms following difficulty in initial management with multiple other first-line treatment modalities. Propranolol is currently not licensed for use in PTSD.

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“…These include cognitive behavioral therapy (CBT) and its variants (e.g., cognitive processing therapy, prolonged exposure therapy, and stress inoculation therapy), other psychotherapies (e.g., interpersonal, supportive, and psychodynamic psychotherapies), family therapy, group therapy, and pharmacotherapies (e.g., selective serotonin reuptake inhibitors, selective norepinephrine reuptake inhibitors), among others (Gartlehner et al, 2013;Management of Post-Traumatic Stress Working Group, 2010). Cochrane reviews provide evidence specifically in support of trauma-focused CBT, group trauma-focused CBT, eye movement desensitization and reprocessing, and nontrauma-focused CBT (Bisson et al, 2013); selective serotonin reuptake inhibitors (Stein, Ipser, and Seedat, 2006); and hydrocortisone (Amos, Stein, and Ipser, 2014) for PTSD. However, many people with PTSD do not seek treatment or do not receive adequate treatment that is empirically based (Institute of Medicine, 2008).…”

Section: Acknowledgmentsmentioning

confidence: 99%