neuro-primary-mental-health-2017-posters-abstracts

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allied
academies
17th International Conference on 4 th International Conference on
NEUROLOGY AND NEUROSCIENCE & MENTAL HEALTH AND PRIMARY CARE
October 16-18, 2017 | Toronto, Canada
J Neurol Neurorehabil Res 2017 | Volume 2 Issue 3
Objective: The central anticholinergic drug trihexylphenidyl
(TP) was previously reported to show remarkable
effectiveness against posttraumatic stress disorder (PTSD)
flashbacks (FB) as well as the associated onset mechanism at
WFSBP, 2015, Athens) and (CINP. 2016, Seoul). The objective
of the current study was to assess the efficacy of TP in
reducing the nightmares associated with PTSD and elucidate
the underlying mechanism.
Methods: An open-label trial was conducted between 2009
and 2017 in outpatients who received a diagnosis of PTSD in
accordance with DSM-5. TP (2 mg 1T-3T) was administered
to 29 outpatients with PTSD depending on their condition.
This study targeted refractory patients who had experienced
no therapeutic benefit from any psychotropic drug over
a number of years. The primary outcome variable was
the change from baseline to endpoint in global Clinician-
Administered PTSD Scale (CAPS-5) score and memory-related
items B2 (nightmares) and B3 (flashbacks) for PTSD memory-
related assessment. Secondary efficacy measures were
the impact of event scale-revised (IES-R), which presents
the overall clinical profile. Informed consent was obtained
from all patients. This study was approved by the Ethical
Committee of Warakukai. UMIN trial ID: UMIN000028461.
Result: The therapeutic outcome in 29 patients demonstrated
an extremely high efficacy rate. with 70.3% achieving
complete remission (CR), indicating CR+ partial remission
(PR: 29.7%=100% (flashbacks CR was 66.5%).
Conclusion: This study is the first pharmacological report
on the novel use of TP against nightmares in PTSD. TP was
markedly effective in the treatment of both nightmares and
flashbacks. The nightmares onset mechanism is more closely
linked to ACh transmission,and the nightmares is different
to regular dream caused by Ch5 (PPN) and Ch6 (LDT) in
the brain stem. Posttraumatic nightmares are flashbacks
in dreams. The state in which neurotransmission of ACh-
memory-rerated-Ccircuit (comprised by Ch4/Meynert-
Amygdala, Ch1/medial septal nucleus, Ch2/Broca’s diagonal
band-hippocampus) generating PTSD-flashbacks is added to
regular REM is considered posttraumatic nightmare (author’s
hypothesis).
e:
New drug treatment and mechanism of the central anticholinergic drug trihexylphenidyl in reducing
posttraumatic nightmares in patients with PTSD
Katsumasa Sogo
Sogo Clinic, Japan