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

Autor(es)

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

Afiliação do(s) autor(es)

^[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

• Tipo de documento: Artigo Científico
• Fonte: BIOLOGICAL PSYCHIATRY; v. 66, n. 1, p. 17-24, JUL 1 2009.
• Citações Web of Science: 27

Resumo

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)

• Processo FAPESP: 99/00170-4 - Estudo sobre a correlação entre a resposta terapêutica a inibidores da recaptura da serotonina, integridade funcional da neurotransmissão serotonérgica e polimorfismo de genes de suscetibilidade de resposta no transtorno obsessivo-compulsivo
• Beneficiário: Márcio Antonini Bernik
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 08/04122-5 - Estudo sobre a precipitação de sintomas em pacientes com transtorno do estresse pós-traumático remitidos com inibidores seletivos de recaptura de serotonina através da redução abrupta de triptofano
• Beneficiário: Márcio Antonini Bernik
• Modalidade de apoio: Auxílio à Pesquisa - Regular