Integrating Endocannabinoid Signaling and Cannabinoids into the Biology and Treatment of Posttraumatic Stress Disorder

Neuropsychopharmacology, Journal Year: 2017, Volume and Issue: 43(1), P. 80 - 102

Published: July 26, 2017

Language: Английский

---

Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review

Current Neuropharmacology, Journal Year: 2023, Volume and Issue: 22(4), P. 557 - 635

Published: May 3, 2023

Abstract: This narrative state-of-the-art review paper describes the progress in understanding and treatment of Posttraumatic Stress Disorder (PTSD). Over last four decades, scientific landscape has matured, with many interdisciplinary contributions to its diagnosis, etiology, epidemiology. Advances genetics, neurobiology, stress pathophysiology, brain imaging have made it apparent that chronic PTSD is a systemic disorder high allostatic load. The current state includes wide variety pharmacological psychotherapeutic approaches, which are evidence-based. However, myriad challenges inherent disorder, such as individual barriers good outcome, comorbidity, emotional dysregulation, suicidality, dissociation, substance use, trauma-related guilt shame, often render response suboptimal. These discussed drivers for emerging novel including early interventions Golden Hours, interventions, medication augmentation use psychedelics, well targeting nervous system. All this aims improve symptom relief clinical outcomes. Finally, phase orientation recognized tool strategize position step progression pathophysiology. Revisions guidelines systems care will be needed incorporate innovative treatments evidence emerges they become mainstream. generation well-positioned address devastating disabling impact traumatic events through holistic, cutting-edge efforts research.

Language: Английский

---

The Psychedelic Future of Post-Traumatic Stress Disorder Treatment

Current Neuropharmacology, Journal Year: 2024, Volume and Issue: 22(4), P. 636 - 735

Published: Jan. 5, 2024

Post-traumatic stress disorder (PTSD) is a mental health condition that can occur following exposure to traumatic experience. An estimated 12 million U.S. adults are presently affected by this disorder. Current treatments include psychological therapies (e.g., exposure-based interventions) and pharmacological selective serotonin reuptake inhibitors (SSRIs)). However, significant proportion of patients receiving standard-of-care for PTSD remain symptomatic, new approaches other trauma-related conditions greatly needed. Psychedelic compounds alter cognition, perception, mood currently being examined their efficacy in treating despite current status as Drug Enforcement Administration (DEA)- scheduled substances. Initial clinical trials have demonstrated the potential value psychedelicassisted therapy treat psychiatric disorders. In comprehensive review, we summarize state science care, including shortcomings. We review studies psychedelic interventions PTSD, disorders, common comorbidities. The classic psychedelics psilocybin, lysergic acid diethylamide (LSD), N,N-dimethyltryptamine (DMT) DMT-containing ayahuasca, well entactogen 3,4-methylenedioxymethamphetamine (MDMA) dissociative anesthetic ketamine, reviewed. For each drug, present history use, somatic effects, pharmacology, safety profile. rationale proposed mechanisms use traumarelated disorders discussed. This concludes with an in-depth consideration future directions applications maximize therapeutic benefit minimize risk individuals communities impacted conditions.

Language: Английский

---

Posttraumatic stress disorder, trauma, and accelerated biological aging among post-9/11 veterans

Translational Psychiatry, Journal Year: 2024, Volume and Issue: 14(1)

Published: Jan. 6, 2024

Abstract People who experience trauma and develop posttraumatic stress disorder (PTSD) are at increased risk for poor health. One mechanism that could explain this is accelerated biological aging, which associated with the accumulation of chronic diseases, disability, premature mortality. Using data from 2309 post-9/11 United States military veterans participated in VISN 6 MIRECC’s Post-Deployment Mental Health Study, we tested whether PTSD exposure were rate assessed using a validated DNA methylation (DNAm) measure epigenetic aging—DunedinPACE. Veterans current aging faster than those did not have PTSD, β = 0.18, 95% CI [0.11, 0.27], p < .001. This effect represented an additional 0.4 months each year. also if they reported more symptoms, 0.13, [0.09, 0.16], 0.001, or higher levels exposure, 0.09, [0.05, 0.13], 0.001. Notably, past slowly -0.21, [-0.35, -0.07], .003. All results accounted age, gender, self-reported race/ethnicity, education, remained when controlling smoking. Our findings suggest help how contributes to health highlights potential benefits providing efficacious treatment populations PTSD.

Language: Английский

---

Metabolism, Metabolomics, and Inflammation in Posttraumatic Stress Disorder

Biological Psychiatry, Journal Year: 2018, Volume and Issue: 83(10), P. 866 - 875

Published: Feb. 22, 2018

Language: Английский

---

Treatment of military-related post-traumatic stress disorder: challenges, innovations, and the way forward

International Review of Psychiatry, Journal Year: 2019, Volume and Issue: 31(1), P. 95 - 110

Published: Jan. 2, 2019

Post-traumatic stress disorder (PTSD) is one of the common mental disorders in military and veteran populations. Considerable research clinical opinion has been focused on understanding relationship between PTSD service implications for prevention, treatment, management. This paper examines factors associated with development this population, considers issues relating to engagement discusses empirical support best practice evidence-based treatment. The goes explore challenges those areas, particular reference treatment barriers care, as well non-response. final section addresses innovative solutions these through improvements agreed terminology definitions, strategies increase engagement, early identification approaches, predictors outcome, innovations Treatment include enhancing existing treatments, emerging non-trauma-focused interventions, novel pharmacotherapy, personalized medicine advancing functional outcomes, family intervention support, attention physical health.

Language: Английский

---

Noncoding RNAs: Stress, Glucocorticoids, and Posttraumatic Stress Disorder

Biological Psychiatry, Journal Year: 2018, Volume and Issue: 83(10), P. 849 - 865

Published: Jan. 31, 2018

Posttraumatic stress disorder (PTSD) is a pathologic response to trauma that impacts ∼8% of the population and highly comorbid with other disorders, such as traumatic brain injury. PTSD affects multiple biological systems throughout body, including hypothalamic-pituitary-adrenal axis, cortical function, immune system, while study underpinnings related disorders are numerous, roles noncoding RNAs (ncRNAs) just emerging. Moreover, deep sequencing has revealed ncRNAs represent most transcribed mammalian genome. Here, we present developing evidence involved in critical aspects pathophysiology. In regard, summarize three classes disorders: microRNAs, long-noncoding RNAs, retrotransposons. This review evaluates findings from both animal human studies special focus on role axis abnormalities glucocorticoid dysfunction We conclude may prove be useful biomarkers facilitate personalized medicines for trauma-related disorders.

Language: Английский

---

Prolonged grief disorder in DSM-5-TR: Early predictors and longitudinal measurement invariance

Australian & New Zealand Journal of Psychiatry, Journal Year: 2021, Volume and Issue: 56(6), P. 667 - 674

Published: July 7, 2021

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision includes prolonged grief disorder as a novel disorder. Prolonged can be diagnosed when acute stays distressing disabling, beyond 12 months following bereavement. Evidence indicates that elevated symptoms in the first year bereavement predict pervasive later time; targeting early may potentially prevent getting chronic. There is limited knowledge about characteristics people who have an chance developing full 12-month time point. This study examined these characteristics.We used self-reported data from 306 adults all completed questions on socio-demographic loss-related plus measure within (Wave 1; since loss: M = 4.97, SD 3.13 months) again 1 2; 17.84, 3.38 months). We prevalence rates probable 2), measurement invariance between waves, associations variables, Wave with at 2.Regarding prevalence, 10.1% (n 31) met criteria for 2). Multigroup confirmatory factor analysis supported longitudinal symptoms. People meeting (except criterion) had significantly increased risk 2. Variables best predicting 2 were 1, lower education, loss child to unnatural/violent causes (sensitivity 56.67%, specificity 98.12%, 93.92% correct classifications).People before anniversary death are full-blown this point, particularly those confronted loss. Findings inform advances preventive care.

Language: Английский

---

An Innovative Framework for Delivering Psychotherapy to Patients With Treatment-Resistant Posttraumatic Stress Disorder: Rationale for Interactive Motion-Assisted Therapy

Frontiers in Psychiatry, Journal Year: 2018, Volume and Issue: 9

Published: May 4, 2018

Despite an array of evidence-based psychological treatments for patients with a posttraumatic stress disorder (PTSD), majority do not fully benefit from the potential these therapies. In veterans PTSD, up to two-thirds retain their diagnosis after psychotherapy and often is treatment-resistant, which calls improvement therapeutic approaches this population. One factors hypothesized underlie low response in PTSD treatment high behavioral cognitive avoidance traumatic reminders. current paper we explore if combination personalized virtual reality, multi-sensory input, walking during exposure can enhance engagement, overcome avoidance, thereby optimize effectiveness. Virtual reality holds increase presence in-session attention facilitate memory retrieval. Multi-sensory input such as pictures music personalize experience. Evidence positive effect physical activity on fear extinction associative thinking, well embodied cognition theories, provide rationale decreased by literally approaching cues memories. A dual-attention task further facilitates new learning reconsolidation. These strategies have been combined innovative framework trauma-focused psychotherapy, named Multi-modular Motion-assisted Memory Desensitization Reconsolidation (3MDR). setting changed face-to-face sedentary position side-by-side activating context walk toward trauma-related images environment. The 3MDR has designed boost treatment-resistant illustrated three case examples. intervention discussed other advancements PTSD. Novel elements approach are activation, personalization empowerment. While developed who optimally respond standardized treatments, also be used patient populations earlier stages

Language: Английский

---

Interactive Motion-Assisted Exposure Therapy for Veterans with Treatment-Resistant Posttraumatic Stress Disorder: A Randomized Controlled Trial

Psychotherapy and Psychosomatics, Journal Year: 2020, Volume and Issue: 89(4), P. 215 - 227

Published: Jan. 1, 2020

<b><i>Background:</i></b> Veterans with posttraumatic stress disorder (PTSD) tend to benefit less from evidence-based treatments than other PTSD populations. A novel virtual reality and motion-assisted exposure therapy, called 3MDR, provides treatment in an immersive, personalized activating context. <b><i>Objective:</i></b> To study the efficacy of 3MDR for veterans treatment-resistant PTSD. <b><i>Method:</i></b> In a randomized controlled trial (<i>n</i> = 43) was compared non-specific component control group. Primary outcome clinician-rated symptoms at baseline, after 12-week 16-week follow-up (primary end point). Intention-to-treat analyses covariance mixed models were applied differences between groups point over course intervention, controlling baseline scores. <b><i>Results:</i></b> The decrease symptom severity significantly greater as group, large effect size (<i>F</i>[1, 37] 6.43, <i>p</i> 0.016, <i>d</i> 0.83). No significant between-group difference detected during when including all time points. dropout rate low (7%), 45% patients group improved clinically. number needed treat 2.86. <b><i>Conclusions:</i></b> this trial, decreased with, on average, history 4 unsuccessful treatments. may be indicative high engagement. However, lack secondary outcomes limits conclusions that can drawn its underlines need larger phase III trials. These data show emerging evidence potential progress (Dutch Trial Register Identifier: NL5126).

Language: Английский

---