Scientists have made good progress in recent years in working out the mechanics of how PTSD affects the brain. But there is still much work to be done when it comes to finding treatments.
So I was interested to read of new research from MIT suggesting a possible drug treatment for PTSD.
The study looked at the chemical process by which trauma imprints memories in the brain and contributes to flashbacks. According to the MIT press release, the research found that “chronic stress causes cells in the amygdala to express many more 5-HT2C receptors, which bind to serotonin.” When a traumatic experience occurs, the heightened sensitivity to serotonin causes the memory to be encoded more strongly, contributing to the “strong flashbacks that often occur in patients with PTSD”.
The way to stop this happening, the researchers suggest, is to use drugs that interfere with serotonin – either before the person has developed PTSD symptoms, or shortly after. One such drug, agomelatine, already exists and may be helpful.
Equally interesting was the suggestion that many antidepressant drugs – those known as SSRIs – may actually make PTSD worse because they enhance the effect of serotonin. If true, this is significant, because many PTSD sufferers (particularly women suffering PTSD after birth) are either misdiagnosed with depression or, in some cases, suffer depression as well as PTSD. In either case, the antidepressants commonly prescribed for them may be delaying recovery rather than helping it.
What else is available?
In England and Wales, the National Institute for Health and Care Excellence (NICE) regards two treatments as having a strong enough evidence base to justify their use: trauma-focused cognitive behaviour therapy (CBT) and eye movement desensitisation and reprocessing (EMDR) therapy.
Both treatments require a number of one-to-one sessions between the patient and the therapist. They are expensive. Numerous alternatives are being investigated, including techniques such as rewind therapy and emotional freedom therapy, but there is a lack of solid evidence at the moment to support them.
The range of treatments being tried for PTSD is wide. In the US, one of the most common treatments used with veterans is prolonged exposure therapy, in which the sufferer is asked to recount the story of their trauma over and over again. It now turns out that this may be ineffective and even counter-productive.
But I’ve also seen articles suggesting that medical marijuana, yoga, keeping dogs as pets and taking part in virtual reality simulations of traumatic situations can help alleviate PTSD. They may work or they may not – we won’t know until more research is carried out.
The MIT study, which has shown the mechanism by which PTSD affects the brain, is a promising step in the right direction.