Pharmacotherapy of PTSD: premises, principles, and priorities

Brain Res. 2009 Oct 13:1293:24-39. doi: 10.1016/j.brainres.2009.03.037. Epub 2009 Mar 28.

Abstract

Post-traumatic stress disorder (PTSD) is a prevalent anxiety disorder that results in multiple disabling symptoms. Research into the underlying neurobiology has implicated dysregulation in multiple neurotransmitter systems including norepinephrine, serotonin, and glutamate as well as the hypothalamic-pituitary axis. Understanding how these biological systems interact with each other and how they may affect key neural structures, such as the amygdala, hippocampus, and prefrontal cortex, to produce post-traumatic symptoms is critical for the development of effective pharmacological treatments. We briefly discuss the proposed biological dysfunctions underlying PTSD and how agents that target these dysfunctions may be utilized in PTSD. We then provide a review of the different pharmacological agents that have been investigated in PTSD. These drugs include: antidepressants, anti-adrenergic agents, anticonvulsants, benzodiazepines, atypical antipsychotics, and novel agents.

Publication types

  • Review

MeSH terms

  • Adrenergic Antagonists / therapeutic use*
  • Anticonvulsants / therapeutic use*
  • Antidepressive Agents / therapeutic use*
  • Glutamic Acid / metabolism
  • Humans
  • Hypothalamo-Hypophyseal System / physiopathology*
  • Norepinephrine / metabolism
  • Pituitary-Adrenal System / physiopathology*
  • Serotonin / metabolism
  • Stress Disorders, Post-Traumatic / drug therapy*
  • Stress Disorders, Post-Traumatic / metabolism

Substances

  • Adrenergic Antagonists
  • Anticonvulsants
  • Antidepressive Agents
  • Serotonin
  • Glutamic Acid
  • Norepinephrine