PMID- 23438728
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20191120
IS  - 2212-3938 (Electronic)
IS  - 1574-8847 (Linking)
VI  - 10
IP  - 2
DP  - 2015
TI  - Non-Antidepressant Long-term Treatment in Post-Traumatic Stress Disorder (PTSD).
PG  - 116-125
LID - 10.2174/157488471002150723122127 [doi]
AB  - INTRODUCTION: Post-traumatic stress disorder (PTSD) is a frequent and disabling 
      condition that occurs after exposure to a traumatic event, and Selective 
      Serotonin Reuptake Inhibitors (SSRIs) are considered the first-line treatment 
      approach for this disorder. However, a large proportion of patients remain 
      symptomatic and other pharmacological agents have been investigated, based on the 
      understanding of the underlying biological dysfunctions of PTSD. METHODS: We 
      conducted a review of the literature on the pharmacological options for PTSD 
      other than the antidepressants, using MedLine and Web of Science databases, with 
      search terms including the pharmacologic class of each agent plus PTSD, or 
      pharmacotherapy, or fear conditioning. The literature review covered articles 
      published until august 2012, including reviews and original articles. RESULTS: 
      Agents like antipsychotics, anticonvulsants, benzodiazepines, anti-adrenergic 
      agents, have been studied in randomized clinical trials (RCTs), with general 
      positive results for antipsychotics, especially as adjunct therapy, and for 
      prazosin for sleep-related disturbances. However, one important target for novel 
      medications is the modulation of the fear conditioning process, through the 
      alteration of retrieval/reconsolidation or enhancement of fear extinction. This 
      is traditionally targeted in prolonged exposure therapy, but pre-clinical 
      findings from studies investigating agents like propanolol, clonidine, 
      N-Methyl-D-aspartic Acid Receptor (NMDAR) compounds, 
      3,4-methylenedioxy-N-methylamphetamine (MDMA) and cannabinoids, indicate 
      promising results in affecting the fear conditioning process and thus improving 
      PTSD core symptoms. DISCUSSION: Antipsychotics can be considered a reasonable 
      alternative option to PTSD, with the largest body of evidence for risperidone, 
      even though larger RCTs are warranted. Prazosin is also a promising agent, 
      especially for sleep-related disturbances, while anticonvulsants and 
      benzodiazepines lack empirical support. However, the most promising area for 
      pharmacotherapy in PTSD is the modulation of the fear conditioning process, 
      through agents used in adjunct to exposure therapy.
CI  - Copyright(c) Bentham Science Publishers; For any queries, please email at 
      epub@benthamscience.org.
FAU - Kerbage, Hala
AU  - Kerbage H
FAU - Richa, Sami
AU  - Richa S
AD  - Department of Psychiatry, Hotel-Dieu de France Hospital, Alfred-Naccache Street, 
      Beyrouth, Lebanon.
LA  - eng
PT  - Journal Article
PL  - United Arab Emirates
TA  - Curr Clin Pharmacol
JT  - Current clinical pharmacology
JID - 101273158
OTO - NOTNLM
OT  - Adrenoreceptor antagonists
OT  - PTSD
OT  - anticonvulsants
OT  - antipsychotics
OT  - benzodiazepines
OT  - fear conditioning
OT  - pharmacotherapy
EDAT- 2013/02/27 06:00
MHDA- 2013/02/27 06:01
CRDT- 2013/02/27 06:00
PHST- 2012/09/04 00:00 [received]
PHST- 2012/12/23 00:00 [revised]
PHST- 2012/12/27 00:00 [accepted]
PHST- 2013/02/27 06:00 [pubmed]
PHST- 2013/02/27 06:01 [medline]
PHST- 2013/02/27 06:00 [entrez]
AID - CCP-EPUB-20130204-5 [pii]
AID - 10.2174/157488471002150723122127 [doi]
PST - ppublish
SO  - Curr Clin Pharmacol. 2015;10(2):116-125. doi: 10.2174/157488471002150723122127.