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Neuroendocrinological treatment targets for posttraumatic stress disorder

Authors
Yoon, SeoyoungKim, Yong-Ku
Issue Date
2-3월-2019
Publisher
PERGAMON-ELSEVIER SCIENCE LTD
Keywords
Posttraumatic stress disorder; Treatment; Prevention; Hydrocortisone; Allopregnanolone; Oxytocin; Neuropeptide Y
Citation
PROGRESS IN NEURO-PSYCHOPHARMACOLOGY & BIOLOGICAL PSYCHIATRY, v.90, pp.212 - 222
Indexed
SCIE
SCOPUS
Journal Title
PROGRESS IN NEURO-PSYCHOPHARMACOLOGY & BIOLOGICAL PSYCHIATRY
Volume
90
Start Page
212
End Page
222
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/67021
DOI
10.1016/j.pnpbp.2018.11.021
ISSN
0278-5846
Abstract
Posttraumatic stress disorder ( PTSD) is prevalent, disabling, and frequently becomes chronic. Despite this, only two selective serotonergic reuptake inhibitors have been approved to date for its treatment by the United States Food and Drug Administration, and treatment results are often disappointing, with a remission rate of < 30%. Certain neuroendocrinological systems are currently gaining attention with respect to their use for PTSD prevention and treatment as standalone options or medication-enhanced psychotherapy due to their involvement in physiological stress reactions, memory consolidation and extinction, cognitive appraisal to stress, and attachment and resilient coping strategies, which are important in the pathogenesis of PTSD. The hypothalamic-pituitary-adrenal axis system takes the most important role in stress reactions. Hydrocortisone has been studied for the prevention of PTSD, and some meta-analyses have suggested its possible efficacy; furthermore, it has been considered both as monotherapy and as an augmentation to psychotherapy in PTSD patients, with some positive results. Glucocorticoid receptor antagonists and corticotropin-releasing factor type 1 antagonists have also been considered for clinical use in PTSD treatment. Additionally, other neuroendocrinological systems have been studied in PTSD including the use of oxytocin for PTSD prevention and augmentation to psychotherapy, allopregnanolone, and neuropeptide Y (NPY) for PTSD treatment. For now, however, these studies offer only limited evidence of efficacy, thus it is prudent to study this issue more vigorously.
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