Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, November 4, 2016

Blood Pressure May Open Door to Personalized Medicine for PTSD

You'll have to tell your doctor about this if you got PTSD from your stroke, because I bet s/he is not reading Biological Psychiatry.

23% chance of stroke survivors getting PTSD.

The latest here:

Blood Pressure May Open Door to Personalized Medicine for PTSD

Reports new study in Biological Psychiatry
Treatment with the drug prazosin effectively reduces symptoms of posttraumatic stress disorder (PTSD) for many people, but about one third of patients don't respond to the treatment at all. Attempts to understand why people respond differently, based on symptom type or severity, have fallen short. Now, a new study reports that soldiers with higher blood pressure before beginning prazosin treatment see better results from the medication. The study, published in Biological Psychiatry, is the first to look for a biological marker that could be used to predict individual response to a drug treatment for combat PTSD.

"These findings suggest that higher standing blood pressure is a biomarker that can contribute to a personalized medicine approach to identifying soldiers and veterans with combat PTSD likely to benefit from prazosin," said Murray Raskind of the VA Puget Sound Health Care System and the University of Washington in Seattle, who led the study.

A biomarker such as blood pressure would have exceptional clinical utility because it would provide an easily measureable and immediate predictor of treatment response that could help doctors determine the role of prazosin or a similar medication in the treatment strategy for an individual.

Prazosin blocks α1-adrenergic receptors (α1AR), and through this mechanism prevents some of the effects of adrenaline and noradrenaline, chemicals released by the body during stress. "It would make sense if prazosin was most effective in those patients with the greatest activation of noradrenaline systems," said John Krystal, Editor of Biological Psychiatry.

However, activity of α1AR cannot be measured directly in humans. So the researchers identified a peripheral biological marker that is regulated by α1AR activity; noradrenaline stimulation of α1AR increases blood pressure, suggesting that blood pressure may be a useful indicator of α1AR activity.

The researchers analyzed the combat PTSD symptoms and blood pressure measures collected previously as part of a randomized controlled trial of 67 soldiers who had returned from Iraq and Afghanistan. Thirty-two participants had received prazosin, and 35 had received placebo for 15 weeks.

"Pretreatment standing systolic blood pressure strongly predicted response to prazosin," said Raskind. By the end of the 15 week treatment period, participants with a higher initial blood pressure saw a bigger improvement in their PTSD symptoms, with a better outcome for every 10 mmHg increment above 110 mmHg.

In addition to suggesting that blood pressure may help predict which soldiers with PTSD will benefit the most from treatment, the findings also provide insight into the pathophysiology of the disorder.

"The increase in blood pressure in these PTSD patients may be a biomarker for patients who are more likely to benefit from prazosin," said Krystal. "If so, it may be a useful indicator of activation of noradrenergic activation associated with PTSD in these patients."
http://www.biologicalpsychiatryjournal.com/article/S0006-3223(16)32278-8/abstract

No comments:

Post a Comment