Preliminary study of carbamazepine in post-traumatic stress disorder

Lipper, Steven; Davidson, Jonathan; Grady, Tana A.; Edinger, Jack D.; Hammett, Elliott B.; Mahorney, Steven L.; Cavenar, Jesse O.

doi:10.1016/s0033-3182(86)72590-5

Cited by 205 publications

(57 citation statements)

References 19 publications

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“…Unfortunately, very little has been published. An early open-label trial of carbamazepine in Vietnam combat veterans was completed by Lipper et al [96], and a similar trial of valproic acid was described by Fesler [97]. Response rates were 70 and 62%, respectively, but no double-blind trials of either of these compounds have been conducted, so their place in managing PTSD remains rather unclear.…”

Section: Review Of the Literaturementioning

confidence: 99%

Posttraumatic Stress Disorder: Diagnosis and Epidemiology, Comorbidity and Social Consequences, Biology and Treatment

et al. 2001

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Epidemiological studies clearly indicate that posttraumatic stress disorder (PTSD) is becoming a major health concern worldwide even if still poorly recognized and not well treated. PTSD commonly co-occurs with other psychiatric disorders, and several symptoms overlap with major depressive disorders, anxiety disorders and substance abuse; this may contribute to diagnostic confusion and underdiagnosis. This anxiety disorder provokes significant occupational, psychiatric, medical and psychosocial disability, and its consequences are enormously costly, not only to the survivors and their families, but also to the health care system and society. Work impairment associated with PTSD is very similar to the amount of work impairment associated with major depression. The pathophysiology of PTSD is multifactorial and involves dysregulation of the serotonergic as well as the noradrenergic system. A rational therapeutic approach should normalize the specific psychobiological alterations associated with PTSD. This can be achieved through the use of antidepressant drugs, mainly of those that potentiate serotonergic mechanisms. Recent double-blind placebo-controlled studies report the efficacy of selective serotonin reuptake inhibitors. Several cognitive-behavioral and psychosocial treatments have also been reported to be efficacious and could be considered when treating PTSD patients.

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Section: Review Of the Literaturementioning

confidence: 99%

Posttraumatic Stress Disorder: Diagnosis and Epidemiology, Comorbidity and Social Consequences, Biology and Treatment

et al. 2001

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“…Diferentes estudios basados en la respuesta favorable a la carbamazepina y otros medicamentos antiepilépticos en pacientes con diagnóstico de estrés postraumático, sugieren que la presencia de actividad paroxística en los EEG puede ser explicada por un modelo de kindling o por un trastorno de tipo paroxístico [13][14] . En nuestro caso en particular, es importante destacar que diferentes regiones que forman parte de los lóbulos frontal y temporal integran el sistema límbico, sistema que como hemos hecho referencia, constituye un centro vulnerable a la acción negativa el agente estresante.…”

Section: Discussionunclassified

Trastorno por estrés agudo: Presentación de un caso

Reyes¹,

Delgado²,

Imas

2012

Cuad. med. forense

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ResumenEl trastorno por estrés agudo puede ser secundario a una lesión grave o una amenaza a la integridad física. Ante este tipo de situación, el individuo responde con una serie de reacciones cognitivas, conductuales, emocionales y físicas todas ellas orquestadas por un órgano rector: el cerebro. Se presenta el caso de una paciente con un trastorno por estrés agudo que aparece tras ser agredida en su puesto laboral. Se trata de una mujer de 55 años, con antecedentes de un adecuado desempeño laboral, que después del evento traumático comienza a presentar cambios conductuales evidenciados por irritabilidad, miedo, ansiedad, nerviosismo y sobresaltos. No quiere salir sola a la calle, aqueja malestar al recordar el evento traumático y pérdida de su estabilidad emocional y laboral. Cuando se realiza la evaluación, la paciente se encontraba bajo tratamiento con antidepresivos y ansiolíticos. Se recomienda integrar estudios electrofisiológicos, psicofisiológicos y métodos de evaluación clinimétrica como complemento en el diagnóstico de esta entidad. Palabras clave: Estrés agudo. Respuesta simpática de la piel. EEG. AbstractAcute stress disorder may be the secondary to a serious injury or a threat to physical integrity. Given this situation, the individual responds with a series of cognitive, behavioral, emotional and physical reactions all orchestrated by a governing body: the brain. A case of a patient with acute stress disorder, which appears after being attacked in her job place, is presented. A 55-year old woman, with antecedents of adequate job performance, begins to show behavioral changes evidenced by irritability, fear, anxiety, nervousness and jumpiness after the traumatic event. She does not want to go alone into the street, explains malaise when remembering the traumatic event and loss of emotional and labour stability. At the time when the assessment is made, the patient was being treated with antidepressants and anxiolytics. It is recommended to integrate electrophysiological, psychophysiological and methods of clinometric evaluation as complements for the diagnosis of this entity.

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“…There is no established role for the use of conventional antipsychotics in the treatment of PTSD. Anticonvulsants such as carbamazapine, valproate, topiramate, lamotrigine are increasingly used in combination with antidepressants to treat symptoms of depression, mood instability and impulsivity observed in PTSD (Lipper et al, 1986, Keck et al, 1992, Fesler, 1991, Berlant and Van Kammen, 2002, Hertzberg et al, 1999, Hamner et al, 2001. These agents are generally reserved as third line agents and used in combination with first or second line agents, due to the paucity of evidence for their efficacy.…”

Section: Combining Treatment Resistant Ptsdmentioning

confidence: 99%