Facilitating Resilience after PTSD: A Translational Approach

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Graziano Pinna, Ph.D. (Editor)
University of Illinois at Chicago, Psychiatric Institute, Chicago, Illinois, USA

Takeshi Izumi, M.D., Ph.D. (Editor)
Health Sciences University of Hokkaido, Japan

Series: Psychiatry – Theory, Applications and Treatments
BISAC: PSY022040

Understanding the mechanisms by which the brain develops resilience, or lack thereof, could help unveil biomarkers for novel therapeutics to facilitate resilience after trauma. As of today, no specific treatment has been discovered for PTSD; nonetheless, 1 in 10 individuals suffer from this debilitating disorder. Selective serotonin reuptake inhibitors (SSRIs) are widely used as a first-line treatment, but with a high non-response rate, and the reasons for their inefficacy in PTSD is examined. This book reviews several biomarker candidates that may be useful to develop a precision medicine and help PTSD patients who fail to respond to traditional therapy. We examine the function of physiologically diverse raphe nucleus 5-HTergic neurons, deficits in amygdalar 5-HTergic neural systems, amygdala dopamine on emotional memory processing and the role of antipsychotics that attenuate excessive dopamine release and improve resilience. Autonomic imbalance, an acquired feature of PTSD, can be improved by trauma-focused psychotherapy and targeted interventions such as biofeedback. New hope via neuroepigenetics may unveil new therapeutic approaches for PTSD. Dysregulation in the HPA-axis and telomere dynamics may prove as key mechanisms in facilitating resilience and limit the risk of suicide. The endocannabinoid and neurosteroid systems as well as their interactions provide a crucial biomarker axis and contribute novel, exciting therapeutic targets to facilitate resilience after trauma.

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Table of Contents

Table of Contents

Preface

Chapter 1. Physiological Diversity of 5-HTergic Neurons in the Dorsal Raphe Nucleus Involved in Emotional Regulation
(Hiroki Shikanai, Department of Pharmacology, Faculty of Pharmaceutical Science, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Japan)

Chapter 2. The Amygdala Is the Target Brain Site of Anxiolytic Effects of SSRIs
(Takeshi Izumi, Yuji Kitaichi, Yan An, Takeshi Inoue, Mitsuhiro Yoshioka, Department of Pharmacology, Pharmaceutical Sciences, Health Sciences University of Hokkaido, Tobetsu, Japan)

Chapter 3. The Role of Amygdala Dopamine in Emotional Memory Processing
(Hidehiro Oshibuchi, Department of Psychiatry, Tokyo Women’s Medical University, Tokyo)

Chapter 4. Limitations of the Anxiolytic Function of Selective Serotonin Reuptake Inhibitors: Why Is Pharmacotherapy Ineffective in Treating Post-Traumatic Stress Disorder?
(Yuji Kitaichi, Takeshi Inoue, Yan An, Ichiro Kusumi, Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo Japan)

Chapter 5. The Cardiovascular Consequences of Autonomic Nervous System Dysregulation in PTSD
(Kimberly A. Arditte Hall, Terra Osterberg, Scott P. Orr, and Suzanne L. Pineles, National Center for PTSD at VA Boston Healthcare System, Boston, MA, USA)

Chapter 6. The Role of Epigenetic Mechanisms in Post-Traumatic Stress Disorder and Stress Resistance
(Kazuya Miyagawa, Minoru Tsuji, and Hiroshi Takeda, Department of Pharmacology, School of Pharmacy, International University of Health and Welfare, Tochigi, Japan)

Chapter 7. Resilience and Suicide
(Ikuo Otsuka, Akitoyo Hishimoto, Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan)

Chapter 8. Neurosteroid-Based Biomarkers and Therapeutic Approaches to Facilitate Resilience after Trauma
(Andrea Locci, Faryal Khan, Mohammad Ali Khan, and Graziano Pinna, The Psychiatric Institute, Department of Psychiatry, University of Illinois at Chicago)

Index

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