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Noradrenergic and serotonergic function in posttraumatic stress disorder

S M Southwick1, J H Krystal, J D Bremner

  • 1Clinical Neurosciences Division, Veterans Affairs Medical Center, West Haven, Conn, USA.

Archives of General Psychiatry
|August 1, 1997
PubMed
Summary

This study found that some patients with posttraumatic stress disorder (PTSD) may have overactive noradrenergic systems, while others may have overactive serotonergic systems, as indicated by their reactions to yohimbine and m-CPP.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Pharmacology

Background:

  • Yohimbine hydrochloride impacts behavior and cardiovascular function in PTSD patients.
  • Noradrenergic and serotonergic systems are implicated in PTSD.
  • This study investigates meta-chlorophenylpiperazine (m-CPP) in PTSD.

Purpose of the Study:

  • To probe noradrenergic activity using yohimbine.
  • To probe serotonergic activity using m-CPP.
  • To compare the effects of yohimbine and m-CPP in PTSD patients.

Main Methods:

  • 26 PTSD patients and 14 healthy controls received intravenous infusions.
  • Infusions included yohimbine hydrochloride, m-CPP, or saline.
  • A randomized, double-blind, balanced order design was used.

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Main Results:

  • 42% of PTSD patients experienced yohimbine-induced panic attacks.
  • 31% of PTSD patients experienced m-CPP-induced panic attacks.
  • Both agents increased anxiety, panic, and PTSD symptoms; m-CPP also increased diastolic blood pressure.

Conclusions:

  • PTSD patients may represent two neurobiological subgroups.
  • One subgroup shows a sensitized noradrenergic system.
  • Another subgroup exhibits a sensitized serotonergic system.