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Govindula A, Ranadive N, Nampoothiri M, Rao CM, Arora D, Mudgal J. Emphasizing the Crosstalk Between Inflammatory and Neural Signaling in Post-traumatic Stress Disorder (PTSD). J Neuroimmune Pharmacol 2023; 18:248-266. [PMID: 37097603 PMCID: PMC10577110 DOI: 10.1007/s11481-023-10064-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 04/16/2023] [Indexed: 04/26/2023]
Abstract
Post-traumatic stress disorder (PTSD) is a chronic incapacitating condition with recurrent experience of trauma-related memories, negative mood, altered cognition, and hypervigilance. Agglomeration of preclinical and clinical evidence in recent years specified that alterations in neural networks favor certain characteristics of PTSD. Besides the disruption of hypothalamus-pituitary-axis (HPA) axis, intensified immune status with elevated pro-inflammatory cytokines and arachidonic metabolites of COX-2 such as PGE2 creates a putative scenario in worsening the neurobehavioral facet of PTSD. This review aims to link the Diagnostic and Statistical Manual of mental disorders (DSM-V) symptomology to major neural mechanisms that are supposed to underpin the transition from acute stress reactions to the development of PTSD. Also, to demonstrate how these intertwined processes can be applied to probable early intervention strategies followed by a description of the evidence supporting the proposed mechanisms. Hence in this review, several neural network mechanisms were postulated concerning the HPA axis, COX-2, PGE2, NLRP3, and sirtuins to unravel possible complex neuroinflammatory mechanisms that are obscured in PTSD condition.
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Affiliation(s)
- Anusha Govindula
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Niraja Ranadive
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Madhavan Nampoothiri
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - C Mallikarjuna Rao
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Devinder Arora
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast campus, Gold Coast, Queensland, 4222, Australia.
| | - Jayesh Mudgal
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
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Sotelo-Tapia C, Medina AC, Cortes PM, Hernández-Arteaga E, Hidalgo-Aguirre RM, Guevara MA, Hernández-González M. Ejaculation latency determines susceptibility to stress in the male rat. Behav Processes 2023; 205:104819. [PMID: 36642152 DOI: 10.1016/j.beproc.2023.104819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/05/2022] [Accepted: 01/10/2023] [Indexed: 01/15/2023]
Abstract
Stress induces diverse effects on sexual behavior, ranging from enhanced execution to the complete abolishment of sexual interaction. However, it is not clear whether some characteristics intrinsic to the individual that experiences stress could also explain this differential effect. This study seeks to relate sexual execution to susceptibility to stress (as post-stress sexual motivation). To this end, we designed a three-session experimental paradigm. In the first session, male rats were allowed to copulate with a female. In the second, the male rats received electric foot shocks as they attempted to approach the female. The third and final session was used to determine the effects of stress on sexual behavior by separating the rats into two groups: a motivation-impaired group (rats that did not cross to achieve copulation), and an unimpaired group (rats that did cross). Mount latency was affected immediately by stress in both groups, though only the non-crossing group presented a reduced number of copulatory events. The rats that did not cross showed slower-paced sexual execution even before stress was applied compared to the rats that crossed. These results show that rats that are more susceptible to stress present higher ejaculation latency even before the application of stress.
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Affiliation(s)
- Carolina Sotelo-Tapia
- Instituto de Neurociencias, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Andrea Cristina Medina
- Departamento de Neurobiología Conductual y Cognitiva, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Mexico
| | - Pedro Manuel Cortes
- Instituto de Neurociencias, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | | | - Rosa María Hidalgo-Aguirre
- Departamento de Ciencias de la Salud, Centro Universitario de los Valles, Universidad de Guadalajara, Jalisco, Mexico
| | - Miguel Angel Guevara
- Instituto de Neurociencias, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
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Barroca NCB, Della Santa G, Suchecki D, García-Cairasco N, Umeoka EHDL. Challenges in the use of animal models and perspectives for a translational view of stress and psychopathologies. Neurosci Biobehav Rev 2022; 140:104771. [PMID: 35817171 DOI: 10.1016/j.neubiorev.2022.104771] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/15/2022] [Accepted: 07/05/2022] [Indexed: 12/25/2022]
Abstract
The neurobiology and development of treatments for stress-related neuropsychiatric disorders rely heavily on animal models. However, the complexity of these disorders makes it difficult to model them entirely, so only specific features of human psychopathology are emulated and these models should be used with great caution. Importantly, the effects of stress depend on multiple factors, like duration, context of exposure, and individual variability. Here we present a review on pre-clinical studies of stress-related disorders, especially those developed to model posttraumatic stress disorder, major depression, and anxiety. Animal models provide relevant evidence of the underpinnings of these disorders, as long as face, construct, and predictive validities are fulfilled. The translational challenges faced by scholars include reductionism and anthropomorphic/anthropocentric interpretation of the results instead of a more naturalistic and evolutionary understanding of animal behavior that must be overcome to offer a meaningful model. Other limitations are low statistical power of analysis, poor evaluation of individual variability, sex differences, and possible conflicting effects of stressors depending on specific windows in the lifespan.
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Affiliation(s)
- Nayara Cobra Barreiro Barroca
- Department of Neuroscience and Behavioral Science, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Giovanna Della Santa
- Department of Neuroscience and Behavioral Science, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Deborah Suchecki
- Department of Psychobiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Norberto García-Cairasco
- Department of Neuroscience and Behavioral Science, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil; Department of Physiology, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Eduardo Henrique de Lima Umeoka
- Department of Neuroscience and Behavioral Science, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil; School of Medicine, University Center UniCerrado, Goiatuba, GO, Brazil
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Vermes JS, Ayres R, Goés AS, Real ND, Araújo ÁC, Schiller D, Neto FL, Corchs F. Targeting the reconsolidation of traumatic memories with a brief 2-session imaginal exposure intervention in post-traumatic stress disorder. J Affect Disord 2020; 276:487-494. [PMID: 32794448 DOI: 10.1016/j.jad.2020.06.052] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 04/30/2020] [Accepted: 06/23/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Evidence suggests that extinction during memory reconsolidation diminishes the return of defensive responses. In order to translate these effects to the clinical setting, we tested whether retrieving a traumatic memory and delivering a brief two-sessions imaginal exposure intervention during its reconsolidation would produce stronger decreases in reactivity to these memories than standard imaginal exposure method. METHODS Participants with Post-Traumatic Stress Disorder (PTSD) had either their traumatic (n = 21) or a neutral (n = 21) memory retrieved 1 h before an imaginal exposure session for two consecutive days. One day before and one day after, participants were exposed to script-driven imagery of their traumatic event, during which skin conductance responses were measured and, immediately after, subjective responses were assessed by means of Visual Analogue Scales. RESULTS Traumatic retrieval improved the physiological, but not the subjective effects of imaginal exposure intervention on over-reactivity to traumatic memories. CONCLUSIONS Our results suggest that delivering extinction-based treatments over the reconsolidation of traumatic memories may enhance its effects. These results suggest that this is a promising path toward the development of new therapeutic techniques.
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Affiliation(s)
- Joana Singer Vermes
- Institute and Department of Psychiatry, University of São Paulo, R. Dr. Ovidio Pires de Campos, 785 - IPq-HC-FMUSP, 05403-010 São Paulo, SP, Brazil; Paradigma Center for Behavior Analysis, Rua Vanderlei, 611 - 04590-000 São Paulo, SP, Brazil
| | - Ricardo Ayres
- Institute and Department of Psychiatry, University of São Paulo, R. Dr. Ovidio Pires de Campos, 785 - IPq-HC-FMUSP, 05403-010 São Paulo, SP, Brazil
| | - Adara Saito Goés
- Institute and Department of Psychiatry, University of São Paulo, R. Dr. Ovidio Pires de Campos, 785 - IPq-HC-FMUSP, 05403-010 São Paulo, SP, Brazil
| | - Natalia Del Real
- Institute and Department of Psychiatry, University of São Paulo, R. Dr. Ovidio Pires de Campos, 785 - IPq-HC-FMUSP, 05403-010 São Paulo, SP, Brazil
| | - Álvaro Cabral Araújo
- Institute and Department of Psychiatry, University of São Paulo, R. Dr. Ovidio Pires de Campos, 785 - IPq-HC-FMUSP, 05403-010 São Paulo, SP, Brazil
| | - Daniela Schiller
- Icahn School of Medicine at Mount Sinai, Gustave L. Levy Place, 10029-5674 New York, NY, USA
| | - Francisco Lotufo Neto
- Institute and Department of Psychiatry, University of São Paulo, R. Dr. Ovidio Pires de Campos, 785 - IPq-HC-FMUSP, 05403-010 São Paulo, SP, Brazil
| | - Felipe Corchs
- Institute and Department of Psychiatry, University of São Paulo, R. Dr. Ovidio Pires de Campos, 785 - IPq-HC-FMUSP, 05403-010 São Paulo, SP, Brazil; Paradigma Center for Behavior Analysis, Rua Vanderlei, 611 - 04590-000 São Paulo, SP, Brazil.
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Zhang J, Xue R, Li YF, Zhang YZ, Wei HW. Anxiolytic-like effects of treadmill exercise on an animal model of post-traumatic stress disorder and its mechanism. J Sports Med Phys Fitness 2020; 60:172-179. [DOI: 10.23736/s0022-4707.20.10120-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Li M, Li K, Zhang H, Jiang Y. Study on the mechanism of TMRK electroacupuncture in repairing synaptic plasticity in amygdala and hippocampus to relieve fear memory in PTSD rats. Technol Health Care 2019; 27:425-443. [PMID: 31045558 PMCID: PMC6598005 DOI: 10.3233/thc-199038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVE Post-traumatic stress disorder (PTSD) is a chronic mental disorder caused by mental or psychological trauma after sudden events of a catastrophic or threatening nature. Synaptic plasticity is the core mechanism of PTSD and the main point of treatment of this disease. METHODS Male Sprague Dawley rats were randomly divided into blank control (Ctrl), SPS (single-prolonged stress) model, SPS&S model (SPS and foot electric shock), SPS+EA (SPS plus electroacupuncture), and SPS&S+EA groups. Tranquilize Mind and Regulate Kidney (TMRK) electroacupuncture method was performed in each rat in the SPS+EA and SPS&S+EA groups, the treatment lasted for 20 minutes per day, simultaneously for 3 consecutive weeks. Behavioral evaluations, molecular tests, electron microscopy, electrophysiological testing were conducted following the treatment. RESULTS First, electro-acupuncture can significantly improve the PTSD-like symptoms. Second, electro-acupuncture can up-regulate the long-term potentiation (LTP) in hippocampus, repair the synaptic morphology and improve BDNF levels in amygdala and hippocampus. Third, electroacupuncture can significantly up-regulate SYN, GAP43, and PSD95 protein levels and mRNA expression in amygdala and hippocampus. CONCLUSIONS The effect of TMRK electro-acupuncture method on the regression of fear memory of PTSD rats may be through its repair of synaptic plasticity in amygdala and hippocampus.
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Affiliation(s)
- Mi Li
- Acupuncture and Tuina College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Kai Li
- Acupuncture and Tuina College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
- Chinese Medicine College, Hainan Medical University, Haikou, Hainan 571199, China
| | - Hong Zhang
- Acupuncture and Tuina College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China
| | - Yong Jiang
- Basic Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan China
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Fang Q, Li Z, Huang GD, Zhang HH, Chen YY, Zhang LB, Ding ZB, Shi J, Lu L, Yang JL. Traumatic Stress Produces Distinct Activations of GABAergic and Glutamatergic Neurons in Amygdala. Front Neurosci 2018; 12:387. [PMID: 30186100 PMCID: PMC6110940 DOI: 10.3389/fnins.2018.00387] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/22/2018] [Indexed: 12/12/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) is an anxiety disorder characterized by intrusive recollections of a severe traumatic event and hyperarousal following exposure to the event. Human and animal studies have shown that the change of amygdala activity after traumatic stress may contribute to occurrences of some symptoms or behaviors of the patients or animals with PTSD. However, it is still unknown how the neuronal activation of different sub-regions in amygdala changes during the development of PTSD. In the present study, we used single prolonged stress (SPS) procedure to obtain the animal model of PTSD, and found that 1 day after SPS, there were normal anxiety behavior and extinction of fear memory in rats which were accompanied by a reduced proportion of activated glutamatergic neurons and increased proportion of activated GABAergic neurons in basolateral amygdala (BLA). About 10 days after SPS, we observed enhanced anxiety and impaired extinction of fear memory with increased activated both glutamatergic and GABAergic neurons in BLA and increased activated GABAergic neurons in central amygdala (CeA). These results indicate that during early and late phase after traumatic stress, distinct patterns of activation of glutamatergic neurons and GABAergic neurons are displayed in amygdala, which may be implicated in the development of PTSD.
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Affiliation(s)
- Qing Fang
- Department of Psychiatry, Tianjin Medical University, Tianjin, China.,National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.,Psychiatric Department, Tianjin Anding Hospital, Tianjin, China
| | - Zhe Li
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.,Cangzhou Medical College, Cangzhou, China
| | - Geng-Di Huang
- Department of Psychiatry, Tianjin Medical University, Tianjin, China.,National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Huan-Huan Zhang
- Department of Psychiatry, Tianjin Medical University, Tianjin, China.,National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Ya-Yun Chen
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Li-Bo Zhang
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Zeng-Bo Ding
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Lin Lu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.,Peking University Sixth Hospital/Peking University Institute of Mental Health, Peking University, Beijing, China
| | - Jian-Li Yang
- Department of Psychiatry, Tianjin Medical University, Tianjin, China.,Tianjin Medical University General Hospital, Tianjin, China
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8
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Peixoto MF, Cesaretti M, Hood SD, Tavares A. Effects of SSRI medication on heart rate and blood pressure in individuals with hypertension and depression. Clin Exp Hypertens 2018; 41:428-433. [PMID: 30047786 DOI: 10.1080/10641963.2018.1501058] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To test the role of escitalopram on blood pressure and heart rate of individuals with hypertension and depression. METHODS A total of 30 individuals participated in this study who were being treated for hypertension and were diagnosed with major depression. Escitalopram (10-20 mg) was administered to 15 individuals, while the other 15 received placebo. These individuals were followed for 8 weeks with regular monitoring of blood pressure and heart rate. Scores on the Hamilton Depression Rating Scale were evaluated within the first, second, fourth, and eighth weeks of the study onset. RESULTS Comparing with placebo, heart rate was lower in the escitalopram group (66.79 ± 9.85 vs. 74.10 ± 9.52 bpm, p = 0.044). There was not a significant decrease of systolic blood pressure (140.80 ± 16.48 vs 139.61 ± 18.92 mmHg, p = 0.85) and diastolic blood pressure (80.55 ± 12.64 vs 80.18 ± 16.36 mmHg, p = 0.94). CONCLUSION Escitalopram decreases HR, but not BP, in individuals with hypertension and depression. Abbreviation: SH: systemic hypertension; BP: blood pressure; DSM: Diagnostic and Statistical Manual of Mental Disorders; SRQ 20: Self-Report Questionnaire; SCID: Structured Clinical Interview for DSM-IV; HR: heart rate; SNS: Sympathetic nervous system; HPA: hypothalamus-pituitary-adrenal axis; RAA: renin, angiotensin, aldosterone system; NE: norepinephrine; CSF: cerebrospinal fluid; HAM-D: Hamilton Depression Rating Scale; CRF: corticotropin releasing factor; ACTH: adrenocorticotropic hormone; BMI: Body mass index; SBP: systolic blood pressure; DBP: diastolic blood pressure; t: time.
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Affiliation(s)
- M F Peixoto
- a Internal Medicine Department, Division of Nephrology , Federal University of Sao Paulo , Sao Paulo , Brazil
| | - Mlr Cesaretti
- a Internal Medicine Department, Division of Nephrology , Federal University of Sao Paulo , Sao Paulo , Brazil
| | - S D Hood
- b Division of Psychiatry, UWA Medical School, Faculty of Health & Medical Sciences , The University of Western Australia , Perth , Australia
| | - A Tavares
- a Internal Medicine Department, Division of Nephrology , Federal University of Sao Paulo , Sao Paulo , Brazil
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Hood SD, Broyd A, Robinson H, Lee J, Hudaib AR, Hince DA. Effects of tryptophan depletion on selective serotonin reuptake inhibitor-remitted patients with obsessive compulsive disorder. J Psychopharmacol 2017; 31:1615-1623. [PMID: 29095069 DOI: 10.1177/0269881117736916] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Serotonergic antidepressants are first-line medication therapies for obsessive-compulsive disorder, however it is not known if synaptic serotonin availability is important for selective serotonin reuptake inhibitor efficacy. The present study tested the hypothesis that temporary reduction in central serotonin transmission, through acute tryptophan depletion, would result in an increase in anxiety in selective serotonin reuptake inhibitor-remitted obsessive-compulsive disorder patients. METHODS Eight patients (four males) with obsessive-compulsive disorder who showed sustained clinical improvement with selective serotonin reuptake inhibitor treatment underwent acute tryptophan depletion in a randomized, double-blind, placebo-controlled, within-subjects design, over two days one week apart. Five hours after consumption of the depleting/sham drink the participants performed a personalized obsessive-compulsive disorder symptom exposure task. Psychological responses were measured using the Spielberger State Anxiety Inventory, Yale-Brown Obsessive Compulsive Scale and Visual Analogue Scales. RESULTS Free plasma tryptophan to large neutral amino acid ratio decreased by 93% on the depletion day and decreased by 1% on the sham day, as anticipated. Psychological rating scores as measured by Visual Analogue Scale showed a significant decrease in perceived control and increase in interfering thoughts at the time of provocation on the depletion day but not on the sham day. A measure of convergent validity, namely Visual Analogue Scale Similar to past, was significantly higher at the time of provocation on both the depletion and sham days. Both the depletion and time of provocation scores for Visual Analogue Scale Anxiety, Spielberger State Anxiety Inventory, Yale-Brown Obsessive Compulsive Scale and blood pressure were not significant. CONCLUSIONS Acute tryptophan depletion caused a significant decrease in perceived control and increase in interfering thoughts at the time of provocation. Acute tryptophan depletion had no effect on the Spielberger State Anxiety Inventory or Visual Analogue Scale Anxiety measures, which suggests that the mechanism of action of selective serotonin reuptake inhibitors may be different to that seen in panic, social anxiety and post-traumatic stress disorder. Successful selective serotonin reuptake inhibitor treatment of obsessive-compulsive disorder may involve the ability of serotonin to switch habitual responding to goal-directed behaviour.
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Affiliation(s)
- Sean D Hood
- Division of Psychiatry, UWA Medical School, The University of Western Australia, Perth, Australia
| | - Annabel Broyd
- Division of Psychiatry, UWA Medical School, The University of Western Australia, Perth, Australia
| | - Hayley Robinson
- Division of Psychiatry, UWA Medical School, The University of Western Australia, Perth, Australia
| | - Jessica Lee
- Division of Psychiatry, UWA Medical School, The University of Western Australia, Perth, Australia
| | - Abdul-Rahman Hudaib
- Division of Psychiatry, UWA Medical School, The University of Western Australia, Perth, Australia
| | - Dana A Hince
- Division of Psychiatry, UWA Medical School, The University of Western Australia, Perth, Australia
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Abstract
Previous attempts to identify a unified theory of brain serotonin function have largely failed to achieve consensus. In this present synthesis, we integrate previous perspectives with new and older data to create a novel bipartite model centred on the view that serotonin neurotransmission enhances two distinct adaptive responses to adversity, mediated in large part by its two most prevalent and researched brain receptors: the 5-HT1A and 5-HT2A receptors. We propose that passive coping (i.e. tolerating a source of stress) is mediated by postsynaptic 5-HT1AR signalling and characterised by stress moderation. Conversely, we argue that active coping (i.e. actively addressing a source of stress) is mediated by 5-HT2AR signalling and characterised by enhanced plasticity (defined as capacity for change). We propose that 5-HT1AR-mediated stress moderation may be the brain's default response to adversity but that an improved ability to change one's situation and/or relationship to it via 5-HT2AR-mediated plasticity may also be important - and increasingly so as the level of adversity reaches a critical point. We propose that the 5-HT1AR pathway is enhanced by conventional 5-HT reuptake blocking antidepressants such as the selective serotonin reuptake inhibitors (SSRIs), whereas the 5-HT2AR pathway is enhanced by 5-HT2AR-agonist psychedelics. This bipartite model purports to explain how different drugs (SSRIs and psychedelics) that modulate the serotonergic system in different ways, can achieve complementary adaptive and potentially therapeutic outcomes.
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Affiliation(s)
- RL Carhart-Harris
- Psychedelic Research Group, Neuropsychopharmacology Unit, Centre for Psychiatry, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - DJ Nutt
- Psychedelic Research Group, Neuropsychopharmacology Unit, Centre for Psychiatry, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
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11
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Hood SD, Bell CJ, Argyropoulos SV, Nutt DJ. Don't panic. A guide to tryptophan depletion with disorder-specific anxiety provocation. J Psychopharmacol 2016; 30:1137-1140. [PMID: 27329165 DOI: 10.1177/0269881116655321] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The 2002 paper "Does 5-HT restrain panic? A tryptophan depletion study in panic disorder patients recovered on paroxetine" by Bell and colleagues - reprinted in this issue of the Journal - reports on a study undertaken in the halcyon days of David Nutt's Psychopharmacology Unit at the University of Bristol, England. In this invited commentary authors of the original work discuss the impact of this paper on the field of acute tryptophan depletion research (especially in the field of clinical anxiety disorders) and the development of disorder-specific anxiogenic provocations over the past decade.
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Affiliation(s)
- S D Hood
- School of Psychiatry & Clinical Neurosciences (M521), University of Western Australia, Perth, WA, Australia
| | - C J Bell
- Mental Health Clinical Research Unit, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - S V Argyropoulos
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK
| | - D J Nutt
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK
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12
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Jakobsen GR, Fisher PM, Dyssegaard A, McMahon B, Holst KK, Lehel S, Svarer C, Jensen PS, Knudsen GM, Frokjaer VG. Brain serotonin 4 receptor binding is associated with the cortisol awakening response. Psychoneuroendocrinology 2016; 67:124-32. [PMID: 26894483 DOI: 10.1016/j.psyneuen.2016.01.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 01/30/2016] [Accepted: 01/30/2016] [Indexed: 12/13/2022]
Abstract
Serotonin signalling is considered critical for an appropriate and dynamic adaptation to stress. Previously, we have shown that prefrontal serotonin transporter (SERT) binding is positively associated with the cortisol awakening response (CAR) (Frokjaer et al., 2013), which is an index of hypothalamic-pituitary-adrenal (HPA)-axis output dynamics. Here, we investigated in healthy individuals if cerebral serotonin 4 receptor (5-HT4r) binding, reported to be a proxy for serotonin levels, is associated with CAR. Thirty healthy volunteers (25 males, age range 20-56 years) underwent 5-HT4r PET imaging with [(11)C]-SB207145, genotyping of the SERT-linked polymorphic region (5-HTTLPR), and performed serial home sampling of saliva (5 time points from 0 to 60min from awakening) to assess CAR. The association between 5-HT4r binding in 4 regions of interest (prefrontal cortex, anterior cingulate cortex, pallidostriatum, and hippocampus) and CAR was tested using multiple linear regression with adjustment for age and 5-HTTLPR genotype. Finally, an exploratory voxel-based analysis of the association was performed. CAR was negatively associated with 5-HT4r binding in pallidostriatum (p=0.01), prefrontal cortex (p=0.03), and anterior cingulate cortex (p=0.002), respectively, but showed no association in hippocampus. The results remained significant when taking into account other potentially relevant covariates. In conclusion, our finding reinforces an association between HPA-axis function and serotonin signaling in vivo in humans. We suggest that higher synaptic serotonin concentration, here indexed by lower 5-HT4r binding, supports HPA-axis dynamics, which in healthy volunteers is reflected by a robust CAR.
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Affiliation(s)
- Gustav R Jakobsen
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, DK-2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Patrick M Fisher
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, DK-2100 Copenhagen, Denmark
| | - Agnete Dyssegaard
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, DK-2100 Copenhagen, Denmark
| | - Brenda McMahon
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, DK-2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark; Psychiatric Center Copenhagen, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark
| | - Klaus K Holst
- Department of Biostatistics, University of Copenhagen, DK-1014 Copenhagen, Denmark
| | | | - Claus Svarer
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, DK-2100 Copenhagen, Denmark
| | - Peter S Jensen
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, DK-2100 Copenhagen, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, DK-2100 Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Vibe G Frokjaer
- Neurobiology Research Unit and Center for Integrated Molecular Brain Imaging, DK-2100 Copenhagen, Denmark; Psychiatric Center Copenhagen, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark.
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Corchs F, Nutt DJ, Hince DA, Davies SJC, Bernik M, Hood SD. Evidence for serotonin function as a neurochemical difference between fear and anxiety disorders in humans? J Psychopharmacol 2015; 29:1061-9. [PMID: 26187054 DOI: 10.1177/0269881115590603] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The relationships between serotonin and fear and anxiety disorders have been much studied yet many important questions remain, despite selective serotonin reuptake inhibitors having been the primary treatments for these disorders for some time. In order to explore this issue we performed a pooled analysis of six of our studies in remitted patients with a fear/anxiety disorder who were exposed to syndrome-specific aversive stimulation under acute tryptophan depletion. We based our analysis on the hypothesis that the inconsistencies observed in the studies could be predicted by Deakin and Graeff's theory about the dual role of serotonin in responses to threats, whereby serotonin is critical to prevent fear (panic) but not anxiety. In accordance with this view, our results give support to a dissociation of the disorders traditionally grouped under fear and anxiety-related disorders in terms of different roles of serotonin in modulation of responses to aversive stimulation. Implications for future studies and psychiatric nosology are discussed.
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Affiliation(s)
- Felipe Corchs
- Institute and Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - David J Nutt
- Neuropsychopharmacology Unit, Division of Experimental Medicine, Imperial College London, London, UK
| | - Dana A Hince
- School of Psychiatry & Clinical Neurosciences (M521), The University of Western Australia, Perth, WA, Australia
| | - Simon J C Davies
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Marcio Bernik
- Institute and Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Sean D Hood
- School of Psychiatry & Clinical Neurosciences (M521), The University of Western Australia, Perth, WA, Australia
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In abstinent MDMA users the cortisol awakening response is off-set but associated with prefrontal serotonin transporter binding as in non-users. Int J Neuropsychopharmacol 2014; 17:1119-28. [PMID: 24524290 DOI: 10.1017/s1461145714000066] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Serotonergic signaling is considered critical for an appropriate adaptation to stress. We have previously observed that in healthy volunteers, prefrontal serotonin transporter (SERT) binding is positively associated with hypothalamic-pituitary-adrenal (HPA)-axis output in terms of the cortisol awakening response (CAR). Here, we tested (1) if such a correlation persists in a human model of chronic serotonin depletion, namely in 3,4-Methylenedioxymethamphetamine (MDMA or 'Ecstasy') users, and (2) if CAR differed between MDMA users (N = 18) and non-using healthy volunteers (N = 32). Participants underwent SERT brain imaging with [11C]DASB-PET, and performed home-sampling of CAR, defined as the area under curve with respect to cortisol increase from awakening level. When adjusting for age and group, CAR was positively coupled to prefrontal SERT binding (p = 0.006) and MDMA users showed significantly higher CAR than the control group (p = 0.0003). In conclusion, our data confirm the recently described positive association between prefrontal SERT binding and CAR, this time in a human model of serotonin deficiency. Also, we find that CAR was higher in MDMA users relative to non-users. We suggest that the inhibitory control on HPA-axis output is less efficient in the off-balance state established by recent MDMA use, most likely through mechanisms other than those that can be compensated by lowering SERT levels.
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Nie H, Peng Z, Lao N, Wang H, Chen Y, Fang Z, Hou W, Gao F, Li X, Xiong L, Tan Q. Rosmarinic acid ameliorates PTSD-like symptoms in a rat model and promotes cell proliferation in the hippocampus. Prog Neuropsychopharmacol Biol Psychiatry 2014; 51:16-22. [PMID: 24418162 DOI: 10.1016/j.pnpbp.2014.01.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 01/03/2014] [Accepted: 01/03/2014] [Indexed: 01/14/2023]
Abstract
Rosmarinic acid (RA) is an important component of Chinese herbal medicine treatments and has been demonstrated to exert therapeutic effects in mood disorders. The present study was designed to assess the effects of RA on post-traumatic stress disorder (PTSD)-like symptoms, hippocampal cell proliferation and phosphorylation extracellular regulated protein kinases (pERK1/2) expression. We found that administration of RA (10mg/kg) alleviated PTSD-like symptoms in rats exposed to an enhanced single prolonged stress (ESPS) paradigm and restored hippocampal proliferation and pERK1/2 expression. Interestingly, the effects of RA were inhibited by the blockage of the ERK signaling. These data support the use of RA for treating PTSD and indicate that the ERK1/2 signaling cascade may play a critical role in the therapeutic efficacy of RA in treating such conditions.
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Affiliation(s)
- Huang Nie
- Department of Psychosomatic Medicine, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China; Department of Anesthesiology, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China
| | - Zhengwu Peng
- Department of Psychosomatic Medicine, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China; Department of Toxicology, School of Public Health, Fourth Military Medical University, Xi'an 710032, China
| | - Ning Lao
- Department of Anesthesiology, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China
| | - Huaning Wang
- Department of Psychosomatic Medicine, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China
| | - Yihuan Chen
- Department of Psychosomatic Medicine, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China
| | - Zongping Fang
- Department of Anesthesiology, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China
| | - Wugang Hou
- Department of Anesthesiology, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China
| | - Fang Gao
- Institute of Neuroscience, The Fourth Military Medical University, Xi'an 710032, China
| | - Xia Li
- Department of Hepatobiliary Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, China
| | - Lize Xiong
- Department of Anesthesiology, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China.
| | - Qingrong Tan
- Department of Psychosomatic Medicine, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China.
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Peng Z, Wang H, Zhang R, Chen Y, Xue F, Nie H, Chen Y, Wu D, Wang Y, Wang H, Tan Q. Gastrodin ameliorates anxiety-like behaviors and inhibits IL-1beta level and p38 MAPK phosphorylation of hippocampus in the rat model of posttraumatic stress disorder. Physiol Res 2013; 62:537-45. [PMID: 24020812 DOI: 10.33549/physiolres.932507] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Gastrodin, a main constituent of a Chinese herbal medicine, has been shown to be effective in treating various mood disorders. The purpose of the present study was to determine whether gastrodin could ameliorate stress-associated behavior in a rat model of enhanced single prolonged stress (ESPS)-induced posttraumatic stress disorder (PTSD). Following ESPS, rats were administered orally with gastrodin (50, 100, or 200 mg/kg daily) or vehicle for 2 weeks. Animals were then tested in the open field and elevated plus-maze, and the levels of IL-6 and IL-1beta, the expression of iNOS, p38 and phospho-p38 (p-p38) in hippocampus were also tested. ESPS exposure resulted in pronounced anxiety-like behavior, elevated IL-6 and IL-1beta levels, and the higher expression of iNOS and p-p38 in hippocampus. However, repeated treatment with gastrodin, particularly at higher doses, reversed the aforementioned changes, including anxiety-like behavior, levels of IL-6 and IL-1beta, and the expression of iNOS and the p38 MAPK phosphorylation. These results indicate that gastrodin possesses anxiolytic effect and may be an effective herbal preparation for the treatment of PTSD.
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Affiliation(s)
- Z Peng
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China. and
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Shiga T, Suzuki T, Nishimura K. Psychological distress in patients with an implantable cardioverter defibrillator. J Arrhythm 2013. [DOI: 10.1016/j.joa.2013.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Tawa J, Murphy S. Psychopharmacological treatment for military posttraumatic stress disorder: an integrative review. J Am Assoc Nurse Pract 2013; 25:419-423. [PMID: 24170638 DOI: 10.1111/1745-7599.12016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE Posttraumatic stress disorder (PTSD) is a serious mental health disorder. The current first-line psychopharmacologic treatment for PTSD is selective serotonin reuptake inhibitors (SSRIs). Recently, the efficacy of SSRIs has been challenged in favor of propranolol use. This article reviews the origins of PTSD, its impact within the veteran population, psychopharmacological treatment of PTSD, and current literature on the use of propranolol for PTSD treatment. DATA SOURCES The search strategies used included ProQuest, Medline, CINAHL, and Psychiatry Online and were searched using the key terms: PTSD, psychopharmacological treatment, SSRIs, propranolol, military, and veterans in multiple combinations. CONCLUSIONS Studies to date indicate that (a) SSRIs are only moderately effective as a first-line treatment for PTSD and less so for military personnel, (b) propranolol has the ability to attenuate traumatic memory in primary and tertiary use, and (c) ethical and moral consideration as well as further research and testing is needed for substantiating propranolol as a first-line PTSD psychopharmacological treatment. IMPLICATIONS FOR PRACTICE Current research has shown propranolol to be an effective treatment option for PTSD.
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Affiliation(s)
- Jennifer Tawa
- (Psychiatric Nurse Practitioner), Nursing Master's Program, Rivier College, Nashua, New Hampshire (Program Director), Division of Nursing, Rivier College, Nashua, New Hampshire
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Peng Z, Zhang R, Wang H, Chen Y, Xue F, Wang L, Yang F, Chen Y, Liu L, Kuang F, Tan Q. Ziprasidone ameliorates anxiety-like behaviors in a rat model of PTSD and up-regulates neurogenesis in the hippocampus and hippocampus-derived neural stem cells. Behav Brain Res 2013; 244:1-8. [PMID: 23384713 DOI: 10.1016/j.bbr.2013.01.032] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 01/22/2013] [Accepted: 01/27/2013] [Indexed: 01/12/2023]
Abstract
Ziprasidone, a widely used atypical antipsychotic drug, has been demonstrated to have therapeutic effects in patients with post-traumatic stress disorder (PTSD), but its underlying mechanisms remain poorly understood. One possible explanation is that the neuroprotective and neurogenetic actions of ziprasidone can attenuate the neuronal apoptosis which occurs in the hippocampus. To test this hypothesis, the present study was designed to assess the effects of ziprasidone treatment on anxiety-like behaviors, hippocampal neurogenesis, and in vivo/in vitro expression of pERK1/2 and Bcl-2 in male Sprague-Dawley rats. The methodology involved 3 different experiments, and the investigations also included the assessment of U0126 interference in ziprasidone treatment. It was found that the in vivo, administration of ziprasidone not only reversed the anxiety-like behaviors in rats that exposed to an enhanced single prolonged stress paradigm, but also restored the proliferation and the protein expression of pERK1/2 and Bcl-2 in the hippocampus of these rats. Also, mild concentrations of ziprasidone promoted the in vitro proliferation of hippocampal-derived neural stem cells (NSCs) and increased the levels of pERK1/2 and Bcl-2 in NSCs. Interestingly, the observed effects of ziprasidone were inhibited by U0126. These data support the use of ziprasidone for the treatment of PTSD and indicate that the changes in the ERK1/2 signaling cascade may play a critical role in the pathophysiology of PTSD and its treatment modalities. Further investigations are needed to elucidate the detailed signal cascades involved in the pathophysiology of stress-related disorders, and confirm the efficacy of ziprasidone in anti-PTSD treatment.
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Affiliation(s)
- Zhengwu Peng
- Department of Psychosomatic Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
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Anxiolytic effects of flavonoids in animal models of posttraumatic stress disorder. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:623753. [PMID: 23316258 PMCID: PMC3539772 DOI: 10.1155/2012/623753] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 11/05/2012] [Accepted: 11/20/2012] [Indexed: 11/18/2022]
Abstract
The dysregulation of the serotonergic system has long been recognized as an important factor underlying the pathophysiology of PTSD. To date, SSRIs have already been established as the firstline pharmacotherapeutic agents for treating acute and chronic PTSD. However, SSRIs largely have several disadvantages which limit their utility. Our previous study has also shown that administration of the total flavonoids, isolated from the extract of Xiaobuxin-Tang (XBXT, mild mind-easing decoction), comprising four Chinese medicines including Haematitum, Flos Inulae, Folium Phyllostachydis Henonis, and Semen Sojae Preparatum, exerted significant antidepressant-like effect in chronically mildly stressed rats, possibly mediated by serotonergic activation. Since the central serotonergic dysfunction is an important and well-known cause mediating the pathophysiology of trauma-related symptoms in PTSD, it is reasonable to predict that flavonoids may exert therapeutic effects on PTSD in animal models. Therefore, the present study aims to examine the effect of flavonoids in alleviating the enhanced anxiety and fear response induced in two PTSD animal models. Ser, an SSRI, was administered as a positive control. Furthermore, the changes of brain monoaminergic neurotransmitters after chronic flavonoids administration have also been assessed in SPS-treated rats.
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Rossi V, Pourtois G. Transient state-dependent fluctuations in anxiety measured using STAI, POMS, PANAS or VAS: a comparative review. ANXIETY STRESS AND COPING 2012; 25:603-45. [DOI: 10.1080/10615806.2011.582948] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Moran VE. Cotinine: Beyond that Expected, More than a Biomarker of Tobacco Consumption. Front Pharmacol 2012; 3:173. [PMID: 23087643 PMCID: PMC3467453 DOI: 10.3389/fphar.2012.00173] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 09/10/2012] [Indexed: 12/15/2022] Open
Abstract
A greater incidence of tobacco consumption occurs among individuals with psychiatric conditions including post-traumatic stress disorder (PTSD), bipolar disorder, major depression, and schizophrenia, compared with the general population. Even when still controversial, it has been postulated that smoking is a form of self-medication that reduces psychiatric symptoms among individuals with these disorders. To better understand the component(s) of tobacco-inducing smoking behavior, greater attention has been directed toward nicotine. However, in recent years, new evidence has shown that cotinine, the main metabolite of nicotine, exhibits beneficial effects over psychiatric symptoms and may therefore promote smoking within this population. Some of the behavioral effects of cotinine compared to nicotine are discussed here. Cotinine, which accumulates in the body as a result of tobacco exposure, crosses the blood-brain barrier and has different pharmacological properties compared with nicotine. Cotinine has a longer plasma half-life than nicotine and showed no addictive or cardiovascular effects in humans. In addition, at the preclinical level, cotinine facilitated the extinction of fear memory and anxiety after fear conditioning, improved working memory in a mouse model of Alzheimer’s disease (AD) and in a monkey model of schizophrenia. Altogether, the new evidence suggests that the pharmacological and behavioral effects of cotinine may play a key role in promoting tobacco smoking in individuals that suffer from psychiatric conditions and represents a new potential therapeutic agent against psychiatric conditions such as AD and PTSD.
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Affiliation(s)
- Valentina Echeverria Moran
- Research and Development, Department of Veterans Affairs, Bay Pines VA Healthcare System Bay Pines, FL, USA ; Tampa VA Healthcare System Tampa, FL, USA ; Department of Molecular Medicine, University of South Florida Tampa, FL, USA
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Browne CA, Clarke G, Dinan TG, Cryan JF. An effective dietary method for chronic tryptophan depletion in two mouse strains illuminates a role for 5-HT in nesting behaviour. Neuropharmacology 2012; 62:1903-15. [DOI: 10.1016/j.neuropharm.2011.12.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 12/01/2011] [Accepted: 12/08/2011] [Indexed: 12/31/2022]
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Zeitlin R, Patel S, Solomon R, Tran J, Weeber EJ, Echeverria V. Cotinine enhances the extinction of contextual fear memory and reduces anxiety after fear conditioning. Behav Brain Res 2011; 228:284-93. [PMID: 22137886 DOI: 10.1016/j.bbr.2011.11.023] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Revised: 11/14/2011] [Accepted: 11/18/2011] [Indexed: 12/14/2022]
Abstract
Posttraumatic stress disorder (PTSD) is an anxiety disorder triggered by traumatic events. Symptoms include anxiety, depression and deficits in fear memory extinction (FE). PTSD patients show a higher prevalence of cigarette smoking than the general population. The present study investigated the effects of cotinine, a tobacco-derived compound, over anxiety and contextual fear memory after fear conditioning (FC) in mice, a model for inducing PTSD-like symptoms. Two-month-old C57BL/6J mice were separated into three experimental groups. These groups were used to investigate the effect of pretreatment with cotinine on contextual fear memory and posttreatment on extinction and stability or retrievability of the fear memory. Also, changes induced by cotinine on the expression of extracellular signal-regulated kinase (ERK)1/2 were assessed after extinction in the hippocampus. An increase in anxiety and corticosterone levels were found after fear conditioning. Cotinine did not affect corticosterone levels but enhanced the extinction of contextual fear, decreased anxiety and the stability and/or retrievability of contextual fear memory. Cotinine-treated mice showed higher levels of the active forms of ERK1/2 than vehicle-treated mice after FC. This evidence suggests that cotinine is a potential new pharmacological treatment to reduce symptoms in individuals with PTSD.
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Affiliation(s)
- Ross Zeitlin
- Bay Pines VA Healthcare System, Bay Pines, FL 33744, USA
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Murrough JW, Czermak C, Henry S, Nabulsi N, Gallezot JD, Gueorguieva R, Planeta-Wilson B, Krystal JH, Neumaier JF, Huang Y, Ding YS, Carson RE, Neumeister A. The effect of early trauma exposure on serotonin type 1B receptor expression revealed by reduced selective radioligand binding. ACTA ACUST UNITED AC 2011; 68:892-900. [PMID: 21893657 DOI: 10.1001/archgenpsychiatry.2011.91] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
CONTEXT Serotonergic dysfunction is implicated in the pathogenesis of posttraumatic stress disorder (PTSD), and recent animal models suggest that disturbances in serotonin type 1B receptor function, in particular, may contribute to chronic anxiety. However, the specific role of the serotonin type 1B receptor has not been studied in patients with PTSD. OBJECTIVE To investigate in vivo serotonin type 1B receptor expression in individuals with PTSD, trauma-exposed control participants without PTSD (TC), and healthy (non-trauma-exposed) control participants (HC) using positron emission tomography and the recently developed serotonin type 1B receptor selective radiotracer [(11)C]P943. DESIGN Cross-sectional positron emission tomography study under resting conditions. SETTING Academic and Veterans Affairs medical centers. PARTICIPANTS Ninety-six individuals in 3 study groups: PTSD (n = 49), TC (n = 20), and HC (n = 27). Main Outcome Measure Regional [(11)C]P943 binding potential (BP(ND)) values in an a priori-defined limbic corticostriatal circuit investigated using multivariate analysis of variance and multiple regression analysis. RESULTS A history of severe trauma exposure in the PTSD and TC groups was associated with marked reductions in [(11)C]P943 BP(ND) in the caudate, the amygdala, and the anterior cingulate cortex. Participant age at first trauma exposure was strongly associated with low [(11)C]P943 BP(ND). Developmentally earlier trauma exposure also was associated with greater PTSD symptom severity and major depression comorbidity. CONCLUSIONS These data suggest an enduring effect of trauma history on brain function and the phenotype of PTSD. The association of early age at first trauma and more pronounced neurobiological and behavioral alterations in PTSD suggests a developmental component in the cause of PTSD.
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Affiliation(s)
- James W Murrough
- Mood and Anxiety Disorders Program, Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, USA.
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Corchs F, Mercante JP, Guendler VZ, Masruha MR, Vieira DS, Bernik MA, Zukerman E, Peres JFP, Peres MFP. Sensitivity to aversive stimulation, posttraumatic symptoms and migraines: what do they have in common? Med Hypotheses 2011; 77:534-5. [PMID: 21763077 DOI: 10.1016/j.mehy.2011.06.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Accepted: 06/05/2011] [Indexed: 10/18/2022]
Abstract
Studies have suggested that the high comorbidity observed between chronic migraine and anxiety disorders can be mediated through a third factor namely increased sensitivity to aversive stimulation. This trait may predispose for both chronic migraines, through medication overuse as an avoidance response, and anxiety disorders. Additional studies have shown that hyper sensitivity to aversive stimulation, migraine chronification and anxiety disorders share other characteristics such as serotonergic mediation and personality traits. Preliminary analysis of empirical data comparing the frequency the impact of traumatic events over chronic [CM] and episodic migraine [EM] patients gives further support to this hypothesis. In spite of CM and EM did not differ in terms of the occurrence of traumatic events, CM patients that had experienced at least one traumatic event during their lives had higher scores in re-experiencing and avoidance (but not in hyperarousal) symptoms than CM patients. These observations suggest that traumatic events have greater impact over CM than over EM patients.
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Affiliation(s)
- Felipe Corchs
- Institute and Department of Psychiatry, University of São Paulo, School of Medicine, and Instituto de Ensino e Pesquisa-Hospital Israelita Albert Einstein, São Paulo, Brazil
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Abstract
OBJECTIVE To examine whether a polymorphism (5-HTTLPR: serotonin transporter linked polymorphic region) in the promoter of the serotonin transporter gene (SLC6A4) moderates cardiovascular reactivity to social threat. METHODS Psychologically healthy young adults delivered a speech and performed mental arithmetic in one of three conditions: a) an evaluative audience condition that gave disapproving and negative nonverbal social signals (n = 59); b) an evaluative audience condition that provided supportive social signals (n = 60); or c) a no audience condition (n = 65). Heart rate (HR) and systolic and diastolic blood pressures (DBP) were measured before, during, and after the stress tasks to assess cardiovascular reactivity and recovery. RESULTS In the negative audience condition, there was a significant association between the 5-HTTLPR and systolic blood pressure, DBP, and HR reactivity. Individuals with the short/short genotype showed the greatest reactivity. The DBP and HR reactivity of short/short individuals in the negative audience condition was also greater than that of individuals with the short/short genotype in the no audience condition. These associations of the 5-HTLPR with HR reactivity were moderated by gender, being limited to females. With respect to cardiovascular recovery, short/short individuals in the negative audience condition exhibited impaired DBP recovery relative to other genotypes in the same condition, as well as short/short individuals in the no audience condition. CONCLUSIONS The 5-HTTLPR moderates cardiovascular reactivity to stress in a threatening evaluative social context, which suggests that the serotonin system may be involved in the processes by which stressful, conflict-ridden social environments affect risk for cardiovascular-related health outcomes.
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Sears SF, Hauf JD, Kirian K, Hazelton G, Conti JB. Posttraumatic Stress and the Implantable Cardioverter-Defibrillator Patient. Circ Arrhythm Electrophysiol 2011; 4:242-50. [PMID: 21505176 DOI: 10.1161/circep.110.957670] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Samuel F. Sears
- From the Department of Psychology, East Carolina University, Greenville, NC (S.F.S., J.D.H., K.K., G.H.); the Department of Cardiovascular Sciences, East Carolina Heart Institute, East Carolina University, Greenville, NC (S.F.S.); and the Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, FL (J.B.C.)
| | - Jessica D. Hauf
- From the Department of Psychology, East Carolina University, Greenville, NC (S.F.S., J.D.H., K.K., G.H.); the Department of Cardiovascular Sciences, East Carolina Heart Institute, East Carolina University, Greenville, NC (S.F.S.); and the Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, FL (J.B.C.)
| | - Kari Kirian
- From the Department of Psychology, East Carolina University, Greenville, NC (S.F.S., J.D.H., K.K., G.H.); the Department of Cardiovascular Sciences, East Carolina Heart Institute, East Carolina University, Greenville, NC (S.F.S.); and the Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, FL (J.B.C.)
| | - Garrett Hazelton
- From the Department of Psychology, East Carolina University, Greenville, NC (S.F.S., J.D.H., K.K., G.H.); the Department of Cardiovascular Sciences, East Carolina Heart Institute, East Carolina University, Greenville, NC (S.F.S.); and the Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, FL (J.B.C.)
| | - Jamie B. Conti
- From the Department of Psychology, East Carolina University, Greenville, NC (S.F.S., J.D.H., K.K., G.H.); the Department of Cardiovascular Sciences, East Carolina Heart Institute, East Carolina University, Greenville, NC (S.F.S.); and the Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, FL (J.B.C.)
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Rapid tryptophan depletion following cognitive behavioural therapy for panic disorder. Psychopharmacology (Berl) 2011; 213:593-602. [PMID: 19823804 DOI: 10.1007/s00213-009-1696-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2009] [Accepted: 09/23/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aim of this study was to examine the effect of rapid tryptophan depletion (RTD) combined with a panicogenic challenge in patients with panic disorder who had responded to treatment with cognitive behavioural therapy (CBT). We hypothesised that RTD (compared with the control drink) would result in an increase in anxiety symptoms when provoked by a panicogenic challenge with the benzodiazepine antagonist, flumazenil. METHODS Nine patients with panic disorder who had responded to CBT received a tryptophan-free amino acid drink on one occasion and a control drink on the other in a double-blind crossover design. In addition, they received flumazenil and placebo infusions on each day. RESULTS Our hypothesis regarding the effects of RTD was supported by findings of a significant interaction between RTD and flumazenil on measures from visual analogues scales (total) and the Spielberger State Anxiety inventory. A somewhat unexpected finding was that in this group of CBT responders, the panicogenic effect of flumazenil was not completely blocked by treatment. This meant that although four of the nine subjects (44%) reported a panicogenic effect of flumazenil on the RTD day, this was not significantly different from the rate of panic attacks in response to flumazenil on the control day. CONCLUSION We suggest that the partial return of symptoms in response to flumazenil reflects a vulnerability to RTD in this group of panic disorder patients who had responded to treatment with CBT.
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Adamec R, Toth M, Haller J, Halasz J, Blundell J. Activation patterns of cells in selected brain stem nuclei of more and less stress responsive rats in two animal models of PTSD - predator exposure and submersion stress. Neuropharmacology 2010; 62:725-36. [PMID: 21112345 DOI: 10.1016/j.neuropharm.2010.11.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Revised: 10/14/2010] [Accepted: 11/18/2010] [Indexed: 10/18/2022]
Abstract
This study had two purposes. First: compare predator and water submersion stress cFos activation patterns in dorsal raphe (DR), locus coeruleus (LC) and periaqueductal gray (PAG). Second: identify markers of vulnerability to stressors within these areas. Rats were either predator or submersion stressed and tested 1.75 h later for anxiety-like behavior. Immediately thereafter, rats were sacrificed and cFos expression examined. In DR, serotonergic cells expressing or not expressing cFos were also counted. Predator and submersion stress increased anxiety-like behavior (in the elevated plus maze- EPM) equally over controls. Moreover, stressed rats spent equally less time in the center of the hole board than handled controls, another indication of increased anxiety-like behavior. To examine vulnerability, rats which were less anxious (LA) and more (highly) anxious (MA) in the EPM were selected from among handled control and stressed animals. LA rats in the stressed groups were considered stress non-responsive and MA stressed rats were considered stress responsive. LA and MA rats did not differ in cFos expression in any brain area, though stressors did increase cFos cell counts in all areas over controls. Intriguingly, the number of serotonergic DR neurons not activated by stress predicted degree of anxiety response to submersion stress only. LA submersion stressed rats had more serotonergic cells than all other groups, and MA submersion stressed rats had fewer serotonergic cells than all other groups, which did not differ. Moreover, these cell counts correlated with EPM anxiety. We conclude that a surplus of such cells protects against anxiogenic effects of submersion, while a paucity of such cells enhances vulnerability to submersion stress. Other data suggest serotonergic cells may exert their effects via inhibition of dorsolateral PAG cells during submersion stress. Findings are discussed with respect to serotonergic transmission in vulnerability to predator stress and relevance of findings for post traumatic stress disorder (PTSD). This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.
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Affiliation(s)
- Robert Adamec
- Dept. of Psychology, Memorial University, St. John's, Newfoundland, Canada.
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Zhao G, Wang J, Qin GW, Guo LH. Cynomorium songaricum extracts functionally modulate transporters of gamma-aminobutyric acid and monoamine. Neurochem Res 2010; 35:666-76. [PMID: 20084455 DOI: 10.1007/s11064-009-0118-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2009] [Indexed: 01/20/2023]
Abstract
Cynomorium songaricum Rupr. (SY) is a central nervous system-oriented herb material that has actions of anti-dementia, anti-epilepsy, and anti-stress. It is unclear whether SY would be biologically active in functionally regulating neurotransmitter transporters. Here, we assessed these potential actions using Chinese hamster ovary cells expressing gamma-aminobutyric acid (GABA) transporter (GAT-1), dopamine transporter (DAT), norepinephrine transporter (NET), or serotonin transporter (SERT) (i.e. G1, D8, N1, or S6 cells, respectively). It was shown that SY extracts, such as SYw, SYa, SYp, SYc, SYe, and SYb (SY water, ethanol, petroleum ether, chloroform, ethyl acetate, and n-butyl alcohol extract, respectively) increased dopamine/norepinephrine (DA/NE) uptake by corresponding D8/N1 cells and decreased gamma-aminobutyric acid/serotoin (GABA/5HT) uptake by corresponding G1/S6 cells; wherein, the potency or efficacy of SYc for up-regulating DA/NE uptake and that of SYb for inhibiting GABA/5HT uptake were relatively stronger. Additionally, GABA/5H-uptake inhibition by SY extracts were also seen in cortical synaptosomes, and DA/NE-uptake enhancement by SYc was dependent on the activity of DAT and NET. Thus, SY extracts especially SYc and SYb are novel neurotransmitter-transporter modulators functioning as DAT/NET activators and/or GAT-1/SERT inhibitors.
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Affiliation(s)
- Gang Zhao
- Cell Star Bio-Technologies Co., Limited, Shanghai, People's Republic of China
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Effects of acute tryptophan depletion in serotonin reuptake inhibitor-remitted patients with generalized anxiety disorder. Psychopharmacology (Berl) 2010; 208:223-32. [PMID: 19936713 DOI: 10.1007/s00213-009-1722-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2009] [Accepted: 11/01/2009] [Indexed: 12/19/2022]
Abstract
BACKGROUND Serotonergic antidepressants [selective serotonin reuptake inhibitor (SSRI)] are first-line treatments for generalised anxiety disorder (GAD); however, it is not known if synaptic serotonin (5-HT) availability is important for SSRI efficacy. The present study tested the hypothesis that temporary reduction in central 5-HT transmission, through acute tryptophan depletion (ATD), would reverse the therapeutic effect of the SSRIs in GAD patients. METHODS Twelve patients (six males) with GAD, who showed sustained clinical improvement with SSRI treatment, underwent ATD in a double-blind, placebo-controlled, within-subjects design over 2 days, 1 week apart. At the peak time of depletion, the participants inhaled 7.5% CO2 and air in random order for at least 12 min each. Psychological responses were measured using the Spielberger State Anxiety Inventory (STAI-S) and GAD-symptom visual analogue scales (VASs; e.g., worry and tense) and Profile of Mood States. RESULTS Free plasma tryptophan to large neutral amino acid (LNAA) ratio decreased by 92% on the depletion day and decreased by 2% on the control day. Irrespective of depletion condition, 7.5% CO(2) inhalation significantly increased STAI-S and GAD-related VAS scores (all p < 0.05) compared with air inhalation. ATD had no effect on any of these measures despite the substantial reduction in free tryptophan/LNAA ratio. CONCLUSIONS Although SSRIs treat GAD effectively, the present results suggest that the mechanism of action is different to that seen in panic, social anxiety, and post-traumatic stress disorders. Successful SSRI treatment of GAD may involve long-term receptor changes or alterations in other neurotransmitter systems downstream of serotonin.
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