Noradrenergic and serotonergic function in posttraumatic stress disorder.

Abstract

BACKGROUND:

Yohimbine hydrochloride produces marked behavioral and cardiovascular effects in combat veterans with posttraumatic stress disorder (PTSD). In the present study, yohimbine was used as a probe of noradrenergic activity, and meta-chlorophenylpiperazine (m-CPP) as a probe of serotonergic activity. To our knowledge, this is the first study to describe the behavioral and cardiovascular effects of meta-CPP in patients with PTSD, and to compare these effects with those of yohimbine.

METHOD:

Twenty-six patients with PTSD and 14 healthy subjects each received an intravenous infusion of yohimbine hydrochloride (0.4 mg/kg), m-CPP (1.0 mg/kg), or saline solution on 3 separate test days in a randomized balanced order and in double-blind fashion. Behavioral and cardiovascular measurements were determined at multiple times.

RESULTS:

Eleven (42%) of the patients with PTSD experienced yohimbine-induced panic attacks and had significantly greater increases compared with controls in anxiety, panic, and PTSD symptoms, but not in cardiovascular measurements. Eight patients (31%) with PTSD experienced m-CPP-induced panic attacks and had significantly greater increases compared with controls in anxiety, panic, and PTSD symptoms, and in standing diastolic blood pressure. Yohimbine-induced panic attacks tended to occur in different patients from m-CPP-induced panic attacks.

CONCLUSION:

These data suggest the presence of 2 neurobiological subgroups of patients with PTSD, one with a sensitized noradrenergic system, and the other with a sensitized serotonergic system.

• Authors: S M Southwick, J H Krystal, J D Bremner, C A Morgan 3rd, A L Nicolaou, L M Nagy, D R Johnson, G R Heninger, D S Charney
• Journal: Archives of general psychiatry (Arch Gen Psychiatry) Vol. 54 Issue 8 Pg. 749-58 (Aug 1997) ISSN: 0003-990X [Print] United States
• PMID: 9283511 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Piperazines
• Yohimbine
• Serotonin
• 1-(3-chlorophenyl)piperazine
• Norepinephrine

Topics

• Adult
• Double-Blind Method
• Humans
• Hypertension (chemically induced)
• Male
• Norepinephrine (physiology)
• Panic Disorder (chemically induced)
• Piperazines (pharmacology)
• Serotonin (physiology)
• Stress Disorders, Post-Traumatic (physiopathology)
• Yohimbine (pharmacology)