Neuroendocrinological treatment targets for posttraumatic stress disorder

Seoyoung Yoon, Yong Ku Kim

Research output: Contribution to journalReview article

4 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)212-222
Number of pages11
JournalProgress in Neuro-Psychopharmacology and Biological Psychiatry
Volume90
DOIs
Publication statusPublished - 2019 Mar 2

Keywords

  • Allopregnanolone
  • Hydrocortisone
  • Neuropeptide Y
  • Oxytocin
  • Posttraumatic stress disorder
  • Prevention
  • Treatment

ASJC Scopus subject areas

  • Pharmacology
  • Biological Psychiatry

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