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Antidepressants PTSD

Matthew J Friedman, Nancy C Bernardy
Posttraumatic stress disorder (PTSD) is a prevalent, disabling, and often chronic condition that may develop following exposure to a traumatic event. Despite the immense social and economic ramifications of PTSD, there has been relatively little recent development of new pharmacotherapies. The majority of pharmacological randomized clinical trials (RCTs) that has been conducted are now dated. Existing treatments for PTSD primarily have come out of research that tested medications developed for other disorders such as antidepressants, anti-hypertensives, antipsychotics, anticonvulsants, and anxiolytics...
November 24, 2016: Neuroscience Letters
Julia König, Sabine Schmid, Eva Löser, Olaf Neumann, Stefan Buchholz, Ralph Kästner
BACKGROUND: There has been increasing research on posttraumatic stress disorder (PTSD) following childbirth in the last two decades. The literature on predictors of who develops posttraumatic stress symptoms (PSS) suggests that both vulnerability and birth factors have an influence, but many studies measure predictors and outcomes simultaneously. OBJECTIVE: In this context, we aimed to examine indirect and direct effects of predictors of PSS, which were measured longitudinally...
2016: European Journal of Psychotraumatology
Patricia Pilkinton, Carlos Berry, Seth Norrholm, Al Bartolucci, Badari Birur, Lori L Davis
OBJECTIVE: Selective serotonin reuptake inhibitors (SSRIs) remain the first-line treatment for posttraumatic stress disorder (PTSD). However, adjunctive atypical antipsychotics are often used to target residual or refractory symptoms. Asenapine is a novel atypical antipsychotic that possesses a high serotonin (5-HT2A) to dopamine (D2) affinity ratio and alpha-adrenergic antagonism, which may be advantageous in treating PTSD. This pilot study aimed to identify the therapeutic potential of asenapine as an adjunctive treatment for PTSD...
August 15, 2016: Psychopharmacology Bulletin
Ilan Harpaz-Rotem, Robert Rosenheck, Somaia Mohamed, Robert Pietrzak, Rani Hoff
BACKGROUND: The pharmacological treatment of post-traumatic stress disorder (PTSD) is extremely challenging, as no specific agent has been developed exclusively to treat this disorder. Thus, there are growing concerns among the public, providers and consumers associated with its use as the efficacy of some agents is still in question. AIMS: We applied a dimensional and symptom cluster-based approach to better understand how the heterogeneous phenotypic presentation of PTSD may relate to the initiation of pharmacotherapy for PTSD initial episode...
September 2016: BJPsych Open
Sarel Jacobus Brand, Brian Herbert Harvey
OBJECTIVE: Post-traumatic stress disorder (PTSD) displays high co-morbidity with major depression and treatment-resistant depression (TRD). Earlier work demonstrated exaggerated depressive-like symptoms in a gene×environment model of TRD and an abrogated response to imipramine. We extended the investigation by studying the behavioural and monoaminergic response to multiple antidepressants, viz. venlafaxine and ketamine with/without imipramine. METHODS: Male Flinders sensitive line (FSL) rats, a genetic model of depression, were exposed to a time-dependent sensitisation (TDS) model of PTSD and compared with stress naive controls...
October 3, 2016: Acta Neuropsychiatrica
Luiz Gustavo Schuch, Anita Yip, Kiana Farah Nouri, Maren Gregersen, Brian Cason, Jasleen Kukreja, Curtis Wozniak, Marek Brzezinski
Serotonin syndrome (SS) is a potentially life-threatening adverse drug reaction that may occur in patients treated with serotonin agonist medications. Medications responsible for serotonin syndrome include commonly prescribed antidepressants, anxiolytics, analgesics, and antiemetics. Veterans with post-traumatic stress disorder (PTSD) are at risk for polypharmacy with serotoninergic medications, given their psychological comorbidities and service-related musculoskeletal injuries. The perioperative period is a particularly vulnerable time owing to the use of high-dose anxiolytics and antiemetics frequently administered in this period, and places PTSD patients at higher risk of SS...
September 2016: Military Medicine
Xixia Chu, Ying Zhou, Zhiqiang Hu, Jingyu Lou, Wei Song, Jing Li, Xiao Liang, Chen Chen, Shuai Wang, Beimeng Yang, Lei Chen, Xu Zhang, Jinjing Song, Yujie Dong, Shiqing Chen, Lin He, Qingguo Xie, Xiaoping Chen, Weidong Li
There is an increasing risk of mental disorders, such as acute stress disorder (ASD), post-traumatic stress disorder (PTSD) and depression among survivors who were trapped in rubble during earthquake. Such long-term impaction of a single acute restraint stress has not been extensively explored. In this study, we subjected mice to 24-hour-restraint to simulate the trapping episode, and investigated the acute (2 days after the restraint) and long-term (35 days after the restraint) impacts. Surprisingly, we found that the mice displayed depression-like behaviors, decreased glucose uptake in brain and reduced adult hippocampal neurogenesis 35 days after the restraint...
2016: Scientific Reports
Sarel Jacobus Brand, Brian Herbert Harvey
OBJECTIVE: Co-morbid depression with post-traumatic stress disorder (PTSD) is often treatment resistant. In developing a preclinical model of treatment-resistant depression (TRD), we combined animal models of depression and PTSD to produce an animal with more severe as well as treatment-resistant depressive-like behaviours. METHODS: Male Flinders sensitive line (FSL) rats, a genetic animal model of depression, were exposed to a stress re-stress model of PTSD [time-dependent sensitisation (TDS)] and compared with stress-naive controls...
August 30, 2016: Acta Neuropsychiatrica
J A Sumner, L D Kubzansky, A L Roberts, P Gilsanz, Q Chen, A Winning, J P Forman, E B Rimm, K C Koenen
BACKGROUND: Post-traumatic stress disorder (PTSD) has been linked to hypertension, but most research on PTSD and hypertension is cross-sectional, and potential mediators have not been clearly identified. Moreover, PTSD is twice as common in women as in men, but understanding of the PTSD-hypertension relationship in women is limited. We examined trauma exposure and PTSD symptoms in relation to incident hypertension over 22 years in 47 514 civilian women in the Nurses' Health Study II. METHOD: We used proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for new-onset hypertension (N = 15 837)...
November 2016: Psychological Medicine
Sidney Zisook, Ilanit Tal, Kimberly Weingart, Paul Hicks, Lori L Davis, Peijun Chen, Jean Yoon, Gary R Johnson, Julia E Vertrees, Sanjai Rao, Patricia D Pilkinton, James A Wilcox, Mamta Sapra, Ali Iranmanesh, Grant D Huang, Somaia Mohamed
OBJECTIVE: Finding effective and lasting treatments for patients with Major Depressive Disorder (MDD) that fail to respond optimally to initial standard treatment is a critical public health imperative. Understanding the nature and characteristics of patients prior to initiating "next-step" treatment is an important component of identifying which specific treatments are best suited for individual patients. We describe clinical features and demographic characteristics of a sample of Veterans who enrolled in a "next-step" clinical trial after failing to achieve an optimal outcome from at least one well-delivered antidepressant trial...
July 26, 2016: Journal of Affective Disorders
Bombi Lee, Bongjun Sur, Mijung Yeom, Insop Shim, Hyejung Lee, Dae-Hyun Hahm
Exposure to severe stress can lead to the development of neuropsychiatric disorders such as depression and post-traumatic stress disorder (PTSD) in at-risk individuals. Gastrodin (GAS), a primary constituent of an Oriental herbal medicine, has been shown to effectively treat various mood disorders. Thus, the present study aimed to determine whether GAS would ameliorate stress-associated depression-like behaviors in a rat model of single prolonged stress (SPS)-induced PTSD. Following the SPS procedure, rats received intraperitoneal administration of GAS (20, 50, or 100 mg/kg) once daily for 2 weeks...
October 2016: Journal of Natural Medicines
J David Kinzie
Refugees are a highly traumatized and culturally diverse group of patients who present many clinical challenges. Refugees have a high prevalence of traumas from torture, ethnic cleansing, and the effects of long civil wars. The most common diagnoses associated with the effects of such traumas are posttraumatic stress disorder (PTSD) or PTSD with comorbid depression; however, psychosis and neurocognitive disorders are also common. For those with PTSD, a suggested treatment approach is long-term supportive psychotherapy with drug treatment directed at reducing the most disruptive symptoms, such as insomnia, nightmares, and irritability or psychosis...
March 2016: Journal of Psychiatric Practice
Daniel J Lee, Carla W Schnitzlein, Jonathan P Wolf, Meena Vythilingam, Ann M Rasmusson, Charles W Hoge
BACKGROUND: Current clinical practice guidelines (CPGs) for posttraumatic stress disorder (PTSD) offer contradictory recommendations regarding use of medications or psychotherapy as first-line treatment. Direct head-to-head comparisons are lacking. METHODS: Systemic review of Medline, EMBASE, PILOTS, Cochrane Central Register of Controlled Trials, PsycINFO, and Global Health Library was conducted without language restrictions. Randomized clinical trials ≥8 weeks in duration using structured clinical interview-based outcome measures, active-control conditions (e...
September 2016: Depression and Anxiety
Ymkje Anna de Vries, Peter de Jonge, Edwin van den Heuvel, Erick H Turner, Annelieke M Roest
BACKGROUND: Antidepressants are established first-line treatments for anxiety disorders, but it is not clear whether they are equally effective across the severity range. AIMS: To examine the influence of baseline severity of anxiety on antidepressant efficacy for generalised anxiety disorder (GAD), social anxiety disorder (SAD), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD) and panic disorder. METHOD: Fifty-six trials of second-generation antidepressants for the short-term treatment of an anxiety disorder were included...
June 2016: British Journal of Psychiatry: the Journal of Mental Science
Valentina Echeverria, J Alex Grizzell, George E Barreto
Neuroinflammation is a common characteristic of several mental health conditions such as major depression, bipolar disorder, post-traumatic stress disorder (PTSD) and schizophrenia (SCHZ). Inflammatory processes trigger and/or further deteriorate mental functions and are regarded as targets for therapeutic drug development. Cotinine is an alkaloid present in tobacco leaves and the main metabolite of nicotine. Cotinine is safe, non-addictive and has pharmacokinetic properties adequate for therapeutic use. Research has shown that cotinine has antipsychotic, anxiolytic, and antidepressant properties and modulates the serotonergic, cholinergic and dopaminergic systems...
2016: Current Pharmaceutical Design
Hiromi Chiba, Misari Oe, Naohisa Uchimura
Major depressive disorder (MDD) has been associated with stressful life events and with posttraumatic stress disorder (PTSD). PTSD and MDD comorbidity was also reported to be associated with greater symptom severity and lower levels of functioning. However, the characteristics of pharmacotherapy for PTSD with MDD are not fully understood. To understand this relationship, we conducted a retrospective review using medical charts at the Department of Neuropsychiatry, Kurume University Hospital. Information from 55 patients with PTSD was analyzed...
2016: Kurume Medical Journal
Z R Donaldson, B le Francois, T L Santos, L M Almli, M Boldrini, F A Champagne, V Arango, J J Mann, C A Stockmeier, H Galfalvy, P R Albert, K J Ressler, R Hen
The G/C single-nucleotide polymorphism in the serotonin 1a receptor promoter, rs6295, has previously been linked with depression, suicide and antidepressant responsiveness. In vitro studies suggest that rs6295 may have functional effects on the expression of the serotonin 1a receptor gene (HTR1A) through altered binding of a number of transcription factors. To further explore the relationship between rs6295, mental illness and gene expression, we performed dual epidemiological and biological studies. First, we genotyped a cohort of 1412 individuals, randomly split into discovery and replication cohorts, to examine the relationship between rs6295 and five psychiatric outcomes: history of psychiatric hospitalization, history of suicide attempts, history of substance or alcohol abuse, current posttraumatic stress disorder (PTSD), current depression...
2016: Translational Psychiatry
John H Krystal, Robert H Pietrzak, Robert A Rosenheck, Joyce A Cramer, Jennifer Vessicchio, Karen M Jones, Grant D Huang, Julia E Vertrees, Joseph Collins, Andrew D Krystal
OBJECTIVE: Sleep disturbances are common among veterans with chronic military-related posttraumatic stress disorder (PTSD). This article reports the results of a multicenter clinical trial that explored the clinical correlates of reported sleep impairment in these veterans and tested the impact of the second-generation antipsychotic risperidone upon these symptoms. METHOD: This article reports secondary analyses of a 24-week multicenter randomized placebo-controlled trial of adjunctive risperidone in patients with chronic military-related PTSD symptoms (n = 267, 97% male) who were symptomatic despite treatment with antidepressants and other medications...
April 2016: Journal of Clinical Psychiatry
Bethany D Ashby, P Kaul
The sexual assault of girls and women in this country is estimated at around 20%. The development of post-traumatic stress disorder (PTSD) following sexual abuse and assault is one of the potential lingering aftereffects. This article will describe PTSD following sexual abuse and its impact on presenting complaints, such as sexually transmitted infections, contraception, and chronic pain, for the pediatric and adolescent gynecology (PAG) clinician. Treatment approaches, including the use of antidepressants and anxiolytics, as well as evidenced based psychotherapies, will be highlighted...
February 9, 2016: Journal of Pediatric and Adolescent Gynecology
Gosia Lipinska, David S Baldwin, Kevin G F Thomas
Symptoms of sleep disturbance, particularly nightmares and insomnia, are a central feature of post-traumatic stress disorder (PTSD). Emerging evidence suggests that specific treatment of PTSD-related sleep disturbance improves other symptoms of the disorder, which in turn suggests that such disturbance may be fundamental to development and maintenance of the disorder. This mini-review focuses on pharmacological treatment of sleep disturbance in adult PTSD (specifically, studies testing the efficacy of antidepressants, adrenergic inhibiting agents, antipsychotics and benzodiazepine and non-benzodiazepine hypnotics)...
March 2016: Human Psychopharmacology
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