Serotonin and Sensitivity to Trauma-Related Exposure in Selective Serotonin Reuptake Inhibitors-Recovered Posttraumatic Stress Disorder

Author(s)

Corchs, Felipe ^[1] ; Nutt, David J. ^[2] ; Hood, Sean ^{[2, 3]} ; Bernik, Marcio ^[1]

Affiliation

^[1] Univ Sao Paulo, Dept & Inst Psychiat, Anxiety Disorders Unit, BR-05508 Sao Paulo - Brazil

^[2] Univ Bristol, Psychopharmacol Unit, Bristol BS8 1TH, Avon - England

^[3] Univ Western Australia, Sch Psychiat & Clin Neurosci, Nedlands, WA 6009 - Australia

• Document type: Journal article
• Source: BIOLOGICAL PSYCHIATRY; v. 66, n. 1, p. 17-24, JUL 1 2009.
• Web of Science Citations: 27

Abstract

Background: Selective serotonin reuptake inhibitors (SSRIs) are first-line treatments for posttraumatic stress disorder (PTSD). Serotonergic (5HT) attenuation of stress sensitivity is postulated from SSRIs' effects in other anxiety disorders, and we studied this in PTSD. Methods: Ten patients with PTSD fully recovered on SSRIs (Clinical Global Impression Scale-I 1 and 2) were enrolled in the study. Patients were tested on two occasions I week apart; in each session, they received a drink containing large neutral amino acids (LNAAs) either with (sham tryptophan depletion {[}STD], control) or without (acute tryptophan depletion {[}ATD]) tryptophan. At 5.5 hours after the drink, subjects were exposed to a trauma-related exposure challenge. Self-reports of PTSD (visual analogue scales {[}VAS] and the Davidson Trauma Scale {[}DTSI), anxiety (Spielberger State Inventory {[}STAI] Form Y-1), and mood (Profile of Mood States {[}POMS]) were obtained. Heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure were also measured. Results: The trauma-related exposure challenge induced anxiety on both days, with more marked responses on the ATD day according to VAS, DTS, POMS, and DBP (p < .05). A trend of significance (.1 > p >.05) was observed for STAI Form Y-1, HR, and SBP. Conclusions: These data demonstrate that ATD accentuates responses to trauma-related stimuli in SSRI-recovered PTSD. They also suggest that SSRI-induced increases in serotonin function restrain PTSD symptoms, especially under provocation, supporting a role for serotonin in mediating stress resilience. (AU)

• FAPESP's process: 08/04122-5 - Research on the induction of symptoms in patients with posttraumatic stress disorder remitted on selective serotonin reuptake inhibitors trough acute tryptophan depletion
• Grantee: Márcio Antonini Bernik
• Support Opportunities: Regular Research Grants