MODERN APPROACHES TO PHARMACOTHERAPY OF POSTTRUMMATIC STRESS DISORDER Zhyvotovska L. V., Boiko D. I., Sokil A. A., Pogorilko O. V., Voloshyn V. A.

Zhyvotovska L. V., Boiko D. I., Sokil A. A., Pogorilko O. V., Voloshyn V. A.

LITERATURE REVIEWS

Scentific article

Post-traumatic stress disorder (PTSD), the development of which is provoked by various emergencies – the most studied and, probably, the most common psychiatric disorder that occurs immediately after traumatic events and catastrophes of different origins. However, there is some uncertainty about the diagnosis and treatment of post-traumatic disorders. The research examined the current trends in the development of psychopharmacology of post-traumatic stress disorder using MDMA, D-cycloserine, cannabidiol, ketamine and neuropeptide Y. In the treatment of PTSD, psychotherapy is preferred, while pharmacotherapy is considered secondary. At the moment, the possibility of using the above-mentioned substances as part of complex and combined therapy is being considered from the point of view of their neurobiological effects, which affect various parts of the biochemical processes of memory reconsolidation. Researches in healthy people have shown that MDMA mediates the processing of emotional memory. DCS affects specific subtypes of NMDA receptors, one of the functions of which is the modulation of the responses to the extinction of fear. Thus, more extensive surveys using exposition therapy and fractional dosage will allow the role of DCS to be added as an additional therapy in the treatment of PTSD. Some investigators describe the relationship between the use of cannabis, as a form of self-treatment, and the force of traumatic events in adolescents as well as in adults. According to modern research, CBD increases the consolidation of averted extinction of memory in healthy people. Noteworthy is the preservation of the potential of neuroplasticity and the stimulation of the glutamatergic system with ketamine as a new direction in the pharmacotherapy of PTSD. Drugs are now at the preclinical stage, using NPY receptors as therapeutic targets. The intranasal administration of NPY is an interesting option, since it has the potential to increase the concentration of peptides directly into the central nervous system without significantly affecting peripheral structures. Such an approach worked successfully in rodent models in PTSD models. However, the systemic introduction of NPY modulators may have unwanted side effects as it has a stimulating effect on vasoconstriction, inflammation, angiogenesis and adipogenesis. Despite a number of positive results, many issues in this area remain unresolved and require further and in-depth study. Priority is the study of new experimental methods of therapy for PTSD that will improve existing rehab programs, improve quality of life and return patients to full social functioning.

PTSD, treatment, MDMA, cannabidiol, D-cycloserine, ketamin, neuropeptide Y.

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«Bulletin of problems biology and medicine» Issue 2 Part 2 (151), 2019 year, 38-44 pages, index UDK 616.89-008-039.12-06:616.45-001.1/3:615.2/3

10.29254/2077-4214-2019-2-2-151-38-44