Noradrenergic dysfunction and the psychopharmacology of posttraumatic stress disorder

Depression and Anxiety
Jeffrey R Strawn, Thomas D Geracioti

Abstract

The catecholamine norepinephrine is a critical effector of the mammalian stress response and has been implicated in the pathophysiology of posttraumatic stress disorder (PTSD)-a syndrome intrinsically related to the experience of extraordinary stress. Symptom-linked hypernoradrenergic derangements have been observed in PTSD and several studies have examined the potential therapeutic effects of agents that dampen the centrally hyperactive noradrenergic state. These agents include compounds that decrease norepinephrine release (e.g. centrally acting alpha(2) agonists such as clonidine) and those which block post-synaptic norepinephrine receptors (e.g. centrally acting alpha(1) or beta receptor antagonists such as prazosin or propranolol). In this article, we review studies of central noreadrenergic hyperactivity under both basal and challenge conditions and explore the evidence for these derangements as potential psychopharmacologic targets in patients with PTSD. Given the significant involvement of CNS norepinephrine hyperactivity in PTSD, and its link to intrusive and hyperarousal symptoms, it is not surprising that interventions directed at this system have therapeutic potential in PTSD. The utility of these anti-adrenergics i...Continue Reading

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Related Concepts

Biological Adaptation to Stress
Neurologic Manifestations
Catecholamine [EPC]
Hyperactive Behavior
Post-Traumatic Stress Disorder
Norepinephrine, (+, -)-Isomer
Adrenergic alpha-Agonists
Adrenergic alpha-Antagonists
Norepinephrine
Norepinephrine Measurement

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