Use of Stimulants and Performance Enhancers During and After Trauma Exposure in a Combat Veteran: A Possible Risk Factor for Posttraumatic Stress Symptoms

Attention Deficit Hyperactivity Disorder and Risk of Posttraumatic Stress and Related Disorders: A Prospective Longitudinal Evaluation in U.S. Army Soldiers

“…The increased risk of deployment-related PTSD associated with preexisting ADHD raises the question of whether treatment of preexisting ADHD may be protective in individuals exposed to trauma. Although it has been proposed that stimulant medications (a first-line treatment for ADHD) could heighten the risk of PTSD by increasing brain norepinephrine and thus strengthening traumatic memories (Crum-Cianflone et al, 2015; Herbst, McCaslin, & Kalapatapu, 2017), preclinical and clinical research has suggested that stimulants may have beneficial effects in individuals who have been exposed to trauma. The stimulant methylphenidate appears to enhance extinction of contextual fear in mice (Abraham, Cunningham, & Lattal, 2012) and improve PTSD-like symptoms in a rat model, particularly when combined with the antidepressant desipramine (Aga-Mizrachi et al, 2014).…”

Performance and image enhancing drugs use in active military personnel and veterans: A contemporary review

“…27,32,33 Keeping up with the physical demands of service was linked with the demands of physical expectations and the strength-based nature of military service. 26,28,34 A qualitative study reported service personnel using PIEDs during deployment to cope with the physical demands of long patrols and also the psychological demands of engaging in combat, holding their nerve and potentially taking another person's life. 35 One participant in the study provided substantial detail about his struggle with deployment and his reservations about firing his weapon and how PIEDs helped him to feel more aggressive and able to engage in combat.…”

“…33,[36][37][38][39][40] Mental health concerns such as panic attacks, extreme aggression, negative self-image, disturbing thoughts, and behavioral change were reported following PIEDs use. 23,24,26,34,35,40,41 3.6 | How are serving military personnel and veterans introduced to PIEDs (ie, was their introduction pre-, during-,…”

“…22,35 This contrasts with other studies reporting that PIEDs use may have started after a break from the armed forces training due to leave or injury. 33,34 However, research investigating when PIEDs use commenced in armed forces users is limited so any generalization must be treated with caution.…”

“…The literature included in the current review suggests that active service personnel either purchased PIEDs online, from other countries when visiting, or from fellow members of the armed forces. 26,34,35 In a qualitative study, participants mentioned traveling to Mexico when stationed in southern USA to purchase anabolic steroids in pill form or to receive anabolic steroid injections. In addition, other participants reported purchasing anabolic steroids from other members of the armed forces including army medics.…”