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Post-Traumatic Stress Disorders: HELP
Articles by Jennifer C. Naylor
Based on 12 articles published since 2010
(Why 12 articles?)
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Between 2010 and 2020, Jennifer Naylor wrote the following 12 articles about Stress Disorders, Post-Traumatic.
 
+ Citations + Abstracts
1 Clinical Trial A randomized controlled trial of ganaxolone in posttraumatic stress disorder. 2017

Rasmusson, Ann M / Marx, Christine E / Jain, Sonia / Farfel, Gail M / Tsai, Julia / Sun, Xiaoying / Geracioti, Thomas D / Hamner, Mark B / Lohr, James / Rosse, Richard / Summerall, Lanier / Naylor, Jennifer C / Cusin, Cristine / Lang, Ariel J / Raman, Rema / Stein, Murray B. ·National Center for PTSD-Women's Health Science Division, Department of Veterans Affairs, Boston University School of Medicine, Boston, MA, USA. ann.rasmusson@va.gov. · VA Boston Healthcare Center, (116B-3), 150 South Huntington Avenue, Boston, MA, 02130, USA. ann.rasmusson@va.gov. · Durham VA Medical Center, VA Mid-Atlantic MIRECC, Duke University School of Medicine, Durham, NC, USA. · University of California, San Diego, La Jolla, CA, USA. · Marinus Pharmaceuticals, Inc., Radnor, PA, USA. · Zogenix, Inc., San Diego, CA, USA. · VA Medical Center Cincinnati and University of Cincinnati College of Medicine, Cincinnati, OH, USA. · Ralph H. Johnson VA Medical Center and Medical University of South Carolina, Charleston, SC, USA. · VA San Diego Healthcare System, San Diego, CA, USA. · Washington DC VA Medical Center, Washington, DC, USA. · Manchester VA Medical Center and White River Junction VA Medical Center, White River Junction, VT, USA. · Massachusetts General Hospital, Boston, MA, USA. · Harvard Medical School, Boston, MA, USA. · University of Southern California, Los Angeles, CA, USA. ·Psychopharmacology (Berl) · Pubmed #28667510.

ABSTRACT: Preclinical and clinical research supports a role for neuroactive steroids in the pathophysiology of posttraumatic stress disorder (PTSD). We investigated ganaxolone (a synthetic 3β-methylated derivative of allopregnanolone, a GABAergic neuroactive steroid) for treatment of PTSD in a proof-of-concept, multisite, double-blind, placebo-controlled trial. Veteran and non-veteran participants (n = 112) were randomized to ganaxolone or placebo at biweekly escalating doses of 200, 400, and 600 mg twice daily for 6 weeks. During an open-label 6-week extension phase, the initial ganaxolone group continued ganaxolone, while the placebo group crossed over to ganaxolone. Eighty-six and 59 participants, respectively, completed the placebo-controlled and open-label phases. A modified intent-to-treat mixed model repeated measures analysis revealed no significant differences between the effects of ganaxolone and placebo on Clinician Administered PTSD Symptom (CAPS) scores, global well-being, negative mood, or sleep. Dropout rates did not differ between groups, and ganaxolone was generally well tolerated. Trough blood levels of ganaxolone at the end of the double-blind phase were, however, lower than the anticipated therapeutic level of ganaxolone in >35% of participants on active drug. Pharmacokinetic profiling of the ganaxolone dose regimen used in the trial and adverse event sensitivity analyses suggest that under-dosing may have contributed to the failure of ganaxolone to out-perform placebo. Future investigations of ganaxolone may benefit from higher dosing, rigorous monitoring of dosing adherence, a longer length of placebo-controlled testing, and targeting of treatment to PTSD subpopulations with demonstrably dysregulated pre-treatment neuroactive steroid levels. Clinicaltrials.gov identifier: NCT01339689.

2 Clinical Trial An open-label pilot study of aripiprazole for male and female veterans with chronic post-traumatic stress disorder who respond suboptimally to antidepressants. 2012

Youssef, Nagy A / Marx, Christine E / Bradford, Daniel W / Zinn, Sandra / Hertzberg, Michael A / Kilts, Jason D / Naylor, Jennifer C / Butterfield, Marian I / Strauss, Jennifer L. ·VA Mid-Atlantic Mental Illness, Research and Clinical Center, Durham Veterans Affairs Medical Center, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27705, USA. ·Int Clin Psychopharmacol · Pubmed #22475888.

ABSTRACT: Emerging data suggest that second-generation antipsychotics such as aripiprazole may be effective in the treatment of post-traumatic stress disorder (PTSD). However, few clinical trials have used aripiprazole in PTSD, and data are limited on its use in Veterans with PTSD. The objective of this pilot trial was to investigate the safety and efficacy of aripiprazole in Veterans with PTSD. Ten individuals (five men and five women) meeting the Diagnostic and statistical manual of mental disorders, 4th ed., PTSD criteria participated in this 12-week, open-label, flexibly dosed monotherapy trial. The dose range of aripiprazole was 5-30 mg/day, titrated to tolerability and clinical response. The primary outcome measure was the Clinician-Administered PTSD Scale. Additional outcomes included the Short PTSD Rating Interview, the Treatment Outcome PTSD Scale (Top-8), the Davidson Trauma Scale, the Positive and Negative Syndrome Scale, the Beck Depression Inventory-Fast Screen, and Clinical Global Impressions-Improvement. Eight participants completed the study, and aripiprazole was generally well tolerated and associated with a significant improvement in PTSD symptoms, as measured by the Clinician-Administered PTSD Scale (primary outcome measure) and by the Short PTSD Rating Interview, the Treatment Outcome PTSD Scale, and the Davidson Trauma Scale. An improvement was also observed on all three Positive and Negative Syndrome Scale subscales and the Beck Depression Inventory-Fast Screen, and the average Clinical Global Impressions-Improvement ratings indicated that patients were 'much improved'. These promising initial results merit further investigation in a larger, randomized-controlled trial.

3 Article Serum Neurosteroid Levels Are Associated With Cortical Thickness in Individuals Diagnosed With Posttraumatic Stress Disorder and History of Mild Traumatic Brain Injury. 2020

Kinzel, Philipp / Marx, Christine E / Sollmann, Nico / Hartl, Elisabeth / Guenette, Jeffrey P / Kaufmann, David / Bouix, Sylvain / Pasternak, Ofer / Rathi, Yogesh / Coleman, Michael J / van der Kouwe, Andre / Helmer, Karl / Kilts, Jason D / Naylor, Jennifer C / Morey, Rajendra A / Shutter, Lori / Andaluz, Norberto / Coimbra, Raul / Lang, Ariel J / George, Mark S / McAllister, Thomas W / Zafonte, Ross / Stein, Murray B / Shenton, Martha E / Koerte, Inga K. ·Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. · cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany. · VA Mid-Atlantic Mental Illness Research and Clinical Center (MIRECC) and Durham VA Medical Center, Durham, NC, USA. · Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA. · Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. · TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. · Department of Neurology, Epilepsy Center, University Hospital Munich, Munich, Germany. · Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. · Department of Radiology, Charité Universitätsmedizin, Berlin, Germany. · Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. · Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA. · Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA. · Departments of Critical Care Medicine, Neurology and Neurosurgery, UPMC Health System/University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. · Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA. · Mayfield Brain & Spine, Cincinnati, OH, USA. · Department of General Surgery, Riverside University Health System Medical Center, Moreno Valley, CA, USA. · VA San Diego Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA, USA. · Department of Psychiatry, University of California San Diego, La Jolla, CA, USA. · Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA. · Psychiatry Department, Medical University of South Carolina, Charleston, SC, USA. · Ralph H. Johnson VA Medical Center, Charleston, SC, USA. · Department of Psychiatry, Indiana School of Medicine, Indianapolis, IN, USA. · Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA. · Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. · VA Boston Healthcare System, Brockton Division, Brockton, MA, USA. · Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. · Graduate School of Systemic Neuroscience, Ludwig-Maximilians-Universität, Munich, Germany. ·Clin EEG Neurosci · Pubmed #32186207.

ABSTRACT: Posttraumatic stress disorder (PTSD) co-occurring with mild traumatic brain injury (mTBI) is common in veterans. Worse clinical outcome in those with PTSD has been associated with decreased serum neurosteroid levels. Furthermore, decreased cortical thickness has been associated with both PTSD and mTBI. However, it is not known whether decreased neurosteroids are associated with decreased cortical thickness in PTSD co-occurring with mTBI. This study included 141 individuals divided into the following groups: (

4 Article Neurosteroid Levels in the Orbital Frontal Cortex of Subjects with PTSD and Controls: A Preliminary Report. 2019

Cruz, Dianne A / Glantz, Leisa A / McGaughey, Kara D / Parke, Gillian / Shampine, Lawrence J / Kilts, Jason D / Naylor, Jennifer C / Marx, Christine E / Williamson, Douglas E. ·Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, USA. · Durham VA Medical Center, Durham, NC, USA. · VA Mid-Atlantic MIRECC, Durham, NC, USA. ·Chronic Stress (Thousand Oaks) · Pubmed #31276078.

ABSTRACT: Background: Neurosteroids mediate stress signaling and have been implicated in the pathogenesis of post-traumatic stress disorder (PTSD) in both preclinical and clinical studies. Compared to controls, subjects with PTSD exhibit altered neurosteroid levels in peripheral blood and cerebrospinal fluid as well as hypoactivity in the medial orbital frontal cortex (mOFC). Therefore, the aim of this study was to compare neurosteroid levels in the mOFC of subjects with PTSD (n = 18) and controls (n = 35). Methods: Gray matter was dissected from fresh-frozen mOFC, and levels of the neurosteroids pregnenolone, allopregnanolone, pregnanolone, epiallopregnanolone, epipregnanolone, tetrahydrodeoxycorticosterone, and androsterone were determined by gas chromatography - tandem mass spectrometry (GC/MS/MS). Results: Analyses of unadjusted levels revealed that males with PTSD had significantly decreased levels of allopregnanolone ( Conclusions: To our knowledge, this is the first report of neurosteroid levels in postmortem brain tissue of subjects with PTSD. Although replication is required in other brain regions and in a larger cohort of subjects, the results suggest a dysregulation of allopregnanolone and androsterone in males with PTSD and pregnanolone in females with PTSD in the mOFC.

5 Article Psychosocial Risk Factors and Other Than Honorable Military Discharge: Providing Healthcare to Previously Ineligible Veterans. 2018

Elbogen, Eric B / Wagner, H Ryan / Brancu, Mira / Kimbrel, Nathan A / Naylor, Jennifer C / Swinkels, Cindy M / Anonymous1061034 / Fairbank, John A. ·Veterans Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), 508 Fulton Street, Durham VA Medical Center, Durham, VA. · Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC. ·Mil Med · Pubmed #29547949.

ABSTRACT: INTRODUCTION: In response to a strong focus on suicide prevention for all veterans, the Department of Veterans Affairs (VA) recently revised policy to provide emergency mental healthcare for veterans who received Other Than Honorable (OTH) discharges from the military. This current study takes a preliminary step toward identifying demographic, historic, military, clinical, and social characteristics of veterans with OTH discharges. MATERIALS AND METHODS: N = 1,172 Iraq/Afghanistan-era veterans were evaluated between 2005 and 2016 in the multi-site VA Mid-Atlantic Mental Illness, Research, Education and Clinical Center (MIRECC) Study of Post-Deployment Mental Health (PDMH Study). RESULTS: Veterans with OTH discharges constituted 2.7% of our sample, approximating the estimated rate in the overall U.S. veteran population. Compared to veterans discharged under honorable conditions, veterans with OTH discharges were more likely to be younger and have greater odds of reporting family history of drug abuse and depression. Further, veterans with OTH discharges reported a lower level of social support and were more likely to be single, endorse more sleep problems, score higher on measures of drug misuse, have a history of incarceration, and meet diagnostic criteria for major depressive disorder. A subsequent matching analysis provided further evidence of the association between OTH discharge and two risk factors: drug misuse and incarceration. CONCLUSION: These findings elucidate potential factors associated with veterans with OTH discharges, particularly substance abuse and criminal justice involvement. Results also indicate higher incidence of risk factors that often accompany suicidal ideation and should be a highlighted component of healthcare delivery to this vulnerable cohort of veterans.

6 Article Chronic Pain, TBI, and PTSD in Military Veterans: A Link to Suicidal Ideation and Violent Impulses? 2018

Blakey, Shannon M / Wagner, H Ryan / Naylor, Jennifer / Brancu, Mira / Lane, Ilana / Sallee, Meghann / Kimbrel, Nathan A / Anonymous4060939 / Elbogen, Eric B. ·Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: sblakey@unc.edu. · Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, North Carolina; Durham VA Medical Center, Durham, North Carolina; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina. · Durham VA Medical Center, Durham, North Carolina. ·J Pain · Pubmed #29526669.

ABSTRACT: The polytrauma clinical triad refers to the co-occurrence of chronic pain, traumatic brain injury (TBI), and posttraumatic stress disorder (PTSD). Despite research implicating dyadic relationships between these conditions and adverse outcomes, scant research has examined the polytrauma clinical triad's relation to suicide or violence. The present cross-sectional study was designed to examine whether this complex clinical presentation increases risk of suicidal ideation and violent impulses after accounting for other established risk factors. Veterans who served in the military since September 11, 2001 (N = 667) who reported chronic pain completed an interview and self-report battery. Bivariate analyses showed that suicidal ideation and violent impulses both correlated with PTSD, TBI+PTSD, pain intensity and interference, drug abuse, and major depressive disorder (MDD). Multiple regression analyses showed that: 1) race, chronic pain with PTSD, alcohol abuse, and MDD significantly predicted suicidal ideation, 2) pain interference, chronic pain with TBI, chronic pain with PTSD, chronic pain with TBI+PTSD, drug abuse, and MDD significantly predicted violent impulses, and 3) pain interference was a more critical predictor of suicidal and violent ideation than pain intensity. Implications for risk assessment and treatment are discussed. PERSPECTIVE: This article presents results from a study examining predictors of suicide and violence risk among a sample of post-9/11 U.S. Veterans with chronic pain. Health care professionals should assess for pain interference, TBI, PTSD, depression, and alcohol/drug abuse when conducting risk assessments with this population.

7 Article Risk factors for concurrent suicidal ideation and violent impulses in military veterans. 2018

Elbogen, Eric B / Wagner, H Ryan / Kimbrel, Nathan A / Brancu, Mira / Naylor, Jennifer / Graziano, Robert / Crawford, Eric / Anonymous2000910. ·Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center. · Department of Psychiatry, University of North Carolina at Chapel Hill. ·Psychol Assess · Pubmed #28627921.

ABSTRACT: Suicide and violence are significant problems in a subset of Iraq/Afghanistan-era veterans. This study investigates how posttraumatic stress disorder (PTSD) and resilience in veterans are associated with suicidal ideation and violent impulses while controlling for known covariates of both adverse outcomes. Structured clinical interviews were conducted of N = 2,543 Iraq/Afghanistan-era U.S. veterans. Compared with veterans denying suicidal ideation or violent impulses (n = 1,927), veterans endorsing both (n = 171) were more likely to meet diagnostic criteria for PTSD, report childhood abuse, combat exposure, physical pain symptoms, and drug misuse, and less likely to endorse self-direction/life purpose. Veterans reporting concurrent suicidal ideation and violent impulses had higher odds of misusing drugs and reporting pain symptoms relative to veterans reporting suicidal ideation only (n = 186) and had lower odds of endorsing self-direction/life purpose compared with veterans reporting violent impulses only (n = 259). The findings underscore the importance of examining drug abuse, physical pain symptoms, and self-direction/life purpose, as well as PTSD and history of trauma, in the context of clinical assessment and empirical research aimed at optimizing risk management of suicide and violence in military veterans. (PsycINFO Database Record

8 Article Cannabis use disorder and suicide attempts in Iraq/Afghanistan-era veterans. 2017

Kimbrel, Nathan A / Newins, Amie R / Dedert, Eric A / Van Voorhees, Elizabeth E / Elbogen, Eric B / Naylor, Jennifer C / Ryan Wagner, H / Brancu, Mira / Anonymous6870894 / Beckham, Jean C / Calhoun, Patrick S. ·Durham Veterans Affairs Medical Center, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA; Duke University Medical Center, Durham, NC, USA. Electronic address: Nathan.Kimbrel@va.gov. · University of Central Florida, Orlando, FL, USA. · Durham Veterans Affairs Medical Center, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA; Duke University Medical Center, Durham, NC, USA. · VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA. · Durham Veterans Affairs Medical Center, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA; Duke University Medical Center, Durham, NC, USA; VA Center for Health Services Research in Primary Care, Durham, NC, USA. ·J Psychiatr Res · Pubmed #28129565.

ABSTRACT: The objective of the present research was to examine the association between lifetime cannabis use disorder (CUD), current suicidal ideation, and lifetime history of suicide attempts in a large and diverse sample of Iraq/Afghanistan-era veterans (N = 3233) using a battery of well-validated instruments. As expected, CUD was associated with both current suicidal ideation (OR = 1.683, p = 0.008) and lifetime suicide attempts (OR = 2.306, p < 0.0001), even after accounting for the effects of sex, posttraumatic stress disorder, depression, alcohol use disorder, non-cannabis drug use disorder, history of childhood sexual abuse, and combat exposure. Thus, the findings from the present study suggest that CUD may be a unique predictor of suicide attempts among Iraq/Afghanistan-era veterans; however, a significant limitation of the present study was its cross-sectional design. Prospective research aimed at understanding the complex relationship between CUD, mental health problems, and suicidal behavior among veterans is clearly needed at the present time.

9 Article Allopregnanolone Levels Are Inversely Associated with Self-Reported Pain Symptoms in U.S. Iraq and Afghanistan-Era Veterans: Implications for Biomarkers and Therapeutics. 2016

Naylor, Jennifer C / Kilts, Jason D / Szabo, Steven T / Dunn, Charlotte E / Keefe, Francis J / Tupler, Larry A / Shampine, Lawrence J / Morey, Rajendra A / Strauss, Jennifer L / Hamer, Robert M / Wagner, H Ryan / Anonymous3150836 / Marx, Christine E. · ·Pain Med · Pubmed #26176345.

ABSTRACT: BACKGROUND AND OBJECTIVES: Pain symptoms are common among Iraq/Afghanistan-era veterans, many of whom continue to experience persistent pain symptoms despite multiple pharmacological interventions. Preclinical data suggest that neurosteroids such as allopregnanolone demonstrate pronounced analgesic properties, and thus represent logical biomarker candidates and therapeutic targets for pain. Allopregnanolone is also a positive GABAA receptor modulator with anxiolytic, anticonvulsant, and neuroprotective actions in rodent models. We previously reported inverse associations between serum allopregnanolone levels and self-reported pain symptom severity in a pilot study of 82 male veterans. METHODS: The current study investigates allopregnanolone levels in a larger cohort of 485 male Iraq/Afghanistan-era veterans to attempt to replicate these initial findings. Pain symptoms were assessed by items from the Symptom Checklist-90-R (SCL-90-R) querying headache, chest pain, muscle soreness, and low back pain over the past 7 days. Allopregnanolone levels were quantified by gas chromatography/mass spectrometry. RESULTS: Associations between pain ratings and allopregnanolone levels were examined with Poisson regression analyses, controlling for age and smoking. Bivariate nonparametric Mann–Whitney analyses examining allopregnanolone levels across high and low levels of pain were also conducted. Allopregnanolone levels were inversely associated with muscle soreness [P = 0.0028], chest pain [P = 0.032], and aggregate total pain (sum of all four pain items) [P = 0.0001]. In the bivariate analyses, allopregnanolone levels were lower in the group reporting high levels of muscle soreness [P = 0.001]. CONCLUSIONS: These findings are generally consistent with our prior pilot study and suggest that allopregnanolone may function as an endogenous analgesic. Thus, exogenous supplementation with allopregnanolone could have therapeutic potential. The characterization of neurosteroid profiles may also have biomarker utility.

10 Article A pilot randomized placebo-controlled trial of adjunctive aripiprazole for chronic PTSD in US military Veterans resistant to antidepressant treatment. 2015

Naylor, Jennifer C / Kilts, Jason D / Bradford, Daniel W / Strauss, Jennifer L / Capehart, Bruce P / Szabo, Steven T / Smith, Karen D / Dunn, Charlotte E / Conner, Kathryn M / Davidson, Jonathan R T / Wagner, Henry Ryan / Hamer, Robert M / Marx, Christine E. ·aResearch and Development/Mental Health Services, Durham Veterans Affairs Medical Center bDepartment of Psychiatry and Behavioral Sciences, Duke University Medical Center cVA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham Departments of dPsychiatry eBiostatistics, University of North Carolina, Chapel Hill, North Carolina, USA. ·Int Clin Psychopharmacol · Pubmed #25647451.

ABSTRACT: Many individuals with post-traumatic stress disorder (PTSD) experience persistent symptoms despite pharmacological treatment with antidepressants. Several open-label monotherapy and adjunctive studies have suggested that aripiprazole (a second-generation antipsychotic) may have clinical utility in PTSD. However, there have been no randomized placebo-controlled trials of aripiprazole use for PTSD. We thus conducted a pilot randomized controlled trial of adjunctive aripiprazole versus placebo among Veterans with chronic PTSD serving in the US military since 11 September 2001 to assess the feasibility, safety, tolerability, and therapeutic potential of aripiprazole. Sixteen Veterans were randomized, and 14 completed at least 4 weeks of the study; 12 completed the entire 8-week trial. Outcome measures included the Clinician-Administered PTSD Scale (CAPS), PTSD Checklist, Beck Depression Inventory, Second Edition, and Positive and Negative Syndrome Scale scores. Aripiprazole was well-tolerated in this cohort, and improvements in CAPS, PTSD Checklist, Beck Depression Inventory, Second Edition, and Positive and Negative Syndrome Scale scores were as hypothesized. Although CAPS change scores did not reach statistical significance, aripiprazole outperformed placebo by 9 points on the CAPS in the last observation carried forward analysis compared with the placebo group (n = 7 per group), and by 20 points in the group randomized to aripiprazole that completed the entire study (n = 5) compared with the placebo group (n = 7). Results suggest promise for aripiprazole as an adjunctive strategy for the treatment of PTSD.

11 Article Amino acids as biomarker candidates for suicidality in male OEF/OIF Veterans: relevance to NMDA receptor modulation and nitric oxide signaling. 2014

Szabo, Steven T / Kilts, Jason D / Naylor, Jennifer C / Youssef, Nagy A / Strauss, Jennifer L / Morey, Rajendra A / Brancu, Mira / Hamer, Robert M / Bradford, Daniel W / Anonymous4320793 / Marx, Christine E. ·Durham Veterans Affairs Medical Center and VA Mid-Atlantic MIRECC, 508 Fulton Street, Mental Health Service Line (116A), Durham, NC 27705. ·Mil Med · Pubmed #24806493.

ABSTRACT: Veteran populations are exposed to multiple stressful events, and suicidality among veterans is a serious problem. Identifying biomarkers of suicidality may enhance detection, prevention, and treatment. Multiple neurotransmitter systems are implicated in the neurobiology of suicidality, including amino acid neurotransmitter systems. Amino acids as biomarker candidates for suicidality were quantified using mass spectrometry in serum samples from 90 male U.S. Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans. Amino acid levels in veterans reporting suicidal ideation (SI) on the Beck Scale for Suicidal Ideation (BSS) (BSS score > 0, n = 19) were compared with those reporting no SI (BSS score = 0, n = 71). Glycine, an excitatory amino acid and N-methyl-d-aspartate receptor modulator, was significantly elevated in serum samples from veterans reporting SI (p = 0.043). Serine and aspartate/asparagine, also excitatory neurotransmitters, were nonsignificantly increased in veterans reporting SI (p = 0.082 and p = 0.097, respectively). In contrast, arginine (nitric oxide [NO] precursor) and citrulline (by-product of NO formation) were nonsignificantly decreased in veterans reporting SI (p = 0.097 and p = 0.093, respectively). Profiling amino acids as possible biomarker candidates for suicidality in OEF/OIF veterans may have clinical utility for identifying suicidal risk. Glutamatergic neurotransmission and NO signaling may be relevant to the neurobiology of suicidality in OEF/OIF veterans.

12 Article A pilot randomized controlled trial with paroxetine for subthreshold PTSD in Operation Enduring Freedom/Operation Iraqi Freedom era veterans. 2013

Naylor, Jennifer C / Dolber, Trygve R / Strauss, Jennifer L / Kilts, Jason D / Strauman, Timothy J / Bradford, Daniel W / Szabo, Steven T / Youssef, Nagy A / Connor, Kathryn M / Davidson, Jonathan R T / Marx, Christine E. ·VA Mid-Atlantic Mental Illness, Research and Clinical Center, Durham, NC, USA. ·Psychiatry Res · Pubmed #23276723.

ABSTRACT: Subthreshold posttraumatic stress disorder (PTSD) is associated with increased risk for suicidality, depression, and functional impairment. We thus conducted a small (N=12) pilot randomized controlled trial (RCT) with paroxetine for subthreshold PTSD in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) era veterans. Hospital Anxiety and Depression Scale (HADS) scores improved by 30.4% in the paroxetine group. Paroxetine may have promise for subthreshold PTSD.