Strategie farmaco terapeutiche nei disturbi post-traumatici. L’esperienza su una popolazione di rifugiati

Titolo Rivista QUADERNI DI PSICOTERAPIA COGNITIVA
Autori/Curatori Emilio Vercillo, Giancarlo Santone, Rossella Carnevali
Anno di pubblicazione 2019 Fascicolo 2018/43 Lingua Italiano
Numero pagine 14 P. 26-39 Dimensione file 103 KB
DOI 10.3280/QPC2018-043002
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La psicofarmacoterapia delle patologie post-traumatiche non è una terapia mirata al quadro diagnostico, e neanche può essere una terapia sintomatica punto a punto su tutti i sintomi della patologia. Gli autori propongono una visione strategica della farmacoterapia del paziente post-traumatico, all’interno della struttura complessiva del trattamento. In questo lavoro viene rivista e commentata la letteratura sull’uso, l’efficacia e l’utilizzo delle varie categorie di farmaci, e vengono presentate infine alcune proposte di uso dei farmaci, basate sulla loro esperienza in un servizio per i rifugiati.;

Keywords:Farmacoterapia, PTSD, dissociazione.

  1. Committee on Treatment of Posttraumatic Stress Disorder (Institute of Medicine) (2007). Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence. Washington, DC: The National Academies Press [cit. in Murray B. Stein et al., 2018 (6)].
  2. Davidson J., Baldwin D., Stein D.J., Kuper E., Benattia I., Ahmed S., Pedersen R., Musgnung J. (2006). Treatment of posttraumatic stress disorder with venlafaxine extended release: a 6-month randomized controlled trial. Arch. Gen. Psychiatry, 63(10): 1158.
  3. Feder A., Parides M.K., Murrough J.W., Perez A.M., Morgan J.E., Saxena S., Kirkwood K., Aan Het Rot M., Lapidus K.A., Wan L.B., Iosifescu D., Charney D.S. (2014). Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder: a randomized clinical trial. JAMA Psychiatry, 71(6): 681.
  4. George K.C., Kebejian L., Ruth L.J., Miller C.W., Himelhoch S. (2016). Meta-analysis of the efficacy and safety of prazosin versus placebo for the treatment of nightmares and sleep disturbances in adults with posttraumatic stress disorder. J. Trauma Dissociation, 17(4): 494. DOI: 10.1080/15299732.2016.114115
  5. Hendrickson R.C., Raskind Murray A. (2016). Noradrenergic dysregulation in the pathophysiology of PTSD. Experimental Neurology, vol. 284, Part B: 181-195.
  6. Hendrickson R., Millard S., Shofer J., Peskind E., Raskind M. (2017). The Effect of Prazosin on Individual PTSD Symptoms and on the Covariance of Symptoms Over Time: Evidence for Pathophysiologically-Related Clustering. ACNP 56th Annual Meeting: Poster Session Neuropsychopharmacology, 42: S111-S293.
  7. Khachatryan D., Groll D., Booij L., Sepehry A.A., Schütz C.G. (2016). Prazosin for treating sleep disturbances in adults with posttraumatic stress disorder: a systematic review and meta-analysis of randomized controlled trials. Gen. Hosp. Psychiatry, 39: 46.
  8. Kierlin L., Littner M.R. (2011). Parasomnias and antidepressant therapy: a review of the literature. Front Psychiatry, 2: 71.
  9. Lillie E.O., Pata B., Diamant J., Issell B., Topol E.J., Schork N.J. (2011). The n-of-1 clinical trial: the ultimate strategy for individualizing medicine? Personalized Medicine, 8(2): 161-173.
  10. Lin K.M., Smith M.W. (2001). Psychopharmacotherapy in the context of culture and ethnicity. In: Ruiz P. (ed.), Review. Ethnicity and Psychopharmacology. Washington, DC: American Psychiatric Association.
  11. Mohamed S., Rosenheck R.A. (2008). Pharmacotherapy of PTSD in the U.S. Department of Veterans Affairs: diagnostic- and symptom-guided drug selection. J. Clin. Psychiatry, 69(6): 959.
  12. Nadorff M.R., Lambdin K.K., Germain A. (2014): Pharmacological and non-pharmacological treatments for nightmare disorder. Int. Rev. Psychiatry, 26(2): 225. DOI: 10.3109/09540261.2014.88898
  13. Porges S. (2001). The polyvagal theory: phylogenetic substrates of a social nervous system. International Journal of Psychophysiology, 42: 123-146. doi.org/10. 1016/S0167-8760(01)00162-3
  14. Porges S. (2011). The polyvagal theory: Neurophysiologial foundations of emotions, attachment, communication, and self-regulation. New York: W.W. Norton & Company.
  15. Raskind M.A., Millard S.P. et al. (2016). Higher Pretreatment Blood Pressure Is Associated With Greater Posttraumatic Stress Disorder Symptom Reduction in Soldiers Treated With Prazosin. Biol. Psychiatry, 15, 80(10): 736-742.
  16. Raskind M.A., Peskind E.R., Chow B. et al. (2018). Trial of Prazosin for Post-Traumatic Stress Disorder in Military Veterans. N. Engl. J. Med., 378: 507-517.
  17. Raskind M.A., Peterson K., Williams T., Hoff D.J., Hart K., Holmes H., Homas D., Hill J., Daniels C., Calohan J., Millard S.P., Rohde K., O’Connell J., Pritzl D., Feiszli K., Petrie E.C., Gross C., Mayer C.L., Freed M.C., Engel C., Peskind E.R. (2013). A trial of prazosin for combat trauma PTSD with nightmares in active-duty soldiers returned from Iraq and Afghanistan. Am. J. Psychiatry, 170(9): 1003.
  18. Ravindran L.N., Stein M.B. (2009). Pharmacotherapy of PTSD: premises, principles, and priorities. Brain Res., 1293: 24.
  19. Ressler Kerry J. (2018). Alpha-Adrenergic Receptors in PTSD – Failure or Time for Precision Medicine? N. Engl. J. Med., 378: 575-576.
  20. Rothbaum B.O., Price M., Jovanovic T., Norrholm S.D., Gerardi M., Dunlop B., Davis M., Bradley B., Duncan E.J., Rizzo A., Ressler K.J. (2014). A randomized, double-blind evaluation of D-cycloserine or alprazolam combined with virtual reality exposure therapy for posttraumatic stress disorder in Iraq and Afghanistan War veterans. Am. J. Psychiatry, 171(6): 640.
  21. Roy-Byrne P. (2018). Prazosin Is Ineffective for Chronic PTSDin Military Veterans, reviewing Raskind M.A. et al. N. Engl. J. Med., 8. - https://www.jwatch.org/na46003/2018/02/07/prazosin-ineffective-chronic-ptsd-military-veterans
  22. Siegel D.J. (1999, 2 ed. 2015). The Developing Mind, Second Edition: How Relationships and the Brain Interact. New York: The Guilford Press.
  23. Singh B., Hughes A.J., Mehta G. et al. (2016). Efficacy of Prazosin in Posttraumatic Stress Disorder: A Systematic Review and Meta-Analysis, Primary Care Companion for CNS Disorders, 18(4).
  24. Standards of Practice Committee, American Academy of Sleep Medicine (2010).Best practice guide for the treatment of nightmare disorder in adults. J. Clin. Sleep Med., 6(4): 389. DOI: 10.5664/JCSM.133
  25. Steenen S.A., van Wijk A.J., van der Heijden G.J., van Westrhenen R., de Lange J., de Jongh A. (2016). Propranolol for the treatment of anxiety disorders: Systematic review and meta-analysis. J. Psychopharmacol., 30(2): 128-39. DOI: 10.1177/026988111561223
  26. Stein D.J., Ipser J.C., Seedat S. (2006). Pharmacotherapy for post traumatic stress disorder (PTSD). Cochrane Database Syst Rev., 25(1).
  27. Stein M.B., Kline N.A., Matloff J.L. (2002). Adjunctive olanzapine for SSRI-resistant combat-related PTSD: a double-blind, placebo-controlled study. Am. J. Psychiatry, 159(10): 1777-9.
  28. Stein M.B., Roy-Byrne P.P., Hermann R. (2018). Pharmacotherapy for posttraumatic stress disorder in adults, UpToDate.
  29. Taylor F., Raskind M.A. (2002). The alpha1-adrenergic antagonist prazosin improves sleep and nightmares in civilian trauma posttraumatic stress disorder. J. Clin. Psychopharmacol., 22(1): 82 PMID: 11799347.
  30. Vercillo E. (1999). Farmacoterapia e etnicità. PSYCHOMEDIA. -- http://www.psychomedia.it/pm/modpsy/pharm/vercillo.htm
  31. Veterans Affairs Cooperative Study No. 504 Group (2011). Adjunctive risperidone treatment for antidepressant-resistant symptoms of chronic military service-related PTSD: a randomized trial. JAMA, 306(5): 493.

Emilio Vercillo, Giancarlo Santone, Rossella Carnevali, Strategie farmaco terapeutiche nei disturbi post-traumatici. L’esperienza su una popolazione di rifugiati in "QUADERNI DI PSICOTERAPIA COGNITIVA" 43/2018, pp 26-39, DOI: 10.3280/QPC2018-043002