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Titolo:
POSTTRAUMATIC-STRESS-DISORDER - PATHOPHYSIOLOGICAL ASPECTS AND PHARMACOLOGICAL APPROACHES TO TREATMENT
Autore:
FICHTNER CG; PODDIG BE; DEVITO RA;
Indirizzi:
ILLINOIS DEPT HUMAN SERV,DIV CLIN SCI,100 W RANDOLPH ST,SUITE 6-400 CHICAGO IL 60601 FINCH UNIV HLTH SCI CHICAGO MED SCH,DEPT PSYCHIAT & BEHAV SCI CHICAGOIL 00000 US DEPT VET AFFAIRS,VET AFFAIRS EDWARD HINES JR HOSP,SERV PHARM HINESIL 60141 LOYOLA UNIV,STRITCH SCH MED,DEPT PSYCHIAT MAYWOOD IL 60153
Titolo Testata:
CNS DRUGS
fascicolo: 4, volume: 8, anno: 1997,
pagine: 293 - 322
SICI:
1172-7047(1997)8:4<293:P-PAAP>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
VIETNAM COMBAT VETERANS; GLUCOCORTICOID RECEPTOR NUMBER; CONCURRENT PSYCHIATRIC-ILLNESS; PLATELET ADENYLATE-CYCLASE; PLASMA BETA-ENDORPHIN; MONOAMINE-OXIDASE; WAR NEUROSIS; PSYCHOPHARMACOLOGICAL TREATMENT; PSYCHOPHYSIOLOGICAL RESPONSES; CATECHOLAMINE EXCRETION;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
239
Recensione:
Indirizzi per estratti:
Citazione:
C.G. Fichtner et al., "POSTTRAUMATIC-STRESS-DISORDER - PATHOPHYSIOLOGICAL ASPECTS AND PHARMACOLOGICAL APPROACHES TO TREATMENT", CNS DRUGS, 8(4), 1997, pp. 293-322

Abstract

Post-traumatic stress disorder (PTSD) is a syndrome of psychophysiological sequelae occurring in the aftermath of severe emotional trauma. Phenomenologically, symptoms occur in 3 clusters: re-experiencing, avoidance and hyperarousal. Other psychiatric disorders such as depression, panic disorder and substance abuse frequently co-occur with PTSD. Treatment strategies for PTSD are often multimodal and attempt to integrate biological, behavioural, cognitive, psychodynamic and social formulations. Pharmacotherapy must target specific symptoms in all 3 clusters, and address the presence of comorbid psychiatric disorders. Psychotropic medication can facilitate psychotherapeutic work, or serve as the primary modality in a biologically based approach to treatment. Specific medications used in the treatment of PTSD span a broad spectrumof pharmacological agents. The most empirically studied agents, tricyclic antidepressants and monoamine oxidase inhibitors, demonstrate a definite but limited impact on specific PTSD symptoms. For the patient who presents in an acute symptomatic state, benzodiazepine anxiolyticsmay be appropriate. For longer term treatment, selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors (SSRIs), particularly fluoxetine, appear to have broader spectrum therapeutic effects on specific PTSD symptom clusters. Both antidepressants and anxiolytics have, in some studies, shown beneficial effects on depressive symptoms and anxiety, without measurable impact on the symptoms more specific to PTSD. Maintenance pharmacotherapy frequently requires a multidrug regimen; an SSRI may serve as the primary agent, with adjunctive agents targeting residual hyperarousal and re-experiencing symptoms. Benzodiazepines, sedating tricyclic or antihistamine compounds, and the noradrenergic drugs clonidine and propranolol are used in this way. Buspirone, a serotonergic anxiolytic, may serve a similar role for some patients, and cyproheptadine in particular appears to be helpful for nightmares. The antikindling agents carbamazepine and valproic acid (sodium valproate) have also been reported to be beneficial, and may provide an alternative for patients with persistent hyper-reactivity and explosiveness that have not responded to other treatments.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/08/20 alle ore 04:02:37