Treatment of co-morbid alcoholism and PTSD in veterans ? comparison with other drug dependencies
11-15-16
Loggins, K., Gutierrez, C.A., PharmD, Wilcox, R.E., PhD.*
Target: Journal of Addiction and Preventive Medicine
ABSTRACT
Combat instigated PTSD is one of the more complicated psychological conditions that occur in the modern world. To add to the complications of treatment, PTSD is often accompanied by other psychological comorbidities and substance use disorders; of which the most frequent is alcoholism. While PTSD is normally associated with veterans (combat or non-combat), many of the studies and treatments designs are based on civilian or non-combat instigated PTSD. The lack of information on PTSD in veterans may weaken society?s ability to treat one of the most affected populations. Currently, treatment for PTSD is still associated with a high incidence of nonresponse and relapse. The purpose of this paper is three-fold: to evaluate current psychological and pharmacological guidelines for treating PTSD with an emphasis on the clinical data from combat veterans; to evaluate treatment of alcohol use …show more content…
In response to stress, the sympathetic nervous system rapidly releases epinephrine and norepinephrine. Through second messengers in the basolateral amygdala, the noradrenergic/norepinephrine (NE) system is a largely implicated in memory consolidation during stress. 103 Epinephrine and norepinephrine are influential in the consolidation and retention of memories during emotional events.59 Noradrenergic signaling is also critical for the later reconsolidation of fear learning.104 Abnormal noradrenergic function in PTSD has been found in both general and veteran patients.5 As mentioned earlier, veteran and general population PTSD patients show heightened levels of norepinephrine in the cerebrospinal fluid and in serum.60,105 General studies have also shown greater 24-hour urinary excretion of epinephrine/norepinephrine
11-15-16
Loggins, K., Gutierrez, C.A., PharmD, Wilcox, R.E., PhD.*
Target: Journal of Addiction and Preventive Medicine
ABSTRACT
Combat instigated PTSD is one of the more complicated psychological conditions that occur in the modern world. To add to the complications of treatment, PTSD is often accompanied by other psychological comorbidities and substance use disorders; of which the most frequent is alcoholism. While PTSD is normally associated with veterans (combat or non-combat), many of the studies and treatments designs are based on civilian or non-combat instigated PTSD. The lack of information on PTSD in veterans may weaken society?s ability to treat one of the most affected populations. Currently, treatment for PTSD is still associated with a high incidence of nonresponse and relapse. The purpose of this paper is three-fold: to evaluate current psychological and pharmacological guidelines for treating PTSD with an emphasis on the clinical data from combat veterans; to evaluate treatment of alcohol use …show more content…
In response to stress, the sympathetic nervous system rapidly releases epinephrine and norepinephrine. Through second messengers in the basolateral amygdala, the noradrenergic/norepinephrine (NE) system is a largely implicated in memory consolidation during stress. 103 Epinephrine and norepinephrine are influential in the consolidation and retention of memories during emotional events.59 Noradrenergic signaling is also critical for the later reconsolidation of fear learning.104 Abnormal noradrenergic function in PTSD has been found in both general and veteran patients.5 As mentioned earlier, veteran and general population PTSD patients show heightened levels of norepinephrine in the cerebrospinal fluid and in serum.60,105 General studies have also shown greater 24-hour urinary excretion of epinephrine/norepinephrine