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Reply to: It Is Time to Look for New Treatments for Posttraumatic Stress Disorder: Can Sympathetic System Modulation Be an Answer?

  • John H. Krystal
    Correspondence
    Address correspondence to John H. Krystal, M.D., Yale University School of Medicine, 300 George Street #901, New Haven, CT 06510.
    Affiliations
    Departments of Psychiatry and Neuroscience, Yale University School of Medicine, New Haven, Connecticut

    Clinical Neuroscience Division, National Center for Posttraumatic Stress Disorder, West Haven, Connecticut

    Psychiatry Services, VA Connecticut Healthcare System, West Haven, Connecticut
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  • Lori L. Davis
    Affiliations
    Research and Development Service, Tuscaloosa VA Medical Center, Tuscaloosa, Alabama

    Department of Psychiatry, University of Alabama School of Medicine, Birmingham, Alabama
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  • Thomas C. Neylan
    Affiliations
    Department of Psychiatry, University of California, San Francisco, California

    San Francisco VA Medical Center, San Francisco, California
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  • Murray Raskind
    Affiliations
    Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington

    VA Puget Sound Health Care System, Seattle, Washington
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  • Paula P. Schnurr
    Affiliations
    Executive Division, National Center for Posttraumatic Stress Disorder, White River Junction, Vermont

    Department of Psychiatry, Geisel School of Medicine at Dartmouth, White River Junction, Vermont
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  • Murray B. Stein
    Affiliations
    Departments of Psychiatry and Family Medicine & Public Health, University of California, San Diego, La Jolla

    VA San Diego Healthcare System, San Diego, California
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  • Jennifer Vessicchio
    Affiliations
    Clinical Neuroscience Division, National Center for Posttraumatic Stress Disorder, West Haven, Connecticut

    Psychiatry Services, VA Connecticut Healthcare System, West Haven, Connecticut
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  • Brian Shiner
    Affiliations
    Executive Division, National Center for Posttraumatic Stress Disorder, White River Junction, Vermont

    Department of Psychiatry, Geisel School of Medicine at Dartmouth, White River Junction, Vermont
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  • Theresa C. Gleason
    Affiliations
    Patient-Centered Outcome Research Institute, Washington, DC
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  • Grant D. Huang
    Affiliations
    VA Cooperative Studies Program Central Office, VA Office of Research and Development, Washington, DC
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      The Posttraumatic Stress Disorder (PTSD) Psychopharmacology Working Group appreciates the opportunity to respond to the letter to the editor from Lipov et al. (
      • Lipov E.
      • Tukan A.
      • Candido K.
      It is time to look for new treatments for posttraumatic stress disorder: Can sympathetic system modulation be an answer?.
      ) regarding the potential application of thoracic and cervical (“stellate”) ganglion blockade to the treatment of PTSD. The Consensus Statement focused on the unmet need for effective pharmacotherapies for the treatment of PTSD (
      • Krystal J.H.
      • Davis L.L.
      • Neylan T.C.
      • Rakind M.A.
      • Schnurr P.P.
      • Stein M.B.
      • et al.
      It is time to address the crisis in the pharmacotherapy of posttraumatic stress disorder: A consensus statement of the PTSD Psychopharmacology Working Group.
      ), but it was not intended to in any way to suggest that advances in other forms of effective treatment for PTSD would not be welcomed. In fact, members of the Working Group are advocates for and are involved in treatment trials beyond psychopharmacologic agents.
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      References

        • Lipov E.
        • Tukan A.
        • Candido K.
        It is time to look for new treatments for posttraumatic stress disorder: Can sympathetic system modulation be an answer?.
        Biol Psychiatry. 2018; 84: e17-e18
        • Krystal J.H.
        • Davis L.L.
        • Neylan T.C.
        • Rakind M.A.
        • Schnurr P.P.
        • Stein M.B.
        • et al.
        It is time to address the crisis in the pharmacotherapy of posttraumatic stress disorder: A consensus statement of the PTSD Psychopharmacology Working Group.
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      Linked Article

      • It Is Time to Look for New Treatments for Posttraumatic Stress Disorder: Can Sympathetic System Modulation Be an Answer?
        Biological PsychiatryVol. 84Issue 2
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          In a recent letter to the editor, Krystal et al. (1) noted that “There is an urgent need to address a critical lack of advancement in the psychopharmacologic treatment of posttraumatic stress disorder (PTSD)” (1). Most medications used on- or off-label for PTSD currently belong to typical categories of psychotropic medications. Current treatments that use psychotherapy and pharmaceuticals have a low success rate in the veteran population. With only 50% of veterans seeking care and a 40% recovery rate, current strategies will effectively reach no more than 20% of all veterans who need PTSD treatment (2).
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