Advertisement

Driving Progress in Posttraumatic Stress Disorder Biomarkers

      Posttraumatic stress disorder (PTSD) is a common, debilitating disorder that affects ∼8% of the U.S. population, with even higher estimates of ∼20%, in U.S. veterans of Afghanistan and Iraq (
      • Kessler R.C.
      • Sonnega A.
      • Bromet E.
      • Hughes M.
      • Nelson C.B.
      Posttraumatic stress disorder in the National Comorbidity Survey.
      ). Although psychotherapeutic and pharmacological interventions can significantly reduce PTSD symptoms, there remains considerable room for improvement (
      • Krystal J.H.
      • Davis L.L.
      • Neylan T.C.
      • Raskind A.M.
      • 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.
      ,
      • Holdeman T.C.
      Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery.
      ). Only two pharmacological therapeutics, sertraline and paroxetine, have been approved by the U.S. Food and Drug Administration (FDA) for PTSD (
      • Krystal J.H.
      • Davis L.L.
      • Neylan T.C.
      • Raskind A.M.
      • 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.
      ). Response to these selective serotonin reuptake inhibitors rarely exceeds 60%, and only 20% to 30% of patients achieve complete remission of symptoms (
      • Holdeman T.C.
      Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery.
      ). Thus, harnessing a better understanding of the biological underpinnings of this heterogeneous disorder and identifying biomarkers of PTSD and trauma-related brain disorders that can stratify the patient population and predict treatment response are overdue for enabling the development of novel therapeutics and precision medicine approaches (
      • Pitman R.K.
      • Rasmusson A.M.
      • Koenen K.C.
      • Shin L.M.
      • Orr S.P.
      • Gilbertson M.W.
      • et al.
      Biological studies of post-traumatic stress disorder.
      ,
      • Yehuda R.
      • Hoge C.W.
      • McFarlane A.C.
      • Vermetten E.
      • Lanius R.A.
      • Nievergelt C.M.
      • et al.
      Post-traumatic stress disorder.
      ,
      • Shalev A.
      • Liberzon I.
      • Marmar C.
      Post-traumatic stress disorder.
      ).
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Biological Psychiatry
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Kessler R.C.
        • Sonnega A.
        • Bromet E.
        • Hughes M.
        • Nelson C.B.
        Posttraumatic stress disorder in the National Comorbidity Survey.
        Arch Gen Psychiatry. 1995; 52: 1048-1060
        • Krystal J.H.
        • Davis L.L.
        • Neylan T.C.
        • Raskind A.M.
        • 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.
        Biol Psychiatry. 2017; 82: e51-e59
        • Holdeman T.C.
        Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery.
        Psychiatr Serv. 2009; 60: 273
        • Pitman R.K.
        • Rasmusson A.M.
        • Koenen K.C.
        • Shin L.M.
        • Orr S.P.
        • Gilbertson M.W.
        • et al.
        Biological studies of post-traumatic stress disorder.
        Nat Rev Neurosci. 2012; 13: 769-787
        • Yehuda R.
        • Hoge C.W.
        • McFarlane A.C.
        • Vermetten E.
        • Lanius R.A.
        • Nievergelt C.M.
        • et al.
        Post-traumatic stress disorder.
        Nat Rev Dis Primers. 2015; 1: 15057
        • Shalev A.
        • Liberzon I.
        • Marmar C.
        Post-traumatic stress disorder.
        N Engl J Med. 2017; 376: 2459-2469
        • FDA-NIH Biomarker Working Group
        BEST (Biomarkers, EndpointS, and other Tools) Resource.
        Food and Drug Administration and National Institutes of Health, Silver Spring and Bethesda, MD2016