Matar Michael A, Cohen Hagit, Kaplan Zeev, Zohar Joseph
Anxiety and Stress Research Unit, Ministry of Health Mental Health Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Neuropsychopharmacology. 2006 Dec;31(12):2610-8. doi: 10.1038/sj.npp.1301132. Epub 2006 Jun 21.
Whereas several well-controlled studies have established the selective serotonin reuptake inhibitors (SSRIs) as the recommended first-line pharmacotherapeutic agents for acute and chronic post-traumatic stress disorder (PTSD), drug interventions in the acute postexposure phase have not been studied to the same extent and tend to be largely speculative. This study employed an animal model which assesses prevalence of individual stress-response behavior patterns in order to assess the short-term effects of a brief treatment regimen with an SSRI (sertraline) administered immediately after stress-exposure, with those of an identical delayed regimen and of saline. Prevalence rates of rats displaying extreme anxiety-like behavioral responses to predator stress, compared to partial and minimal responses, were assessed in the elevated plus maze and startle response paradigms, with and without intraperitoneal administration of sertraline for 7 days immediately postexposure, or 7 days after exposure. Immediate postexposure administration of sertraline reduced anxiety-like and avoidant behavior, decreased hyperarousal responses and diminished the overall incidence of extreme (PTSD-like) behavioral responses, compared to the delayed treatment regimen and to saline controls. Brief immediate poststress exposure treatment with sertraline reduced prevalence rates of extreme behavioral disruption in the short-term. SSRI drugs are thus worthy of further investigation as agents of secondary prevention in the acute aftermath of stress-exposure.
尽管多项严格对照研究已将选择性5-羟色胺再摄取抑制剂(SSRIs)确立为急性和慢性创伤后应激障碍(PTSD)的推荐一线药物治疗剂,但在急性暴露后阶段的药物干预尚未得到同等程度的研究,且在很大程度上往往是推测性的。本研究采用了一种动物模型,该模型评估个体应激反应行为模式的发生率,以评估在应激暴露后立即给予SSRI(舍曲林)的简短治疗方案、相同的延迟治疗方案以及生理盐水的短期效果。在高架十字迷宫和惊吓反应范式中,评估了大鼠对捕食者应激表现出极端焦虑样行为反应的发生率,并与部分和最小反应进行比较,在暴露后立即或暴露后7天腹腔注射舍曲林7天。与延迟治疗方案和生理盐水对照组相比,暴露后立即给予舍曲林可减少焦虑样和回避行为,降低过度觉醒反应,并减少极端(PTSD样)行为反应的总体发生率。应激暴露后立即用舍曲林进行简短治疗可在短期内降低极端行为紊乱的发生率。因此,SSRI药物作为应激暴露后急性期二级预防药物值得进一步研究。