Propranolol for the treatment of anxiety disorders: Systematic review and meta-analysis

Steenen, Serge A.; Wijk, Arjen J. van; Heijden, Geert J. M. G. van der; Westrhenen, Roos van; Lange, Jan de; Jongh, Ad de

doi:10.1177/0269881115612236

Cited by 181 publications

(132 citation statements)

References 60 publications

(83 reference statements)

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“…Increased salience network connectivity has also been documented in a host of anxiety disorders, notably including PTSD (Peterson et al, 2014). Furthermore, propranolol-another pharmacological agent investigated as an adjunct for PTSD therapy (Brunet et al, 2008, but see Wood et al, 2015;Steenen et al, 2016)-decreases connectivity within the salience network (Hermans et al, 2011). Thus, it is worth considering whether action at the salience network might be an important component of the mechanism by which MDMA operates in MDMA-assisted psychotherapy for PTSD (Mithoefer et al, 2011;Mithoefer et al, 2012;Oehen et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Altered Insula Connectivity under MDMA

Walpola

Nest

Roseman

et al. 2017

Neuropsychopharmacol

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Recent work with noninvasive human brain imaging has started to investigate the effects of 3,4-methylenedioxymethamphetamine (MDMA) on large-scale patterns of brain activity. MDMA, a potent monoamine-releaser with particularly pronounced serotonin-releasing properties, has unique subjective effects that include: marked positive mood, pleasant/unusual bodily sensations and pro-social, empathic feelings. However, the neurobiological basis for these effects is not properly understood, and the present analysis sought to address this knowledge gap. To do this, we administered MDMA-HCl (100 mg p.o.) and, separately, placebo (ascorbic acid) in a randomized, doubleblind, repeated-measures design with twenty-five healthy volunteers undergoing fMRI scanning. We then employed a measure of global resting-state functional brain connectivity and follow-up seed-to-voxel analysis to the fMRI data we acquired. Results revealed decreased right insula/salience network functional connectivity under MDMA. Furthermore, these decreases in right insula/salience network connectivity correlated with baseline trait anxiety and acute experiences of altered bodily sensations under MDMA. The present findings highlight insular disintegration (ie, compromised salience network membership) as a neurobiological signature of the MDMA experience, and relate this brain effect to trait anxiety and acutely altered bodily sensations-both of which are known to be associated with insular functioning.

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Section: Discussionmentioning

confidence: 99%

Altered Insula Connectivity under MDMA

Walpola

Nest

Roseman

et al. 2017

Neuropsychopharmacol

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“…Desr echerches trèsr é centeso nt commencé sur l'intérêtd up ropanolol dans la prévention du syndrome de stress post-traumatique après un évènement traumatisant [52,53]. La prescriptiond 'anxiolytiques est possible mais pour un temps court en raison du risque de dépendance.…”

Section: La Prise En Chargeunclassified

La psychocardiologie : une nouvelle spécialité

Houppe¹

2017

Hegel

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RésuméLe corps et l'esprit sont intimement liés. Les relations entre coeur et cerveau sont très fortes. La naissance de la psychocardiologie apparaîtc omme une évidence. Le stress psychosocial est à la fois un facteur de risque indépendant et un facteur pronostic d'événements cardiovasculaires. Il comprend des aspects psychologiques, des composantes sociologiques et socio-économiques. Il apparaîta ussi que la maladie cardiaque est elle-même un événement déclenchant de stress psychosocial.Les recommandations européennes sont de grade 1A pour l'évaluation du risque psychosocial et de grade 1B pour la prise en charge.Les connaissances actuelles sur le développement cérébral permettent de mieux comprendre la relation qui existe entre le stress psychosocial et le risque cardiovasculaire. Le risque psychosocial augmente les facteurs de risque classiques et entraîne par ailleurs une dysfonction endothéliale, une réponse inflammatoire et une activation de la coagulation.Les anxiolytiques et les antidépresseurs ne sont pas très efficaces dans la prise en charge du stress psychosocial, en revanche l'activité physique et les psychothérapies sont plus indiquées en particulier les thérapies cognitivo-comportementales, les thérapies de la pleine conscience et la thérapie EMDR.Depuis qu'il a été proposéàla find es années 70, le modèle biopsychosocial ne cesse d'accumuler des preuves de sa pertinence. Les recherches en médecine psychosomatique ,e nc ardiologie et en psychologie de la santé ont permis de faire en sorte que la psychocardiologie devienne une nouvelle spécialité fondées ur l'evidence based medicine. Il reste maintenant à faire en sorte que ces connaissances puissent être transmises aux praticiens et qu'ils puissent inclure cet aspect dans leur pratique quotidienne. Mots-clésCardiologie ;P sychocardiologie ;S tress psychosocial ;P sychothérapie ;P r é vention cardiaque Abstract Body and mind are closely linked. The relationships between the brain and the heart are very strong.T he emergence of pyschocardiology appears to be as imple truism. On the one hand

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“…Many have successfully used pharmacological agents such as the FDA-approved b-adrenergic antagonist, propranolol, in preclinical studies to prevent reconsolidation of fear memories as a means of memory "erasure" (Debiec and Ledoux 2004). However, translating these achievements to the clinic has come with varying levels of success (Soeter and Kindt 2012;Steenen et al 2016). This has motivated investigations of additional mechanisms, including epigenetic modifications.…”

Section: Epigenetics and The Modulation Of Fear Memorymentioning

confidence: 99%

The potential of epigenetics in stress-enhanced fear learning models of PTSD

et al. 2016

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Prolonged distress and dysregulated memory processes are the core features of post-traumatic stress disorder (PTSD) and represent the debilitating, persistent nature of the illness. However, the neurobiological mechanisms underlying the expression of these symptoms are challenging to study in human patients. Stress-enhanced fear learning (SEFL) paradigms, which encompass both stress and memory components in rodents, are emerging as valuable preclinical models of PTSD. Rodent models designed to study the long-term mechanisms of either stress or fear memory alone have identified a critical role for numerous epigenetic modifications to DNA and histone proteins. However, the epigenetic modifications underlying SEFL remain largely unknown. This review will provide a brief overview of the epigenetic modifications implicated in stress and fear memory independently, followed by a description of existing SEFL models and the few epigenetic mechanisms found to date to underlie SEFL. The results of the animal studies discussed here highlight neuroepigenetics as an essential area for future research in the context of PTSD through SEFL studies, because of its potential to identify novel candidates for neurotherapeutics targeting stress-induced pathogenic memories.Post-traumatic stress disorder (PTSD) is triggered by experiencing or witnessing a traumatic event and is characterized by pathogenic memory (e.g., recurrent, involuntary memories that trigger intense stress), avoidance of reminders, hyperarousal and reactivity, negative mood, cognitive alterations, and a persistence of symptoms for at least 1 mo. Although only a fraction of people exposed to trauma develop PTSD, a history of stress exposure prior to witnessing a traumatic event increases the risk (Breslau et al. 2014). Therefore, some animal models of PTSD use multidimensional stress and fear memory paradigms to model the disorder. In stress-enhanced fear learning (SEFL), a rodent is exposed to a stressor or combination of stressors prior to undergoing classical fear conditioning. Models that utilize SEFL closely reproduce many core symptoms of PTSD, including enhanced fear learning, generalized anxiety, heightened startle, and impaired extinction.

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Propranolol for the treatment of anxiety disorders: Systematic review and meta-analysis

Cited by 181 publications

References 60 publications

Altered Insula Connectivity under MDMA

Altered Insula Connectivity under MDMA

La psychocardiologie : une nouvelle spécialité

The potential of epigenetics in stress-enhanced fear learning models of PTSD

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