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The Role of Serotonin in Posttraumatic Stress Disorder: Neurobiology and Pharmacotherapy

Published online by Cambridge University Press:  07 November 2014

Kathryn M. Connor  and
Jonathan R.T. Davidson
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Abstract

Much attention has been given to the role of catecholamine dysfunction in posttraumatic stress disorder (PTSD), and only recently have researchers begun to focus on serotonin (5-HT) in PTSD. Serotonin appears to be a factor in responses followin extreme stress, such as those that precede PTSD. In this review, the authors provide a brief overview of the concept of PTSD and specific issues of clinical concern. The role 5-HT in the neurobiology of PTSD is explored in a review of animal model studies and of clinical investigations of paroxetine binding, pharmacologic challenges, and neuroimaging. Data on the use of 5-HT in PTSD treatment are provided in a review of both open-label and controlled studies of serotonergically active drugs.

Type
Supplement Monograph
Information
CNS Spectrums , Volume 3 , Issue S2: Posttraumatic Stress Disorder: The Hidden Epidemic of Modern Times , August 1998 , pp. 42 - 51
Copyright
Copyright © Cambridge University Press 1998

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References

REFERENCES

1.Resnick, PJ. Guidelines for the evaluation of malingering in posttraumatic stress disorder. In: Simon, RL, ed. Posttraumatic Stress Disorders in Litigation. Washington, DC: American Psychiatric Association Press; 1995:117–136.Google Scholar
2.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 3rd ed. Washington, DC: American Psychiatric Association Press; 1980.Google Scholar
3.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association Press; 1994.Google Scholar
4.Solomon, SD, Davidson, JRT. Trauma, prevalence, impairment, service use, and cost. J Clin Psychiatry. 1997;58(suppl 9):5–11.Google Scholar
5.Bresalu, N, Davis, GC, Andreski, P, et al.Traumatic events and posttraumatic stress disorder in an urban population of young adults. Arch Gen Psychiatry. 1991;48:216–222.Google Scholar
6.Robin, RW, Chester, B, Rasmussen, JK, et al.Prevalence and characteristics of trauma and posttraumatic stress disorder in a southwestern American Indian community. Am J Psychiatry. 1997;154:1582–1588.Google Scholar
7.McFarlane, AC. The aetiology of posttraumatic morbidity: predisposing, precipitating, and perpetuating factors. Br J Psychiatry. 1989;154:221–228.Google Scholar
8.Kessler, R, Sonnega, A, Bromet, E, et al.Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995;52:1048–1060.Google Scholar
9.Breslau, N, Davis, GC, Andreski, P, et al.Traumatic events and posttraumatic stress disorder in an urban population of young adults. Arch Gen Psychiatry. 1991;48:216–222.CrossRefGoogle Scholar
10.Blank, AS. The longitudinal course of posttraumatic stress disorder. In: Davidson, JRT, Foa, EB, eds. Posttraumatic Stress Disorder: DSM-IV and Beyond. Washington, DC: American Psychiatric Association Press; 1993:3–12.Google Scholar
11.Rothbaum, BO, Foa, EB. Symptoms of posttraumatic stress disorder and duration of symptoms. In: Davidson, JRT, Foa, EB, eds. Posttraumatic Stress Disorder: DSM-IV and Beyond. Washington, DC: American Psychiatric Association Press; 1993:23–26.Google Scholar
12.Rothbaum, BO, Foa, EB, Riggs, DS, et al.A prospective examination of post-traumatic stress disorder in rape victims. J Trauma Stress. 1992;5:455–475.Google Scholar
13.Koss, MP, Woodruff, WJ, Koss, PG. Criminal victimization among primary care medical patients: prevalence, incidence, and physician usage. Behavioral Science and Law. 1990;9:85–96.CrossRefGoogle Scholar
14.Kimerling, R, Calhoun, KS. Somatic symptoms, social support, and treatment among sexual assault victims. J Consult Clin Psychol. 1994;62:333–340.Google Scholar
15.Weissman, A, Herbert, CA. Recent developments relating serotonin and behavior. Annual Reports of Medicinal Chemistry. 1972;7:47–58.CrossRefGoogle Scholar
16.Hensman, R, Guimaraes, FS, Wang, M, Deakin, JFW. Effects of ritanserin on aversive classical conditioning in humans. Psychopharmacology. 1991;104:220–224.Google Scholar
17.Deakin, JFW. 5HT2 receptors, depression, and anxiety. Pharmacol Biochem Behav. 1988;29:819–826.Google Scholar
18.Joseph, MH, Kennell, GA. Corticosteroid response to stress depends upon increased tryptophan availability. Psychopharmacology. 1983;79:79–81.Google Scholar
19.Kennett, GA, Dickinson, SL, Curzon, G. Enhancement of some 5-HT-dependent behavioural responses following repeated immobilization in rats. Brain Res. 1985;330:253–23.Google Scholar
20.Petty, F, Kramer, GL, Wu, J. Serotonergic modulation of learned helplessness. In: Yehuda, R, McFarlane, AC, eds. Psychobiology of Posttraumatic Stress Disorder. New York, NY: The New York Academy of Sciences; 1997:538–541.Google Scholar
21.Arora, RC, Fichtner, CG, O'Connor, F, Crayton, JW. Paroxetine binding in the blood platelets of posttraumatic stress disorder patients. Life Sci. 1993;53:919–928.CrossRefGoogle Scholar
22.Fichtner, CG, Arora, RC, O'Connor, FL, Crayton, JW. Platelet paroxetine binding and fluoxetine pharma-cotherapy in posttraumatic stress disorder: preliminary observations on a possible predictor of clinical treatment response. Life Sci. 1994;54:39–44.CrossRefGoogle Scholar
23.Southwick, SM, Yehuda, R, Morgan, CA III., Clinical studies of neurotransmitter alterations in post-traumatic stress disorder. In: Friedman, MJ, Charney, DS, Deutsch, AY, eds. Neurobiology and Clinical Consequences of Stress: From Normal Adaptation to PTSD. New York, NY: Lippincott-Raven; 1995:335–349.Google Scholar
24.Shuff, N, Marmar, CR, Weiss, DS, et al.Reduced hippocampal volume and N-acetyl aspartate in posttraumatic stress disorder. In: Yehuda, R, McFarlane, AC, eds. Psychobiology of Posttraumatic Stress Disorder. New York, NY: The New York Academy of Sciences: 1997:516–520.Google Scholar
25.McDougle, CJ, Southwick, SM, Charney, DS, St. James, RL. An open clinical trial of fluoxetine in the treatment of posttraumatic stress disorder. J Clin Psychopharmacol. 1991;11:325–327.Google Scholar
26.Shay, J. Fluoxetine reduces explosiveness and elevates mood of Vietnam combat veterans with PTSD. J Trauma Stress. 1992;5:97–101.CrossRefGoogle Scholar
27.Nagy, LM, Morgan, CA, Southwick, SM, Charney, DS. Open prospective trial of fluoxetine for posttraumatic stress disorder. J Clin Psychopharmacol. 1993;13:107–114.Google Scholar
28.Davidson, J, Roth, S, Newman, E. Fluoxetine in post-traumatic stress disorder. J Trauma Stress. 1991;4:419–423.Google Scholar
29.De Boer, M, Op den Velde, W, Falger, RJR, et al.Fluvoxamine treatment for chronic PTSD. Psychother Psychosom. 1991;57:158–163.Google Scholar
30.Marmar, CR, Schoenfeld, F, Weiss, DS, et al.Open trial of fluvoxamine treatment for combat-related posttraumatic stress disorder. J Clin Psychiatry. 1996;14:79–81.Google Scholar
31.Rothbaum, BO, Ninan, PT, Thomas, L. Sertraline in the treatment of rape victims with posttraumatic stress disorder. J Trauma Stress. 1996;9:865–871.Google Scholar
32.Kline, NA, Dow, BM, Brown, SA, Matloff, JA. Sertraline efficacy in depressed combat veterans with posttraumatic stress disorder. Am J Psychiatry. 1994;151:621.Google Scholar
33.Davidson, JRT, Weisler, RH, Malik, ML, Connor, MK. Treatment of posttraumatic stress disorder with nefazodone. Int Clin Psychopharmacol. 1998. In press.Google Scholar
34.Fichtner, CG, Crayton, JW. Buspirone in combat-related posttraumatic stress disorder. J Clin Psychiatry. 1994;57(suppl 8):66–72.Google Scholar
35.Hertzberg, MA, Feldman, ME, Beckham, JC, Davidson, JRT. Trial of trazodone for posttraumatic stress disorder using a multiple baseline group design. J Clin Psychopharmacol. 1996;16:294–298.Google Scholar
36.Brophy, MH. Cyproheptadine for combat nightmares in posttraumatic stress disorder and dream anxiety disorder. Mil Med. 1991;156:100–101.CrossRefGoogle ScholarPubMed
37.Van der Kolk, BA, Dreyfuss, D, Michaels, M, et al.Fluoxetine in posttraumatic stress disorder. J Clin Psychiatry. 1994;55:517–522.Google ScholarPubMed
38.Davidson, JRT, Kudler, H, Smith, R, et al.Treatment of post-traumatic stress disorder with amitriptyline and placebo. Arch Gen Psychiatry. 1990;47:259–266.Google Scholar
39.Davidson, JRT, Kudler, HS, Saunders, WB, et al.Predicting response to amitriptyline in posttraumatic stress disorder. Am J Psychiatry. 1993;150:1024–1029.Google Scholar
40.Kosten, TR, Frank, JB, Dan, E, et al.Pharmacotherapy for posttraumatic stress disorder using phenelzine or imipramine. J Nerv Ment Dis. 1991;1179:366–70.Google Scholar
41.Katz, RJ, Lott, MH, Arbus, P, et al.Pharmacotherapy of post-traumatic stress disorder with a novel psychotropic. Anxiety. 1995;1:169–174.Google Scholar
42.Baker, DG, Diamond, BI, Gillette, G, et al.A double-blind, randomized, placebo-controlled, multi-center study of brofaromine in the treatment of post-traumatic stress disorder. Psychopharmacobgy. 1995;122:386–389.CrossRefGoogle ScholarPubMed
43.Connor, KM, Davidson, JRT, Tupler, LA, et al.Pharmacotherapy for Civilians with Posttraumatic Stress Disorder: Differential Response Patterns of Fluoxetine and Placebo. Presented at the National Institute of Mental Health New Clinical Drug Evaluation Unit Meeting. Boca Raton, Florida. June, 1998.Google Scholar