CONTACT US: Contact info
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Citation |
Tuerk PW, Wangelin BC, Powers MB, Smits JAJ, Acierno RE, Myers US, Orr SP, Foa EB, Hamner MB. Cogn. Behav. Ther. 2018; 47(5): 351-371. |
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Affiliation |
Ralph H. Johnson VA Medical Center , Charleston , SC , USA. |
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Copyright |
(Copyright © 2018, Informa - Taylor and Francis Group) |
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DOI |
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PMID |
29448886 |
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Abstract |
The alpha-2 adrenergic receptor antagonist, yohimbine, can facilitate fear extinction in animals and humans. One potential mechanism is increased noradrenergic activity and associated arousal in the presence of conditioned stimuli. Accordingly, yohimbine might augment prolonged exposure (PE) therapy for posttraumatic stress disorder (PTSD), where heightened exposure-oriented arousal is a theorized driver and empirical predictor of treatment success. A double-blind placebo-controlled randomized trial (NCT 01031979) piloted yohimbine augmentation in 26 males with combat-related PTSD. Participants were given one-time dose of yohimbine or placebo prior to the first imaginal exposure. Subsequently, both arms completed standard PE. The primary outcome was trauma-cued heart-rate reactivity a week after the drug/exposure visit, a highly specified, objective measure sensitive to incremental change. Secondary outcomes included arousal during the drug/exposure visit and slope of distress, PTSD, and depression over the course of PE. Consistent with hypothesis, yohimbine led to higher objective and subjective arousal during the drug/exposure visit and to lower trauma-cued heart-rate reactivity one-week later. One dose of yohimbine also led to greater between-session habituation and more rapid improvement on depression, but not PTSD, over the course of care. Language: en |
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Keywords |
PTSD; RCT; Yohimbine; biological markers; empirically-supported treatments; evidence-based treatments; extinction augmentation; prolonged exposure therapy; psychophysiology; treatment augmentation |