title: PTSD: from neurobiology to pharmacological treatments.
abstract: Posttraumatic stress disorder (PTSD) is a chronic debilitating psychiatric disorder characterized by symptoms of re-experience, avoidance, and hyperarousal that can arise immediately or many years after exposure to a traumatic event and injury. Although extensive research has been done over the past 30 years, the etiology of PTSD remains largely unknown. Several neurobiological systems have been implicated in the pathophysiology and vulnerability for developing PTSD; however, first-line pharmacotherapies are limited. Less than 30% achieve full remission, and even then, approved pharmacological treatments often take weeks for therapeutic effect. This article aims to review the pathophysiology of PTSD within multiple neurobiological systems and how these mechanisms are used as pharmacologic targets of treatment, as well as their potential for future targets of intervention.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT.|Clinical Neuroscience Division, Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, CT; ben.kelmendi@yale.edu.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Kelmendi
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT.|Clinical Neuroscience Division, Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, CT.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Adams
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Yarnell
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT.|Clinical Neuroscience Division, Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, CT.
authors.forename: Steven
authors.initials: S
authors.lastname: Southwick
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT.|Clinical Neuroscience Division, Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, CT.
authors.forename: Chadi G
authors.initials: CG
authors.lastname: Abdallah
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT.|Clinical Neuroscience Division, Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, CT.|Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT.
authors.forename: John H
authors.initials: JH
authors.lastname: Krystal
keywords: GABA; PTSD; cannabinoid; glutamate; ketamine; noradrenergic; pharmacology; serotonin