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Abnormal noradrenergic function in posttraumatic stress disorder

S M Southwick1, J H Krystal, C A Morgan

  • 1National Center for Post Traumatic Stress Disorder, West Haven Veterans Affairs Medical Center, CT.

Archives of General Psychiatry
|April 1, 1993
PubMed
Summary
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Posttraumatic stress disorder (PTSD) patients exhibit abnormal noradrenergic neuronal regulation, showing heightened responses to yohimbine, including panic attacks and increased PTSD symptoms. This suggests stress-induced neurobiological changes contribute to PTSD.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Pharmacology

Background:

  • Posttraumatic stress disorder (PTSD) is associated with altered noradrenergic function.
  • Uncontrollable stress may lead to sustained increases in noradrenergic activity.

Purpose of the Study:

  • To investigate noradrenergic neuronal regulation in PTSD patients.
  • To compare the effects of yohimbine hydrochloride in PTSD patients and healthy controls.

Main Methods:

  • Intravenous administration of yohimbine hydrochloride (0.4 mg/kg) to 20 male PTSD patients and 18 healthy male subjects.
  • Assessment of behavioral, biochemical (plasma 3-methoxy-4-hydroxyphenylglycol), and cardiovascular (blood pressure, heart rate) responses.
  • Evaluation of PTSD symptom changes.

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Main Results:

  • PTSD patients experienced higher rates of yohimbine-induced panic attacks (70%) and flashbacks (40%).
  • PTSD patients showed significantly greater increases in plasma 3-methoxy-4-hydroxyphenylglycol, systolic blood pressure, and heart rate post-yohimbine.
  • Yohimbine administration exacerbated core PTSD symptoms, including intrusive thoughts and emotional numbing.

Conclusions:

  • Abnormal noradrenergic regulation is evident in PTSD patients.
  • Findings support the link between severe stress, noradrenergic hyperactivity, and PTSD pathophysiology.
  • Implications for understanding PTSD and its relationship with anxiety disorders like panic disorder.