Protection from PTSD
The drug for the therapy of Parkinson's disease helped from nightmares and flashbacks in PTSD
Victoria Baranovskaya, N+1
Japanese doctors in a study involving 34 patients showed the effectiveness of the acetylcholine receptor blocker trihexyphenidyl in reducing nightmares and flashbacks (involuntary recurrent memories) in PTSD. In a paper published in the journal Brain and Behavior, scientists write that this is the first study demonstrating the potential effectiveness of trihexyphenidyl in relieving symptoms of post-traumatic stress disorder, but further clinical studies are needed.
Post-traumatic stress disorder develops as a result of a traumatic event experienced and is accompanied by periodic flashbacks, panic attacks in response to triggers and sleep problems. The mechanisms underlying disturbing memories and nightmares are not yet fully understood. Cognitive behavioral psychotherapy helps to cope with the disorder, including methods of prolonged immersion in a traumatic situation and immersion in virtual reality. Also for treatment Several classes of medications are used for PTSD, including antidepressants and antipsychotics. Selective serotonin reuptake inhibitors (sertraline and paroxetine) are approved by the U.S. Food and Drug Administration for the treatment of this disorder. However, 40-60 percent of patients do not respond to these drugs.
Now, doctors led by Katsumasa Sogo from the Institute of Post-Traumatic Stress Disorder in Hiroshima have discovered that a drug called trihexyphenidyl, which is commonly used for motor disorders, can significantly reduce the frequency of flashbacks and nightmares experienced by patients with PTSD.
Trihexyphenidyl is an acetylcholine antagonist used to treat diseases such as parkinsonism and to alleviate a number of side effects caused by drugs acting on the central nervous system. The trade name of this substance, the most common in Russia, is cyclodol.
Cholinolytics have not previously been specifically investigated as drugs that alleviate the symptoms of PTSD in humans. The use of trihexyphenidyl in the treatment of the disorder was inspired by a case that occurred in their practice in 2009. They encountered a 21-year-old patient who had been suffering from severe flashbacks and nightmares associated with post-traumatic stress disorder for 9 years. Once, due to infectious diarrhea, she was prescribed an IV containing antibiotics and m-cholinolytic. 20 minutes after the IV, the patient's disturbing memories disappeared. In addition, a study last year showed that a single administration of trihexyphenidyl to rats prevented the development of stressful behavior and suppressed memories of fear. One of the possible mechanisms of action of trihexyphenidyl is the inhibition of increased acetylcholine release in areas of the brain associated with memory.
Doctors invited 34 patients with PTSD who were observed in their clinic from 2012 to 2019 to participate in the study. Previously, patients received psychiatric treatment, but no significant progress was made. Some of them, in addition to post-traumatic stress disorder, suffered from other concomitant mental illnesses, including schizophrenia (3 people), Asperger's syndrome (2 people) and attention deficit hyperactivity disorder (1 person).
The patients were divided into two groups to participate in a simple blind (12 people) and open (22 people) study. Participants were injected with 2 milligrams of trihexyphenidyl twice a day for two weeks. Patients reported a noticeable effect within an hour. There were no side effects, except for the feeling of "floating" in the first days of admission (in two people). The change in the severity of post-traumatic stress symptoms was assessed on the clinical PTSD Scale (Clinical–Administered PTSD Scale - CAPS).
Due to the small sample, the researchers presented the results of patients from both groups in aggregate. In general, the majority of patients managed to get rid of nightmares (88 percent) and disturbing flashbacks (79 percent). Doctors found that a noticeable improvement in the condition occurred within 2-3 days. In both groups, the frequency of nightmares decreased on average from almost daily episodes to 1-2 times a month.
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