Innovative Therapies for PTSD

At the Military Health Research Forum, held August 31 to September 3 in Kansas City, MO, several exciting developments in post-traumatic stress disorder (PTSD) research were presented. Among the presentations were the following:

Virtual Environments for Cognitive and Affective Dysfunction in Mild Traumatic Brain Injury and Post-Traumatic Stress Disorder: Development of a 21st Century Treatment Platform

A team of researchers, working under Charles Levy, MD, North Florida Foundation for Research and Education, Inc, is in the midst of building a virtual world environment (VWE) prototype in which to conduct therapy for mild traumatic brain injury or PTSD. The VWE allows for the simulation of everyday encounters that tend to be challenging to those who suffer from these conditions, and it also allows for the patient and therapist to “overcome barriers that block successful social reintegration,” including access to care due to location.

The current VWE, still under construction, is a virtual supermarket in which patients are cognitively and emotionally challenged through such scenarios as following a shopping list, making change, bumping into other shopping carts, and checking out. Both the therapist and patient can enter the virtual supermarket separately from their own computers but experience the challenges set forth together.

"Oftentimes, the nuances of everyday life can unexpectedly trigger angry responses from warfighters hindered by mTBI and PTSD," Levy said. "This project shows great potential to expedite and expand care to veterans and wounded warriors in a short timeframe, in a way that minimizes travel for treatment, and in a cost-effective manner."

Pharmacologic Management of Post-Traumatic Stress Disorder and Co-Morbid Alcohol Dependence in Veterans

Data from two trials presented at the forum show that medications—previously proven effective in both alcoholism and PTSD alone—may be effective for the treatment of comorbid PTSD and alcohol dependence. In the first study of 93 patients with PTSD and alcohol dependence who were randomized to naltrexone and disulfiram alone or in combination for 12 weeks, participants in each group experienced less alcohol craving and use and fewer psychiatric symptoms compared to those who received placebo. In the second study, despiramine and paroxeine were shown to be equally effective in reducing PTSD symptoms in participants, but the addition of naltrexone for reducing alcohol consumption showed no advantage.

"Post-traumatic stress disorder coupled with alcohol dependence continues to handicap our veterans," said Principal Investigator Ismene Petrakis, Associate Professor of Psychiatry at the Yale University School of Medicine. "These studies suggest that there are treatments available for patients who are suffering acute symptoms as well as for those who are relatively stable."