Abilify for ptsd

Aripiprazole for Post-traumatic Stress Disorder: A Systematic Review

Review

. 2017 Nov/Dec;40(6):273-278.

doi: 10.1097/WNF.0000000000000251.

Sara R Britnell¹, Anna D Jackson, Jamie N Brown, Bruce P Capehart

Affiliations

Affiliation

¹ *Durham Veterans Affairs Health Care System, Durham; †University of North Carolina Eshelman School of Pharmacy, Chapel Hill; and ‡Duke University School of Medicine, Durham, NC.

PMID: 29059134
DOI: 10.1097/WNF.0000000000000251

Review

Sara R Britnell et al. Clin Neuropharmacol. 2017 Nov/Dec.

. 2017 Nov/Dec;40(6):273-278.

doi: 10.1097/WNF.0000000000000251.

Authors

Sara R Britnell¹, Anna D Jackson, Jamie N Brown, Bruce P Capehart

Affiliation

¹ *Durham Veterans Affairs Health Care System, Durham; †University of North Carolina Eshelman School of Pharmacy, Chapel Hill; and ‡Duke University School of Medicine, Durham, NC.

PMID: 29059134
DOI: 10.1097/WNF.0000000000000251

Abstract

Objective: The aim of this study was to review the safety and efficacy of aripiprazole as monotherapy and adjunct therapy for the treatment of post-traumatic stress disorder (PTSD).

Methods: A search of both MEDLINE (1956 to May 2017) and EMBASE (1957 to May 2017) was conducted using the terms "aripiprazole" and "post-traumatic stress disorder," "posttraumatic stress disorder," or "PTSD." Studies evaluating the primary endpoint of PTSD in patients taking aripiprazole as monotherapy or adjunct therapy were analyzed for relevance. Those that met the objective of this study were included for evaluation: 1 placebo-controlled trial; 4 open-label trials; and 1 retrospective chart review.

Results: In patients with a history of PTSD, aripiprazole resulted in significant improvements in the primary outcome, including Clinician-Administered PTSD Symptom Scale or PTSD Checklist-Military scores, in all but 1 study analyzed. Study durations ranged from 10 to 16 weeks. Initial doses of aripiprazole ranged from 2 to 15 mg daily that could be titrated up or down in the range of 2 to 30 mg daily based on efficacy and tolerability. Overall, aripiprazole was well tolerated with the most common treatment-related study discontinuations attributed to the adverse events of anxiety, insomnia, akathisia, asthenia, restlessness, and somnolence.

Conclusions: Based on the reviewed literature, aripiprazole is a reasonable therapy option as monotherapy or adjunct therapy in patients with PTSD. Larger randomized controlled trials are needed to better understand the role of this atypical antipsychotic in patients with PTSD.

Cited by

Quetiapine Treatment for Post-traumatic Stress Disorder: A Systematic Review of the Literature.
Crapanzano C, Damiani S, Casolaro I, Amendola C. Crapanzano C, et al. Clin Psychopharmacol Neurosci. 2023 Feb 28;21(1):49-56. doi: 10.9758/cpn.2023.21.1.49. Clin Psychopharmacol Neurosci. 2023. PMID: 36700311 Free PMC article. Review.
Block of Voltage-Gated Sodium Channels by Aripiprazole in a State-Dependent Manner.
Föhr KJ, Rapp M, Fauler M, Zimmer T, Jungwirth B, Messerer DAC. Föhr KJ, et al. Int J Mol Sci. 2022 Oct 25;23(21):12890. doi: 10.3390/ijms232112890. Int J Mol Sci. 2022. PMID: 36361681 Free PMC article.
The Choice of Either Quetiapine or Aripiprazole as Augmentation Treatment in a European Naturalistic Sample of Patients With Major Depressive Disorder.
Bartova L, Fugger G, Dold M, Kautzky A, Swoboda MMM, Rujescu D, Zohar J, Souery D, Mendlewicz J, Montgomery S, Fabbri C, Serretti A, Kasper S. Bartova L, et al. Int J Neuropsychopharmacol. 2022 Feb 11;25(2):118-127. doi: 10.1093/ijnp/pyab066. Int J Neuropsychopharmacol. 2022. PMID: 34637516 Free PMC article.
A Case of Comorbid PTSD and Posttraumatic OCD Treated with Sertraline-Aripiprazole Augmentation.
Rossi R, Niolu C, Siracusano A, Rossi A, Di Lorenzo G. Rossi R, et al. Case Rep Psychiatry. 2020 Jan 27;2020:2616492. doi: 10.1155/2020/2616492. eCollection 2020. Case Rep Psychiatry. 2020. PMID: 32047692 Free PMC article.
Management of nightmares in patients with posttraumatic stress disorder: current perspectives.
El-Solh AA. El-Solh AA. Nat Sci Sleep. 2018 Nov 26;10:409-420. doi: 10.2147/NSS.S166089. eCollection 2018. Nat Sci Sleep. 2018. PMID: 30538593 Free PMC article. Review.

Publication types

MeSH terms

Substances

WHY I PRESCRIBE ABILIFY AND SEROQUEL XR FOR PTSD - Dr. Payton's Blog

Abilify [aripiprazole] and Seroquel XR [quetiapine XR] are called atypical antipsychotic medications with their atypicalness relating to the fact that they increase levels of the neurotransmitters serotonin and norepinephrine as well as decreasing the neurotransmitter dopamine which the typical antipsychotics do as well. Research studies have shown that Abilify and Seroquel XR can treat bipolar and depressive mood symptoms as well as psychotic symptoms. Both Abilify and Seroquel XR have low doses available that are helpful for people with mood symptoms without psychotic symptoms as they are more likely to respond to lower doses.

I have also found that low doses of Abilify and Seroquel XR are helpful in reducing the anxiety that people with Post Traumatic Stress Disorder [PTSD] experience. PTSD is felt to be caused by someone experiencing an overwhelming event and then recalling the traumatic nature of the event by having a very sudden intense recalling of the event [a flashback], and/or avoiding situations that are likely to lead to a recollection of the event, and/or re-experiencing smells, or sounds or emotions connected to the event. It used to be thought that only people who have been in combat situations developed PTSD. It is now recognized that many types of events can lead to the development of PTSD. This is very important as in my experience, PTSD is often overlooked as people adapt to chronic stress and are reluctant to report past traumatic events as they are afraid that they will re-experience the trauma, especially as avoidance is a commonly used coping mechanism.

So, why are powerful medications with the risk of metabolic and glucose metabolism side-effects necessary to help in the treatment of PTSD? [As a side note, these side-effects are not common and if any occur the medication is stopped and the side-effects also are stopped with return of normal functioning]. When we are traumatized and we continue to react like we will be traumatized again, our brains are ever alert to any possible threat and will react instantly to alert us to possible danger. This reaction causes stress and anxiety and yet from a survival standpoint is better than not reacting and being overwhelmed and possibly going into shock. In other words, the brain seems willing to have many false positive reactions to avoid the one false negative non-reaction. It seems that our brains would rather have us react thousands of times when we don't need to in order to avoid not reacting when it is critical that we do react. Other medications can help to lower anxiety levels and reactivity but frequently do not stop the majority of the brains instantaneous anxiety reactions. To stop our brains from reacting to these perceived threats we need to have our anxiety levels lowered so that our brain's alarm system is not triggered. We can then learn ways to cope with stress that keep our anxiety levels low and then we will no longer need these medications.

Non-pharmacological treatments for PTSD include: Trauma-Focused Cognitive Behavioral Therapy [TF-CBT]. This treatment can be very helpful in reducing or even eliminating symptoms of PTSD if someone's anxiety level is low enough that they do not feel threatened with being re-traumatized. Interpersonal therapy has also been shown to be helpful in treating PTSD. In addition, mindfulness practices are also helpful and I have blogged about studies that support using these treatments for PTSD.

Do we need federal clinical guidelines for post-traumatic stress disorder in children and adolescents? //Psychological newspaper

Diagnostic concepts for post-traumatic stress disorder (PTSD) and other disorders directly related to stress are intensely debated by the scientific community. PTSD and adjustment disorder are among the most widely used diagnoses in mental health care worldwide. In this article, we review proposals aimed at maximizing the clinical application of the classification and grouping of disorders directly related to stress in the forthcoming 11th revision of the International Classification of Diseases (ICD-11). We propose to consider the role of didactogenic factors in the occurrence of one of the variants of post-traumatic stress disorder - post-didactic stress disorder (PDSD), which allows making a diagnosis based on the history and symptoms of PTSD. In addition, in the article we will try to show the role of diseases such as diabetes mellitus, bronchial asthma, cancer in the occurrence of PTSD in children and adolescents.

Currently, among physicians and psychologists, the Draft Clinical Guidelines "Post-Traumatic Stress Disorder" are being actively discussed [5].

In our opinion, the Draft Clinical Guidelines for PTSD is timely and very necessary for clinicians and rehabilitation specialists, since PTSD is now considered to be one of the five major psychological pathologies. But this Project only considers PTSD in adults. The main disadvantage of the Project, in our opinion, is that it does not consider PTSD in children of different age groups and adolescents. And the factors that cause PTSD in children depend on their age, gender and various causes of stress, so the diagnosis, treatment and rehabilitation of children with PTSD will differ in many ways from that of adults.

Severny A.A. , Iovchuk N.M. in their work conducted a study of the relationship between didactogeny and mental disorders in children caused by schooling. The authors analyzed the psychogenic factors causing or provoking didactogenic depression in primary school students. The article discusses the clinical picture of didactogenic depression, raises the question of its diagnosis and the possibilities of correction [8].

Our earlier survey of 220 students revealed the following deviations in them after a conflict with teachers: 52.7% complained of depressed mood; 67.1% had neurotic disorders; 22.5% - depression; 14.4% - abdominal pain; 47.5% - headaches. Exacerbation of chronic diseases occurred in 14.9%. We regarded these deviations in the state of health as post-didactic stress disorder (PSDD) [1–4].

We have proposed a classification of PDSD in children and adolescents, which presents the periods, course and severity of post-stress disorder. PDSR period: acute crisis phase, PDSR phase, early recovery period, late recovery period, period of residual phenomena. The course of PDSR: acute, subacute, chronic, delayed, deformations of the emotional-volitional sphere. Severity of PDSD: mild, moderate, severe, very severe, suicidal outcome.

In targeted scientific studies, scientists have consistently found significant rates of PTSD symptoms in children and adolescents with a variety of chronic conditions. Studies of pediatric patients and their parents have consistently found high rates of PTSD and PTSD symptoms in various chronic conditions. For example, the prevalence of PTSD in children with cancer ranged from 2% to 20% in survivors, even many years after the end of cancer treatment. In addition, PTSD has been found to be significantly associated with the severity of asthma or life-threatening asthma attacks in children. In severe bronchial asthma, 26% of children had symptoms of PTSD.

So Vanderbilt D. et al. conducted a study of the relationship of post-traumatic stress in children with bronchial asthma aged 7 to 17 years. PTSD has been found to be significantly associated with asthma severity, quality of life, and health care seeking. Identification and treatment of symptoms of post-traumatic stress in children with severe asthma, according to the authors, can help improve the course of asthma and quality of life [9].

In another study Kean E.M. et al. assessed the prevalence of post-traumatic stress (PTS) symptoms in adolescents with and without asthma and their parents, as well as the relationship between PTS symptoms and asthma incidence. This study involved three groups of adolescents aged 12 to 18 years, incl. 49 adolescents who had a life-threatening episode of asthma, 71 from the control group with asthma and 80 healthy children (control group). Adolescents with asthma and their parents, especially those who experienced a life-threatening event, had high rates of asthma-related PTSD symptoms. Therefore, interventions to improve asthma outcomes should include assessment and management of trauma and post-traumatic stress symptoms [10].

Landolt M.A. et al. surveyed 209 children aged 6 to 14 years, 180 mothers and 175 fathers of these children 5–6 weeks after an accident, newly diagnosed cancer, or type 1 diabetes, using the Childhood PTSD Response Index. Importantly, 16% of fathers and 23.9% of mothers fully met the diagnostic criteria for current PTSD. The authors of the study concluded that the type of injury affects parents and children differently [11].

A special group of children and adolescents, in our opinion, includes children and adolescents who have suffered shelling, wounds and contusions, devastation, hunger, injuries and death of people close to them [6; 7]. That is why it is necessary to comprehend and study this problem by specialists working with this group of children and adolescents.

Conclusion

Diagnosis, prevention and rehabilitation of PTSD in children and adolescents is an urgent problem, because. its prevalence, etiology and consequences of PTSD are currently poorly understood, and the rehabilitation of such patients is not widely practiced. Therefore, it is necessary to combine the efforts of the leading specialists of our country dealing with the problem of PTSD to develop the Clinical Guidelines of the Ministry of Health of the Russian Federation on PTSD in children and adolescents. It should specifically highlight the chapter on the diagnosis, treatment and rehabilitation of children with PTSD, depending on age and gender.

Literature

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Ganuzin V.M. Syndrome of pedagogical violence as a form of didactogeny // Medical psychology in Russia. 2013. Volume 5. No. 5. doi: 10.24411/2219-8245-2013-15150
Ganuzin V.M., Borokhov B.D. Psychotraumatic factors at school age and their impact on health: post-didactic stress disorder (review) // Medical Psychology in Russia. 2022. Volume 14. No. 1.
Ganuzin V.M. Bullying, didactogeny and the syndrome of pedagogical violence in domestic and foreign studies // Issues of mental health of children and adolescents. 2020. Volume 20. No. 4. pp. 106-114.
Clinical guidelines (draft) "Post-traumatic stress disorder". https://psy.su/content/files/6016.pdf (date of access: 01/02/2023).
Padun M.A. Complex PTSD: features of psychotherapy of the consequences of prolonged traumatization // Consultative Psychology and Psychotherapy. 2021. Volume 29. No. 3. pp. 69-87. doi:10.17759/cpp.20212
Portnova A.A. Mental disorders in children and adolescents in emergency situations. Abstract diss. ... doctor of medical sciences. M., 2004. 40 p.
Severny A.A., Iovchuk N.M. On the issue of didactogenic depression in younger schoolchildren [Electronic resource] // Psychological science and education psyedu.ru. 2012. Volume 4. No. 1. URL: https://psyjournals.ru/psyedu_ru/2012/n1/50833.shtml (date of access: 01/02/2023).
Vanderbilt D., Young R., MacDonald H.Z., Grant-Knight W., Saxe G., Zuckerman B. Asthma severity and PTSD symptoms among inner city children: a pilot study. J Trauma Dissociation. 2008, 9:191-207. doi: 10.1080/15299730802046136
Kean E.M., Kelsay K. , Wamboldt F., Wamboldt M.Z: Posttraumatic stress in adolescents with asthma and their parents. J Am Acad Child Adolesc Psychiatry. 2006, 45: 7886.10.1097 doi: 10.1097/01.chi.0000186400.67346.02
Landolt M.A., Vollrath M., Ribi K., Gnehm H.E., Sennhauser F.H. Incidence and associations of parental and child posttraumatic stress symptoms in pediatric patients. J Child Psychol Psychiatry. 2003, 44: 1199-1207. doi: 10.1111/1469-7610.00201

PTSD

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PTSD is a normal response
for severe traumatic events.
This booklet deals with symptoms,
symptoms and treatments for PTSD.

New York State
Department of Mental Health

Have you experienced a terrible and dangerous event? Note please, those cases in which you recognize yourself.

Sometimes, out of the blue, everything that happened to me is happening again. I never know when to expect it again.
I have nightmares and memories of the terrible incident which I have experienced.
I avoid places that remind me of that incident.
I jump on the spot and feel uneasy at any sudden movement or surprise. I feel alert all the time.
It's hard for me to trust someone and get close to someone.
Sometimes I just feel emotionally drained and deaf.
I get angry very easily.
I am tormented by guilt that others died, but I survived.
I sleep poorly and experience muscle tension.

PTSD is a very serious condition that needs to be treated.

Many people who have experienced terrible events suffer from this disease.

It is not your fault that you fell ill, and you should not suffer from it.

Read this booklet to find out how you can be helped.

You can get well and enjoy life again!

What is post-traumatic stress disorder (PTSD/PTSD)?

PTSD is a very serious condition. PTSD symptoms may occur in a person who has experienced a terrible traumatic event. This disease is susceptible medical and therapeutic treatment.

PTSD can occur after you:

Have been a victim of sexual abuse
Were victims of physical or emotional abuse in the family
Victim of a violent crime
Have been in a car accident or plane crash
Survived a hurricane, tornado, or fire
Were at war
Survived a life-threatening event
Witnessed any of the above events

If you have post-traumatic stress disorder, you often have nightmares or memories associated with the event. you try to hold on away from anything that might remind you of the experience.

You are angry and unable to trust or care for others. You are always on your guard and see a hidden threat in everything. You become not by itself, when something happens suddenly and without warning.

When does PTSD start and how long does it last?

In most cases, post-traumatic stress manifests itself approximately three months after the traumatic event. In some cases, signs Post-traumatic stress symptoms only show up years later. Post-traumatic Stress affects people of all ages. Even children are not immune from it.

Some get better after six months, others may suffer from it illness for much longer.

Am I the only one with this disease?

No, you are not alone. Every year, 5.2 million Americans suffer from PTSD.

Women suffer from this disease two and a half times more often than men. The most common traumatic events that cause PTSD in men are: rape, participation in hostilities, abandonment and abuse in childhood. The most traumatic events in women are rape, sexual molestation, physical assault, threat weapons and childhood abuse.

What other conditions can accompany PTSD?

Common depression, alcoholism and drug addiction, or other anxiety disorders. The likelihood of successful treatment increases if these comorbidities to identify and treat in time.

Frequent headaches, gastroenterological problems, problems with the immune system, dizziness, chest pain or discomfort in other parts of the body. It often happens that a doctor treats physical symptoms, unaware that their cause lies in PTSD.

The National Institute of Mental Health (NIMH) recommends therapists to learn from patients about experiences of violence, recent losses and traumatic events, especially when symptoms persist are returning. After diagnosing PTSD, it is recommended to refer patient to a mental health specialist who has experience in the treatment of patients with PTSD.

What can I do to help myself in this situation?

Talk to your doctor and tell him about your experience, and how you feel. If you are visited by terrible memories, overcomes depression and sadness if you have trouble sleeping and constantly embittered - you should tell your doctor about all this. Tell him Are any of these conditions preventing you from doing your daily activities? lead a normal life. You may want to show this booklet to your doctor. This may help explain to him how you feel. Ask your doctor examine you to make sure there are no physical illnesses.

Ask your doctor if he has previously had patients suffering from post-traumatic stress. If your doctor does not have a special preparation, ask him for directions to doctor with relevant experience.

How can a doctor or psychotherapist help me?

Your doctor may prescribe medication to help reduce your fear or tension. However, it should be borne in mind that usually several weeks before the medicine starts to work.

Many PTSD sufferers benefit from talking with a professional or other people who have experienced traumatic events. This is called "therapy". Therapy will help you get over your nightmare.

One man's story:
"After I was attacked, I He constantly felt fear and depression, became irritable. I couldn't sleep well and lost my appetite. Even when I tried not think about what happened, I was still tormented nightmares and terrible memories.

“I was completely at a loss and didn't know what to do. one buddy advised to see a doctor. My doctor helped me find a specialist in post-traumatic stress."

“I needed a lot of strength, but after medication and a course of therapy, I gradually come to my senses. It’s good that I called my doctor then.”

PTSD and the military

If you are in the military, you have probably been in combat. You, probably got into terrible and life-threatening situations. They shot at you you have seen your friend shot, you have seen death. experienced you events can cause PTSD.

Experts say PTSD occurs:

Nearly 30% of Vietnam War veterans
Nearly 10% of Gulf War veterans (Operation Desert Storm)
Almost 25% of veterans of the war in Afghanistan (operations "Introducing freedom") and veterans of the war in Iraq (operations "Iraqi Freedom")

Other factors of the military environment can serve as an additional stress to and so stressful situation and can contribute to the development of PTSD and other mental problems. Among these factors are the following: your military specialty, the political aspects of the war, where the battle takes place and who your enemy is.

Another reason that contributes to PTSD in military personnel can be Military Sexual Assault (MST) – any form of sexual harassment or sexual abuse while serving in the military. MST can happen with men and women, and can occur in peacetime, during war training or during the war.

Veterans Affairs (VA) health care approximately:

23 out of 100 women (23%) report sexual violence during military service
55 out of 100 women (55%) and 38 out of 100 men (38%) were exposed to sexual harassment while serving in the army

Although the trauma of sexual assault is more common in the military among women, more than half of veterans who have experienced sexual trauma violence in the army - it's men.

Remember, you can get the help you need right now:

Tell your doctor about your experience and how you feel. If your doctor does not have special training in the treatment of PTSD, ask him for a referral to a doctor who has relevant experience.

PTSD research

To help those suffering from PTSD, the National Institute of Conservation Mental Health (NIMH) supports research into the study of PTSD, as well as other thematically related to PTSD research on problems anxiety and fear. The challenge for research is to find new ways to help people cope with trauma, as well as find new treatment options and, The main thing is to prevent disease.

Research on possible risk factors for PTSD

having terrible memories. Understanding the mechanism of "creation" of scary memories can help improve or find new ways to alleviate symptoms of PTSD. For example, PTSD researchers have identified genes that are responsible for:

Statmin is a protein involved in the formation terrible memories. During one experiment, mice were placed in environment designed to instill fear in them. In this situation mice lacking the statmin gene, in contrast to normal mice were less likely to "freeze" - i.e. exercise natural defensive response to danger. Also in the environment designed to evoke innate fear in them, they demonstrated it to a lesser extent than normal mice, more willingly mastering the open "dangerous" space. ¹

GRP (gastrin-releasing peptide/ GRP) - signal substance brain released during emotional events. At in mice, GWP helps control the fear response, and lack of GWP can lead to a longer memory of fear. ²

Scientists have also discovered a variant of the 5-HTTLPR gene that controls the level of serotonin (a brain substance associated with mood), which, as it turns out, feeds the fear response. ³ It seems that, like in the case of other mental disorders, in the development of PTSD different genes are involved, each of which contributes to the formation of the disease.

Understanding the causes of PTSD can also be helped by studying different areas brain responsible for fear and stress. One of these areas is cerebellar amygdala, responsible for emotions, learning and memory. It turned out that she plays an active role in the emergence of fear (or other words, "teaches" to be afraid of something, for example, to touch a hot stove), as well as in the early phases of fear repayment (or in other words, "teaches" Do not be scared). ⁴

The storage of faded memories and the weakening of the initial fear reaction are associated with the prefrontal cortex (PFC / PFC) of the brain, ⁴ responsible for decision making, problem solving and situation assessment. Each zone PFC has its own role. For example, when the PFC believes that a stressor is amenable to control, the medial prefrontal zone of the PFC suppresses the anxiety center deeply in the brainstem and controls the response to stress. ⁵ Ventromedial PFC helps maintain long-term fading of fearful memories, and her ability to perform this feature can be affected by its size. ⁶

Individual differences in genes or characteristics of brain regions brain can only set the stage for PTSD, but by themselves do not cause no symptoms. environmental factors such as childhood trauma, head trauma or mental illness in family, favor the development of the disease and increase the risk of disease, affecting the brain in the early stages of its growth. ⁷ Except In addition, how people adapt to trauma is likely to be influenced by and characteristics of character and behavior, such as optimism and a tendency to consider problems in a positive or negative way, as well as social factors such as availability and use of social support. ⁸ Further research may show what combination of these factors or what other factors will allow ever predict who has a traumatic event cause PTSD, and who doesn't.

PTSD research

Currently, psychotherapy is used in the treatment of PTSD ("talk" therapy), drugs or drug-therapeutic combination.

Psychotherapy

Cognitive behavioral therapy (CBT) helps you learn differently think and react to frightening events that are the impetus for development PTSD, and can help bring the symptoms of the disease under control. There are several types cognitive behavioral therapy, including:

"Push" method - uses mental images, notes or visiting a place experienced trauma to help those affected face the overwhelming their fear and take control of it.

Behavior restructuring (cognitive restructuring) - encourages survivors of a traumatic event express depressing (often erroneous) thoughts about experienced trauma, challenge these thoughts and replace them with more balanced and appropriate.

Implementation in a stressful situation - teaches ways to reduce anxiety and the ability to cope with it, helping to reduce the symptoms of PTSD, and helps to correct the erroneous train of thought associated with the trauma experienced. NIMH is currently conducting research to study the reaction brain response to cognitive behavioral therapy versus response sertraline (Zoloft) - one of two drugs recommended and approved US Food and Drug Administration funds (FDA) for the treatment of post-traumatic stress. This research may help find out why some people respond better to medications, and others for psychotherapy

Medicines

Recently, in a small study, NIMH researchers found that if patients who are already taking a dose of prazosin (Minipress) at bedtime, add a daily dose, then this weakens the general symptoms of PTSD and stress reaction to reminders of the trauma experienced. ⁹

Another drug of interest is D-cycloserine (Seromycin), which increases the activity of a brain substance called N-methyl-D-aspartate, needed to pay off fear. During the study, which was attended by 28 people suffering from a fear of heights, scientists found that patients who received "push" therapy before a session D-cycloserine, showed lower levels of fear during the session compared to those who did not receive the drug. ¹⁰ Currently scientists study the effectiveness of the combined use of D-cycloserine and therapy for the treatment of post-traumatic stress.

Propranolol (Inderal), a beta-blocker drug, also under study whether it can be used to reduce post-traumatic stress and break the chain of scary memories. First experiments gave consoling results: it was possible to successfully weaken and, it seems, prevent PTSD in a small number of victims of traumatic events. ¹¹

For example, in one preliminary study, scientists created a website self-help, based on the use of a psychotherapeutic method implementation in a stressful situation. First, patients with PTSD meet in person with doctor. After this meeting, participants can go to the site to find more information about PTSD and how to deal with the problem; their doctors may also visit the site to give advice or briefing. In general, scientists believe that therapy in this form - promising treatment for a large number of people suffering from PTSD. ¹²

Scientists are also working to improve methods for testing early treatment and monitoring of survivors of massive trauma, on developing ways to teach them self-assessment skills and introspection and referral mechanism to psychiatrists (if necessary).

Prospects for PTSD research

In the last decade, rapid progress in the study of mental and biological PTSD has led scientists to conclude that there is a need to focus on prevention, as the most realistic and important goal.

For example, in order to find ways to prevent PTSD, with funding NIMH conducts research to develop new and orphan drugs, aimed at combating the underlying causes of the disease. During another research scientists are looking for ways to enhance behavioral, personality and social protective factors and minimizing risk factors for prevent the development of PTSD after trauma. Another study is studying the question of what factors influence the difference in response to one or another method of treatment, which will help in the development of more individual, effective and productive methods of treatment.

Where can I find more information?

MedlinePlus - resource from the American National Library of Medicine (U.S. National Library of Medicine and the National Institutes of Health) - offers the latest information on many health issues. Information about You can find PTSD at: www.nlm.nih.gov/medlineplus/posttraumaticstressdisorder.html.

National Institute of Mental Health
Office of Science Policy, Planning, and Communications
[National Institute of Mental Health
Science Policy Division research, planning and communications]
6001 Executive Boulevard
Room 8184, MSC 9663
Bethesda, MD 20892-9663
Phone: 301-443-4513; Fax: 301-443-4279
fax answering system Free answering machine: 1-866-615-NIMH (6464)
Text phone: 1-866-415-8051 toll-free
Email: [email protected]

National Center for Post-traumatic Stress Disorder
[National PTSD Center]
VA Medical Center (116D)
215 North Main Street
White River Junction, VT 05009
802-296-6300
www. ncptsd.va.gov

NOTES

Shumyatsky GP, Malleret G, Shin RM, et al. Stathmin, a Gene Enriched in the Amygdala, Controls Both Learned and Innate Fear. cell. Nov 18 2005;123(4):697-709.
Shumyatsky GP, Tsvetkov E, Malleret G, et al. Identification of a signal network in lateral nucleus of amygdala important for inhibiting memory specifically related to learned fear. cell. Dec 13 2002;111(6):905-918.
Hariri AR, Mattay VS, Tessitore A, et al. Serotonin transporter genetic variation and the response of the human amygdala.Science. Jul 192002;297(5580):400-403.
Milad MR, Quirk GJ. Neurons in medial prefrontal cortex signal memory for fear extinction. Nature. Nov 7 2002;420(6911):70-74.
5 Amat J, Baratta MV, Paul E, Bland ST, Watkins LR, Maier SF. Medial prefrontal cortex determines how stressor controllability affects behavior and dorsal raphe nucleus. Nat Neurosci. Mar 2005;8(3):365-371.
Milad MR, Quinn BT, Pitman RK, Orr SP, Fischl B, Rauch SL. Thickness of ventromedial prefrontal cortex in humans is correlated with extinction memory. Proc Natl Acad Sci USA. Jul 26 2005;102(30):10706-10711.
Gurvits TV, Gilbertson MW, Lasko NB, et al. Neurological soft signs in chronic posttraumatic stress disorder.Arch Gen Psychiatry. Feb 2000;57(2):181-186.
Brewin CR. Risk factor effect sizes in PTSD: what this means for intervention. J Trauma Dissociation. 2005;6(2):123-130.
Taylor FB, Lowe K, Thompson C, et al. Daytime Prazosin Reduces Psychological Distress toTrauma Specific Cues in Civilian Trauma Posttraumatic stress disorder. Biol Psychiatry. Feb 3 2006.
Ressler KJ, Rothbaum BO, Tannenbaum L, et al. Cognitive enhancers as adjuncts to psychotherapy: use of D-cycloserine in phobic individuals to facilitate extinction of fear. Arch Gen Psychiatry. Nov 2004;61(11):1136-1144.
Pitman RK, Sanders KM, Zusman RM, et al. Pilot study of secondary prevention of posttraumatic stress disorder with propranolol.Biol Psychiatry. Jan 15 2002;51(2):189-192.
Litz BTWL, Wang J, Bryant R, Engel CC.A therapist-assisted Internet self-help program for traumatic stress. Prof Psychol Res Pr. December 2004;35(6):628-634.

New York State Department of Mental Health expresses thanks to the National Institute of Mental Health for the information, used in this booklet.

Published by the State Division of Mental Health New York, June 2008.

New York State
Andrew M. Cuomo Governor

Mental Health Division
Head of Department Michael F. Hogan, PhD
For more information about this edition contact:
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Abilify for ptsd

Aripiprazole for Post-traumatic Stress Disorder: A Systematic Review

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