Post-traumatic stress disorder roles

In addition to their proven efficacy in the treatment of all types of depression, the SSRIs have been shown to be the drugs of choice in the treatment of panic disorder, obsessive-compulsive disorder, bulimia nervosa, and as an adjunct to the treatment of alcohol withdrawal and relapse prevention, premenstrual dysphoric disorder and post-traumatic stress disorder. The usefulness of these drugs in treating such a diverse group of disorders reflects the primary role of serotonin in the regulation of sleep, mood, impulsivity and food intake. 

Heim C, Ehlert U, Rexhausen J, Hanker JP, Hellhammer DH (1998) Abuse-related post-traumatic stress disorder and alterations of the hypothalamic-pituitary-adrenal axis in women with chronic pelvic pain. Psychosom Med 60 309-318 Heim C, Ehlert U, Hellhammer DH (2000) The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders. Psychoneuroendocrinology 25 1 -35 Heim C, Newport DJ, BonsaU R, MiUer AH, Nemeroff CB (2001) Altered pituitary-adrenal axis responses to provocative challenge tests in adult survivors of childhood abuse. Am J Psychiatry 158 575-581... 

Sher L. The role of endogenous opioids in the placebo effect in post-traumatic stress disorder. Forsch Komple-mentarmed Klass Naturheilkd. 2004 11 354-359. 

Pathological inability to forget aversive events may be therefore explained by reduced NE transmission in the PFC (Mueller et al., 2008b). Therefore, the NE system might playan important role in the pathology of generalized anxiety disorder (GAD), panic disorder (PD) and post-traumatic stress disorder (PTSD). However, different NE pathways may be involved. 

What effect does trauma have on dreams There are two paradoxically contradictory answers to this question enormous impact and very little. We don t understand why, in some cases, the trauma is almost always dominant and, in others, it has such a small role to play in the shaping of dreams. One answer may be that victims of trauma, e.g. post-traumatic stress disorder patients who have had violent experiences in war, have a specific kind of awakening experience. Their sleep is interrupted by terrors akin to the night terrors of children, and, like in the night terrors of children, these do not occur in REM sleep when normal dreaming takes place. Instead, they occur in NREM sleep, the phase of sleep in which the brain is less completely activated, but in which powerful emotions can nevertheless make themselves felt. 

HT2 receptors might have played a causal role, because 5-HT2 receptor antagonists, such as nefazodone, can be helpful in the treatment of nightmares, for example in patients with post-traumatic stress disorder. 

Keane, T. M. (1995). The role of exposure therapy in the psychological treatment of PTSD. National Centre for Post-Traumatic Stress Disorder Clinical Quarterly 5 1-6. 

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