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Effects of exogenous glucocorticoid on combat-related PTSD symptoms

Alina Surís, PhD, ABPP

VA North Texas Health Care System, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA

Carol North, MD, MPE

VA North Texas Health Care System, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA

Bryon Adinoff, MD

VA North Texas Health Care System, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA

Craig M. Powell, MD, PhD

Department of Psychiatry, Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA

Robert Greene, MD, PhD

VA North Texas Health Care System, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA

BACKGROUND: Very few systematic human studies focus on changing the underlying traumatic memory after posttraumatic stress disorder (PTSD) has been established. Evidence from animal and human studies indicates that cortisol can be used to address traumatic memories. This translational pilot study is based on our previous rodent research in which extinction of fear memories was enhanced by glucocorticoids. The current study aims to assess the effectiveness of glucocorticoids in augmenting memory extinction and reducing clinical symptoms in veterans with combat-related PTSD.

METHODS: In a double-blind, placebo-controlled study, veterans with combat-related PTSD were exposed to a memory reactivation task using well established imagery and psychophysiology assessment technique followed by administration of either glucocorticoid or placebo.

RESULTS: One week after glucocorticoid or placebo administration, participants who received the study medication showed significant PTSD-related symptom (cluster C) improvement compared with control participants who received placebo only. However, reduction of symptoms degraded at a 1-month postadministration assessment.

CONCLUSIONS: These findings are consistent with a glucocorticoid-mediated enhancement of extinction to ameliorate PTSD symptoms. The use of traumatic memory reactivation temporally paired with glucocorticoid administration holds potential for developing a viable therapeutic option.

KEYWORDS: posttraumatic stress disorder, glucocorticoids, memory extinction, pharmacotherapy

ANNALS OF CLINICAL PSYCHIATRY 2010;22(4):274–279

CORRESPONDENCE: Alina Surís, PhD, ABPP, VA North Texas Health Care System, Mental Health 116A, 4500 S. Lancaster Road, Dallas, TX 75216 USA, E-MAIL Alina.Suris@va.gov
Annals of Clinical Psychiatry ©2010 Quadrant HealthCom Inc.

 
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