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The Psychobiology of Posttraumatic Stress Disorder

David J. Nutt, DM, MRCP, FRCPsych

Published: May 31, 2000

Article Abstract

Posttraumatic stress disorder (PTSD) develops after exposure to events that are threatening and/orintensely distressing. Accumulating evidence suggests that intense psychological trauma can causelong-standing alterations in the neurobiological response to stress. These alterations translate into anumber of symptoms commonly experienced by patients with PTSD. Current treatments for this disorderare only partially effective in managing the disease, and patients have to endure unpleasantsymptoms associated with hyperarousal. As a result, they often withdraw from social interaction andincrease the use of central nervous system depressants. Data suggest that biological dysregulation ofthe glutamatergic, amine neurotransmitter (noradrenergic and serotonergic), and neuroendocrinepathways plays a fundamental part in the pathology of PTSD and may cause brain structural as well asfunctional abnormalities. Knowledge of these pathologic changes in PTSD provides direction for thedevelopment of new treatments that will offer more comprehensive management of PTSD and enablepatients to enjoy a much improved quality of life. This article reviews current knowledge regardingthe psychobiology of PTSD and considers specific agents that are emerging as key modulators of thispathological process.

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