Lin Chen-Cheng, Liu Yia-Ping
Laboratory of Cognitive Neuroscience, Department of Physiology and Biophysics, National Defense Medical Center, Taipei 114, Taiwan.
Department of Psychiatry, Cheng Hsin General Hospital, Taipei 112, Taiwan.
Pharmaceuticals (Basel). 2022 Jun 24;15(7):788. doi: 10.3390/ph15070788.
Post-traumatic stress disorder (PTSD) is a unique clinical mental abnormality presenting a cluster of symptoms in which patients primarily experience flashbacks, nightmares and uncontrollable thoughts about the event that triggered their PTSD. Patients with PTSD may also have comorbid depression and anxiety in an intractable and long-term course, which makes establishing a comprehensive treatment plan difficult and complicated. The present article reviews current pharmacological manipulations for adjusting abnormal fear memory. The roles of the central monoaminergic systems (including serotonin, norepinephrine and dopamine) within the fear circuit areas and the involvement of the hypothalamic-pituitary-adrenal (HPA) axis and glucocorticoid receptor (GR) are explored based on attempts to integrate current clinical and preclinical basic studies. In this review, we explain how these therapeutic paradigms function based on their connections to stages of the abnormal fear memory process from condition to extinction. This may provide useful translational interpretations for clinicians to manage PTSD.
创伤后应激障碍（PTSD）是一种独特的临床精神异常，表现为一系列症状，患者主要经历闪回、噩梦以及对引发其PTSD的事件的无法控制的想法。PTSD患者在难治且长期的病程中还可能合并抑郁和焦虑，这使得制定全面的治疗计划变得困难和复杂。本文综述了当前用于调节异常恐惧记忆的药理学方法。基于整合当前临床和临床前基础研究的尝试，探讨了恐惧回路区域内中枢单胺能系统（包括5-羟色胺、去甲肾上腺素和多巴胺）的作用以及下丘脑-垂体-肾上腺（HPA）轴和糖皮质激素受体（GR）的参与情况。在本综述中，我们根据这些治疗模式与从条件化到消退的异常恐惧记忆过程各阶段的联系来解释其作用机制。这可能为临床医生管理PTSD提供有用的转化解释。
