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Article ; Online: A Neuroanatomic and Pathophysiologic Framework for Novel Pharmacological Approaches to the Treatment of Post-traumatic Stress Disorder.

Norred, Michael A / Zuschlag, Zachary D / Hamner, Mark B

2024 Volume 84, Issue 2, Page(s) 149–164

Abstract: Post-traumatic stress disorder (PTSD) is a debilitating disorder inflicting high degrees of symptomatic and socioeconomic burdens. The development of PTSD results from a cascade of events with contributions from multiple processes and the underlying ... ...

Abstract	Post-traumatic stress disorder (PTSD) is a debilitating disorder inflicting high degrees of symptomatic and socioeconomic burdens. The development of PTSD results from a cascade of events with contributions from multiple processes and the underlying pathophysiology is complex, involving neurotransmitters, neurocircuitry, and neuroanatomical pathways. Presently, only two medications are US FDA-approved for the treatment of PTSD, both selective serotonin reuptake inhibitors (SSRIs). However, the complex underlying pathophysiology suggests a number of alternative pathways and mechanisms that may be targets for potential drug development. Indeed, investigations and drug development are proceeding in a number of these alternative, non-serotonergic pathways in an effort to improve the management of PTSD. In this manuscript, the authors introduce novel and emerging treatments for PTSD, including drugs in various stages of development and clinical testing (BI 1358894, BNC-210, PRAX-114, JZP-150, LU AG06466, NYV-783, PH-94B, SRX246, TNX-102), established agents and known compounds being investigated for their utility in PTSD (brexpiprazole, cannabidiol, doxasoin, ganaxolone, intranasal neuropeptide Y, intranasal oxytocin, tianeptine oxalate, verucerfont), and emerging psychedelic interventions (ketamine, MDMA-assisted psychotherapy, psilocybin-assisted psychotherapy), with an aim to examine and integrate these agents into the underlying pathophysiological frameworks of trauma-related disorders.
MeSH term(s)	Humans ; Stress Disorders, Post-Traumatic/drug therapy ; Psychotherapy/methods ; Selective Serotonin Reuptake Inhibitors/pharmacology ; Selective Serotonin Reuptake Inhibitors/therapeutic use ; Ketamine/therapeutic use
Chemical Substances	Selective Serotonin Reuptake Inhibitors ; Ketamine (690G0D6V8H)
Language	English
Publishing date	2024-02-28
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	120316-2
ISSN	1179-1950 ; 0012-6667
ISSN (online)	1179-1950
ISSN	0012-6667
DOI	10.1007/s40265-023-01983-5
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Zs.A 762: Show issues

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Article ; Online: Smoking cessation in homeless veterans.

Hamner, Mark B

The Journal of clinical psychiatry

2015 Volume 76, Issue 7, Page(s) e911–2

MeSH term(s)	Female ; Homeless Persons ; Humans ; Male ; Mobile Applications ; Smoking Cessation/methods ; Tobacco Use Disorder/therapy ; Veterans
Language	English
Publishing date	2015-07
Publishing country	United States
Document type	Comment ; Journal Article
ZDB-ID	716287-x
ISSN	1555-2101 ; 0160-6689
ISSN (online)	1555-2101
ISSN	0160-6689
DOI	10.4088/JCP.14com09726
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Article ; Online: The role of PTSD in adjudicating violent crimes.

Hamner, Mark B

The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics

2014 Volume 42, Issue 2, Page(s) 155–160

Abstract: PTSD was formalized as a diagnosis by the American Psychiatric Association in 1980 with the publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM), 3rd edition. Since that time, the diagnosis has been widely utilized in the courts ...

Abstract	PTSD was formalized as a diagnosis by the American Psychiatric Association in 1980 with the publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM), 3rd edition. Since that time, the diagnosis has been widely utilized in the courts including the use in criminal proceedings. PTSD may play a role in the assessment of violent crimes both as a possible contributing factor in the perpetrators as well as a consequence in the victims. There are a number of ethical and clinical considerations in the use of this diagnosis. Importantly, the diagnostic criteria have changed to a degree with subsequent editions of the DSM. This may have an impact on the interpretation of past legal judgments. Moreover, extensive psychiatric comorbidity may complicate the clinical picture, e.g., mood disorders, substance use disorders, or psychosis. The diagnosis of PTSD is still based on clinical, largely subjective criteria, e.g., biological markers are not yet utilized. As such, there may not be consistent agreement about the diagnosis among experts. This paper summarizes some of these relevant issues in adjudicating violent crimes.
MeSH term(s)	Criminal Behavior ; Criminal Law ; Domestic Violence ; Humans ; Risk Factors ; Stress Disorders, Post-Traumatic/diagnosis
Language	English
Publishing date	2014
Publishing country	United States
Document type	Journal Article ; Legal Cases
ZDB-ID	1168812-9
ISSN	1748-720X ; 1073-1105 ; 0277-8459
ISSN (online)	1748-720X
ISSN	1073-1105 ; 0277-8459
DOI	10.1111/jlme.12131
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Zs.A 2075: Show issues

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Article ; Online: Biomechanical effects of fatigue on lower-body extremities during a maximum effort kettlebell swing protocol.

Levine, Nicholas A / Baek, Seungho / Tuttle, Noelle / Alvis, Hunter B / Hung, Cheng-Ju / Sokoloski, Matthew L / Kim, Jemin / Hamner, Mark S / Lee, Sangwoo / Rigby, Brandon R / Kwon, Young-Hoo

Sports biomechanics

2023 , Page(s) 1–18

Abstract: Kettlebell training provides multiple health benefits, including the generation of power. The primary purpose of this study was to examine the kinematics and kinetics of lower-body joints during a repeated, maximum effort kettlebell swing protocol. ... ...

Abstract	Kettlebell training provides multiple health benefits, including the generation of power. The primary purpose of this study was to examine the kinematics and kinetics of lower-body joints during a repeated, maximum effort kettlebell swing protocol. Sixteen resistance and kettlebell swing experienced males performed 10 rounds of a kettlebell swing routine (where one round equates to 30s of swings followed by 30s of rest). Kinematic (i.e., swing duration and angular velocities) and kinetic (i.e., normalised sagittal plane ground reaction force, resultant joint moment [RJM] and power) variables were extracted for the early portion and late portion of the round. Average swing duration and the magnitude of normalised ground reaction forces (GRF) increased within rounds, while hip joint power decreased. Changes in swing duration were minimal, but consistent due to an increase in overall fatigue. An increase in the magnitude of GRF was observed at the end of rounds, which is a potential concern for injury. Hip joint power decreased primarily due to a slower angular velocity. This protocol may be an effective routine for those who are resistance trained with kettlebell swing experience, and who want to optimise power in their exercise program.
Language	English
Publishing date	2023-05-01
Publishing country	England
Document type	Journal Article
ISSN	1752-6116
ISSN (online)	1752-6116
DOI	10.1080/14763141.2023.2207556
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Article: Characterizing the Effects of Quetiapine in Military Post-Traumatic Stress Disorder.

Villarreal, Gerardo / Hamner, Mark B / Qualls, Clifford / Cañive, José M

Psychopharmacology bulletin

2018 Volume 48, Issue 2, Page(s) 8–17

Abstract: Objectives: A previous randomized placebo-controlled trial in military veterans posttraumatic stress disorder (PTSD) found that quetiapine improved global PTSD symptoms severity, depression and anxiety as well as the re-experiencing and hypearousal ... ...

Abstract	Objectives: A previous randomized placebo-controlled trial in military veterans posttraumatic stress disorder (PTSD) found that quetiapine improved global PTSD symptoms severity, depression and anxiety as well as the re-experiencing and hypearousal clusters. However, it is not known if individual symptoms had a preferential response to this medication. The goal of this study was to analyze the individual symptom response in this group of patients. Methods: Data from a previous trial was re-analyzed. Each of the of the scale items was analyzed individually using Repeated Measures Analysis of Variance. Results: Compared to placebo, there was a significant decline in the Clinician-Administered PTSD Scale intrusive memories and insomnia questions. In the Davidson Trauma Scale, greater improvements were observed on irritability, difficulty concentrating, hyperstartle and a trend was observed on avoiding thoughts or feelings about the event. Greater improvements compared with placebo were noted on the Hamilton Depression (HAM-D) middle and late insomnia items. On the Hamilton Anxiety scale (HAM-A), the insomnia item was significantly improved. Conclusions: Quetiapine demonstrated greater effect than placebo on several symptoms. The strongest response was seen on insomnia, which the highest significance level on the CAPS. The insomnia items of both the HAM-D and HAM-A also demonstrated improvement with quetiapine. These finding indicate quetiapine improved sleep measure. Insomnia can be a difficult problem to treat in PTSD patients, therefore quetiapine should be considered in difficult cases.
MeSH term(s)	Adult ; Antipsychotic Agents/administration & dosage ; Antipsychotic Agents/pharmacology ; Combat Disorders/drug therapy ; Combat Disorders/physiopathology ; Humans ; Male ; Outcome Assessment (Health Care) ; Psychiatric Status Rating Scales ; Quetiapine Fumarate/administration & dosage ; Quetiapine Fumarate/pharmacology ; Stress Disorders, Post-Traumatic/drug therapy ; Stress Disorders, Post-Traumatic/physiopathology ; Veterans
Chemical Substances	Antipsychotic Agents ; Quetiapine Fumarate (2S3PL1B6UJ)
Language	English
Publishing date	2018-04-30
Publishing country	United States
Document type	Clinical Study ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	4113-0
ISSN	0048-5764 ; 0376-0162
ISSN	0048-5764 ; 0376-0162
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Zs.A 958: Show issues

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Article: Biomarker Response to Mindfulness Intervention in Veterans Diagnosed with Post-traumatic Stress Disorder.

Shapira, Itamar / Richman, Joshua / Pace, Thaddeus W W / Lim, Kelvin O / Polusny, Melissa A / Hamner, Mark B / Bremner, J Douglas / Mumba, Mercy N / Jacobs, M Lindsey / Pilkinton, Patricia / Davis, Lori L

Mindfulness

2022 Volume 13, Issue 10, Page(s) 2448–2460

Abstract: Objectives: This study evaluates the effects of treatment with mindfulness-based stress reduction (MBSR) compared to the active control, present-centered group therapy (PCGT), on morning plasma cortisol, interleukin-6 (IL-6), and C-reactive protein (CRP) ...

Abstract	Objectives: This study evaluates the effects of treatment with mindfulness-based stress reduction (MBSR) compared to the active control, present-centered group therapy (PCGT), on morning plasma cortisol, interleukin-6 (IL-6), and C-reactive protein (CRP) in veterans diagnosed with post-traumatic stress disorder (PTSD). Methods: In a post hoc exploratory analysis, we pooled biomarkers and clinical outcomes of mindfulness, PTSD, and depression from two randomized controlled trials comparing MBSR ( Results: Cortisol levels were inversely related to self-reported PTSD symptoms at baseline ( Conclusions: Increased mindfulness is associated with a recalibration of cortisol levels which may be indicative of therapeutic response, especially in patients with lower baseline cortisol. Furthermore, mindfulness-based practices improve symptoms of PTSD and depression in a significant correlation with self-reported levels of mindfulness. Clinical trial registration clinicaltrialsgov: NCT01532999 and NCT01548742.
Language	English
Publishing date	2022-09-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2543424-X
ISSN	1868-8535 ; 1868-8527
ISSN (online)	1868-8535
ISSN	1868-8527
DOI	10.1007/s12671-022-01969-6
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Article ; Online: Ziprasidone Augmentation of SSRI Antidepressants in Posttraumatic Stress Disorder: A Randomized, Placebo-Controlled Pilot Study of Augmentation Therapy.

Hamner, Mark B / Hernandez-Tejada, Melba A / Zuschlag, Zachary D / Agbor-Tabi, Deborah / Huber, Michael / Wang, Zhewu

Journal of clinical psychopharmacology

2019 Volume 39, Issue 2, Page(s) 153–157

Abstract: Background: Posttraumatic stress disorder (PTSD) is often a chronic, disabling illness for which antidepressant medications (ie, SSRI) are considered the primary psychopharmacological treatment. However, many patients remain refractory to ... ...

Abstract	Background: Posttraumatic stress disorder (PTSD) is often a chronic, disabling illness for which antidepressant medications (ie, SSRI) are considered the primary psychopharmacological treatment. However, many patients remain refractory to antidepressants alone or in combination with psychotherapy. Safe and effective treatments for individuals with refractory PTSD are needed. This study aimed to examine ziprasidone augmentation of SSRI treatment of PTSD. Methods: This was a 2-phase study. In phase 1, subjects were treated with paroxetine or sertraline for 8 weeks. Individuals refractory to the SSRI treatment then entered into phase II of the study and were randomized, in a double-blind fashion, to 8 weeks of treatment with either ziprasidone or placebo. The primary outcome measure was change in Clinician Administered PTSD Scale total scores with the intent-to-treat sample. Secondary outcome measures included Positive and Negative Syndrome Scale scores, measures of depression and anxiety, and safety measures. Results: No significant differences were observed on the Clinician Administered PTSD Scale, Positive and Negative Syndrome Scale, or other outcome measures between ziprasidone and placebo groups. No significant differences were observed for safety measures including metabolic profiles, extrapyramidal symptoms/movement disorder rating scales, nor study dropout. Conclusions: Although no significant differences were noted in efficacy or safety measures between ziprasidone and placebo in this pilot study, the small sample size prevents definitive conclusions.
MeSH term(s)	Antipsychotic Agents/administration & dosage ; Antipsychotic Agents/therapeutic use ; Double-Blind Method ; Drug Therapy, Combination ; Female ; Humans ; Male ; Middle Aged ; Paroxetine/administration & dosage ; Paroxetine/therapeutic use ; Pilot Projects ; Piperazines/administration & dosage ; Piperazines/therapeutic use ; Psychiatric Status Rating Scales ; Serotonin Uptake Inhibitors/administration & dosage ; Serotonin Uptake Inhibitors/therapeutic use ; Sertraline/administration & dosage ; Sertraline/therapeutic use ; Stress Disorders, Post-Traumatic/drug therapy ; Stress Disorders, Post-Traumatic/physiopathology ; Thiazoles/administration & dosage ; Thiazoles/therapeutic use ; Treatment Outcome
Chemical Substances	Antipsychotic Agents ; Piperazines ; Serotonin Uptake Inhibitors ; Thiazoles ; Paroxetine (41VRH5220H) ; ziprasidone (6UKA5VEJ6X) ; Sertraline (QUC7NX6WMB)
Language	English
Publishing date	2019-01-10
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Randomized Controlled Trial
ZDB-ID	604631-9
ISSN	1533-712X ; 0271-0749
ISSN (online)	1533-712X
ISSN	0271-0749
DOI	10.1097/JCP.0000000000001000
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Article ; Online: Pyrotherapy for the Treatment of Psychosis in the 21st Century: A Case Report and Literature Review.

Zuschlag, Zachary D / Lalich, Callie J / Short, Edward B / Hamner, Mark / Kahn, David A

Journal of psychiatric practice

2016 Volume 22, Issue 5, Page(s) 410–415

Abstract: The concept that fevers can improve the condition of patients with certain medical and psychiatric diseases dates back to Hippocrates. Over the centuries, it has been observed that fevers and infectious agents have been beneficial for a broad spectrum of ...

Abstract	The concept that fevers can improve the condition of patients with certain medical and psychiatric diseases dates back to Hippocrates. Over the centuries, it has been observed that fevers and infectious agents have been beneficial for a broad spectrum of diseases, including neurologic conditions such as epilepsy and psychiatric illnesses including melancholy and psychosis. Interest in the concept of fever as a treatment for disease, termed pyrotherapy or pyretotherapy, peaked in the late 1800s and early 1900s thanks to the Nobel Prize winning work of Julius Wagner-Jauregg for his studies with malaria therapy for general paralysis of the insane, now more commonly referred to as neurosyphilis. The use of inoculations of infectious agents for their fever-inducing effects in the treatment of neurosyphilis quickly spread throughout the world, and, by the 1920s, it was considered by many to be the treatment of choice for neurosyphilis as well as other psychotic disorders. However, with the discovery of penicillin for the treatment of syphilis, which coincided with the advent of convulsion-oriented practices including electroconvulsive therapy and insulin coma for the treatment of psychotic disorders, pyrotherapy soon lost favor among psychiatrists and, since the 1950s, it has largely been overlooked by the scientific community. In this article, the authors provide a brief literature review of the history of pyrotherapy and present a case report of a woman with schizoaffective disorder and severe psychotic symptoms who experienced a remarkable resolution of psychotic symptoms following an episode of bacteremia with high fever.
MeSH term(s)	Adult ; Female ; History, 20th Century ; History, 21st Century ; Humans ; Hyperthermia, Induced/history ; Hyperthermia, Induced/methods ; Neurosyphilis/complications ; Neurosyphilis/history ; Psychotic Disorders/etiology ; Psychotic Disorders/therapy
Language	English
Publishing date	2016-09-19
Publishing country	United States
Document type	Case Reports ; Historical Article ; Journal Article ; Review
ZDB-ID	2022726-7
ISSN	1538-1145 ; 1527-4160
ISSN (online)	1538-1145
ISSN	1527-4160
DOI	10.1097/PRA.0000000000000181
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Zs.A 4753: Show issues

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Article ; Online: Augmenting treatment efficiency in exposure therapy for PTSD: a randomized double-blind placebo-controlled trial of yohimbine HCl.

Tuerk, Peter W / Wangelin, Bethany C / Powers, Mark B / Smits, Jasper A J / Acierno, Ron / Myers, Ursula S / Orr, Scott P / Foa, Edna B / Hamner, Mark B

Cognitive behaviour therapy

2018 Volume 47, Issue 5, Page(s) 351–371

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 ...

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. Results of this controlled pilot indicate support for continued investigation of yohimbine-augmented exposure therapy for PTSD.
MeSH term(s)	Adolescent ; Adrenergic alpha-2 Receptor Antagonists/therapeutic use ; Adult ; Combined Modality Therapy ; Double-Blind Method ; Fear ; Humans ; Implosive Therapy ; Male ; Middle Aged ; Stress Disorders, Post-Traumatic/drug therapy ; Stress Disorders, Post-Traumatic/psychology ; Stress Disorders, Post-Traumatic/therapy ; Treatment Outcome ; Veterans/psychology ; Yohimbine/therapeutic use ; Young Adult
Chemical Substances	Adrenergic alpha-2 Receptor Antagonists ; Yohimbine (2Y49VWD90Q)
Language	English
Publishing date	2018-02-15
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2076060-7
ISSN	1651-2316 ; 1650-6073
ISSN (online)	1651-2316
ISSN	1650-6073
DOI	10.1080/16506073.2018.1432679
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Zs.A 3702: Show issues

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Article ; Online: Rivastigmine Transdermal Patch Treatment for Moderate to Severe Cognitive Impairment in Veterans with Traumatic Brain Injury (RiVET Study): A Randomized Clinical Trial.

Journal of neurotrauma

2021 Volume 38, Issue 14, Page(s) 1943–1952

Abstract: Cognitive impairment is common in veterans with histories of traumatic brain injury (TBI). Cholinergic deficits have been hypothesized as contributors to this impairment. We report the effects of cholinesterase inhibitor rivastigmine transdermal patch ... ...

Abstract	Cognitive impairment is common in veterans with histories of traumatic brain injury (TBI). Cholinergic deficits have been hypothesized as contributors to this impairment. We report the effects of cholinesterase inhibitor rivastigmine transdermal patch treatment in veterans with TBI and post-traumatic memory impairment. Our objective was to evaluate the efficacy and safety of a 9.5 mg/24 h (10 cm
MeSH term(s)	Adult ; Brain Injuries, Traumatic/psychology ; Brain Injuries, Traumatic/therapy ; Cholinesterase Inhibitors/administration & dosage ; Cognitive Dysfunction/drug therapy ; Cognitive Dysfunction/etiology ; Cohort Studies ; Double-Blind Method ; Female ; Humans ; Male ; Middle Aged ; Rivastigmine/administration & dosage ; Transdermal Patch ; Treatment Failure ; Veterans/psychology
Chemical Substances	Cholinesterase Inhibitors ; Rivastigmine (PKI06M3IW0)
Language	English
Publishing date	2021-03-08
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial
ZDB-ID	645092-1
ISSN	1557-9042 ; 0897-7151
ISSN (online)	1557-9042
ISSN	0897-7151
DOI	10.1089/neu.2020.7146
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