The Weekly Mind Reader: Antihypertensive Drugs and PTSD

by Staff Writer
August 4, 2023 at 9:05 AM UTC

The Journal of Clinical Psychiatry published a paper that shows psychological pain is a risk factor for suicidal ideation.

Sometimes a drug designed to treat one condition demonstrates unexpected benefits for treating another condition. That’s why a new The Journal of Clinical Psychiatry study exploring the use of antihypertensive medications to treat PTSD is so intriguing. 

Unexpected Benefits

The researchers collected data from over 1.4 million people who had experienced trauma between 1994 and 2016 in the Danish national registries and examined the incidence of PTSD over a 22-year period. The Boston University-led study focused on four classes of antihypertensive drugs: beta-adrenoceptor blockers, angiotensin II receptor blockers, angiotensin-converting enzyme inhibitors, and calcium channel blockers.

Calcium channel blockers were the only ones associated with a decreased incidence of PTSD. The other classes of antihypertensive drugs had no significant effect. Specifically, individuals who filled a prescription for calcium channel blockers within 60 days before their trauma had a 37 percent lower risk of developing PTSD compared to those who didn’t take this kind of medication. 

How The Drugs May Work

The renin-angiotensin system (RAS) is a hormonal system that regulates blood pressure and fluid balance in the body. It activates in response to stress and can contribute to the release of stress hormones such as cortisol and adrenaline. Angiotensin II, a key component of the RAS, also increases the levels of calcium ions in the brain cells that cause damage to the mitochondria during times of stress. This damage can lead to inflammation and oxidative stress, which have been linked to the development of PTSD.

Calcium channel blockers may have a protective effect on the brain by dampening RAS activity as well as blocking the entry of calcium ions into cells.  The researchers suggested that in addition to lowering blood pressure, this process might also have a protective effect against stress on the brain.

The study provides some initial insights into the potential benefits of antihypertensive medications in reducing the incidence of PTSD. But the authors said that they want a better understanding of the underlying mechanisms before they’d recommend calcium channel blockers as a treatment for PTSD. They also noted that the study only examined individuals who had experienced trauma. So, their findings don’t necessarily apply to the general population.



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Original Research

Psychological Pain as a Risk Factor for Suicidal Ideation: An Ecological Momentary Assessment Study on Inpatients With Depression With and Without Comorbid Borderline Personality Disorder

In inpatients with depression, psychological pain is a risk factor for suicidal ideation. Those with borderline personality disorder may experience more prominent and temporally unstable psychological pain, likely underlying their vulnerability to suicidal ideation.

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