Magazine article Drug Topics

Trauma Researchers Seek Drugs Tailored for PTSD

Magazine article Drug Topics

Trauma Researchers Seek Drugs Tailored for PTSD

Article excerpt

Only two drugs are currently approved for use in posttraumatic stress disorder (PTSD); both are selective serotonin reuptake inhibitors (SSRIs). While effective in reducing some of the symptoms, paroxetine (Paxil, GlaxoSmithKline) and sertraline (Zoloft, Pfizer) were designed for other psychiatric disorders.

"They were tried, and fortunately they worked in PTSD. They're still considered a major advance in treatment," said researcher Matthew Friedman, M.D., executive director of the National Center for Posttraumatic Stress Disorder, VA Hospital, White River junction, Vt. "They help ease the symptoms of depression, anxiety, and panic, and promote sleep. By contrast, classic anxiolytics such as the benzodiazepines are widely prescribed, but there's no evidence they work against the core PTSD symptoms."

Friedman spoke at a special science writers' symposium in New York conducted by the National Mental Health Association called "Beyond 9/11: Exploring Trauma in America." He and his fellow panelists described PTSD as a devastating condition that can occur after a terrifying personal experience, such as being violently assaulted, taking part in military combat, or barely escaping from a disaster. Symptoms typically begin about three months after the event but sometimes lie buried in the unconscious for years. Studies show people who have been abused as children or suffered other trauma early on are most at risk.

"PTSD seems to take on a life of its own," explained Friedman, who is a professor of psychiatry and also of pharmacology and toxicology at Dartmouth Medical School, Hanover, N.H. "The dreadful experience is relived over and over in flashbacks and nightmares. Virtually all the patient's energies go into trying to hide from his intense rage and anxiety. Often amnesia takes over or the patient becomes emotionally numb and seems to have no feelings at all."

In the United States an estimated 4% of adults-more than five million people-live with the illness in a given year. With treatment-or, on occasion, spontaneously-PTSD may dear up in about six months. Usually, however, it is a chronic disease.

"PET scans show that PTSD clearly alters certain basic brain mechanisms," said Friedman. "First come disturbing alterations in the brain's shape and metabolism; then, if treatment works, there's a return to more normal structure and function. …

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