No evidence to suggest medicinal cannabis is effective for depression, anxiety or PTSD: research

 This contradicts a lot of previous research, so have your competent? doctor DETAIL EXACTLY WHY! 

• PTSD, (98 posts to July 2012)
• Post stroke depression(33% chance).

• Post stroke anxiety(20% chance).  
• marijuana (163 posts to February 2011)

One line in there is interesting; medical cannabis may be beneficial for spasticity in multiple sclerosis(Ask your doctor if this would work for spasticity in stroke. NO answer, your doctor is FUCKING INCOMPETENT!)

No evidence to suggest medicinal cannabis is effective for depression, anxiety or PTSD: research

Psychedelics Remodel Myelin to Heal PTSD

 Your competent? doctor is already prescribing psychedelics, right?

DMT (8 posts to November 2020)

ecstasy (19 posts to November 2012)

LSD (5 posts to September 2018)

CerAxon (5 posts to January 2012)

citicoline (15 posts to October 2011)

magic mushrooms (10 posts to October 2014) 

psilocybin (14 posts to May 2014)

Psychedelics (25 posts to August 2018)

And knows of the need for myelin repair post stroke!

myelin (79 posts to April 2011)

myelin regeneration (3 posts to August 2024)

myelin repair (5 posts to January 2025)

And knows all about preventing and fixing your PTSD!

Since there is a 23% chance of stroke survivors getting PTSD what is your doctor's treatment plan?

OH NO, your doctor is incompetent in all points! What will you do to correct that problem?

Psychedelics Remodel Myelin to Heal PTSD

Summary: For years, scientists have focused on how psychedelics “rewire” neurons. But a groundbreaking study has found a “missing link” in long-term PTSD recovery: myelin remodeling. Researchers discovered that psilocybin and MDMA do more than just alter brain activity; they trigger the physical repair of myelin—the insulating layer that protects nerve fibers and synchronizes brain signals.

By “re-insulating” the circuits that have been frayed by trauma, these drugs help harmonize the rhythm of brain networks, turning a temporary “psychedelic window” into a permanent structural recovery.

Key Facts

• The “Missing Link”: While psychedelics provide rapid relief, long-term stability requires circuit-level repair. This study identifies adaptive myelination as the key to sustaining those benefits.
• Brain Synchronization: Myelin acts as the brain’s insulation. Remodeling this layer allows disrupted brain circuits (common in PTSD) to synchronize and harmonize their electrical rhythms again.
• Mechanistic Proof: Researchers used a rat model to show that blocking myelin repair prevented the long-term anti-anxiety effects of psilocybin and MDMA, proving that structural repair is necessary for recovery.
• Oligodendrocytes Matter: The study shifts the focus from neurons to oligodendrocytes—the cells that produce myelin—as the “gatekeepers” of long-lasting psychedelic healing.
• Anti-Inflammatory Effects: In addition to repairing insulation, both drugs were found to reduce astrocyte reactivity, lowering brain inflammation associated with chronic stress.

Source: Elsevier

Post-traumatic stress disorder (PTSD) is not only characterized by strongly encoded traumatic memories, but also by disrupted coordination across brain networks.

New research shows that treatment with psychedelic drugs triggers a large-scale reconfiguration of brain network dynamics driven by the remodeling of myelin—the neuronal insulation layer.

The findings from the novel study in Biological Psychiatry show enhancing myelination might be a viable strategy to augment or sustain the therapeutic effects of psychedelic-assisted treatments for PTSD and related disorders.

Psilocybin and 3,4-methylenedioxymethamphetamine (MDMA) produce rapid clinical effects in patients with PTSD. However, durable benefits require circuit-level stabilization.

As the underlying cellular mechanisms remain incompletely understood, the current study identifies myelin as the missing link bridging the short-lived psychedelic experience and longer-term maintenance of healthier neural network dynamics.

The study shows that activity-dependent oligodendrogenesis and myelin remodeling can tune the disrupted timing and persistent response to threat observed in PTSD by synchronizing and harmonizing the rhythm of brain circuits.

John Krystal, MD, Editor of Biological Psychiatry, explains, “The focus of psychedelic and MDMA research has been the effects of these drugs on neurons and neuroplasticity. This work has largely ignored a potentially important role for other cell types in the neurobiology of their therapeutic effects.

“Oligodendrocytes play a number of roles in the brain, which produce the myelin that insulates neurons. Subgroups of oligodendrocytes take up glutamate and contribute to glutamate homeostasis, protecting the brain from neurotoxicity. Another group of oligodendrocytes is involved in immune and inflammatory functions in the brain.”

Researchers used a rat model of contextual fear conditioning and administered repeated low doses of psilocybin or MDMA. They then quantified anxiety-like and exploration behaviors and assessed spatial learning and memory.

The results showed that anxiety-like behaviors were reduced—a shift accompanied by changes in oligodendrocyte biology and multi-omic (genetic) signatures towards myelin remodeling in the dentate gyrus (part of the hippocampus, the brain’s memory center).

“To test whether myelin integrity was simply associated with behavioral change—or actually required for it—we combined the drug interventions with models that either damaged brain insulation (demyelination) or chemically enhanced it (promyelination) to see how these changes affected recovery,” explains lead investigator Mehmet Bostancıklıoğlu, PhD, Department of Physiology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey.

Using high-powered microscopy and genetic analysis, the researchers confirmed both psilocybin and MDMA trigger physical myelin repair. Furthermore, a serotonin receptor 5-HT_2A blockade prevented both the behavioral and myelin-associated effects.

When the team used a different drug (anisomycin) to block the formation of fear memories, anxiety decreased, but the myelin remained unrepaired. This suggests that while memories can be suppressed, biological recovery requires the structural support of myelin.

“Taken together, this moves oligodendrocytes and adaptive myelination from ‘background correlates’ to a mechanistically testable gate on the durability of psychedelic-associated circuit change,” notes Dr. Bostancıklıoğlu.

“The implication of oligodendrocytes in the therapeutic effects of psychedelics and MDMA is important because of their many functions in the brain, including myelin formation, glutamate homeostasis, and neuroinflammation. The dependency of the therapeutic effects of these drugs in animals may suggest that myelin compromise may undermine their efficacy,” adds Dr. Krystal.

“Overall, these data suggest that psychedelics and MDMA, like selective serotonin reuptake inhibitors (SSRIs) and ketamine, may promote the recovery from stress-related damage to myelin, contributing to clinical recovery.”

The study also found that psilocybin and MDMA reduce astrocyte reactivity that can cause inflammation.

The investigators point out that enhancing myelination would not be expected to replace psychotherapy; rather, it could support consolidation and maintenance of healthier network communication after the acute psychedelic session, when the brain is transitioning from destabilization back towards reintegration.

Dr. Bostancıklıoğlu concludes, “We often talk about psychedelics as ‘opening a window’ for brain plasticity. Recent work emphasizes that these drugs can acutely loosen entrenched network patterns and then leave a sub-acute period in which experience can reshape circuits.

“What we show here is that myelin-producing cells may be an underappreciated part of that story—helping translate a transient window into longer-lasting circuit change, at least in a fear-based rat model.”

Key Questions Answered:

Q: Do psychedelics just “mask” traumatic memories?

A: No—this study shows they actually help fix the wiring. Trauma “frays” the insulation (myelin) of your brain’s communication lines, leading to static and mistimed signals. Psychedelics like psilocybin and MDMA trigger the brain to physically re-wrap those wires, allowing for clearer, calmer communication.

Q: Why is “neural insulation” so important for PTSD?

A: In PTSD, the brain’s fear circuits are often “over-active” and poorly timed. Myelin ensures that signals travel at the right speed. By repairing this insulation, the brain can better synchronize its networks, helping to “turn down the volume” on persistent threat responses.

Q: Does this mean I can just take psilocybin and be cured?

A: Not quite. The researchers emphasize that these drugs “open a window” of plasticity. The physical repair of myelin provides the structural support needed for that window to stay open, but it works best alongside therapy to reintegrate those healthier network patterns.

Editorial Notes:

• This article was edited by a Neuroscience News editor.
• Journal paper reviewed in full.
• Additional context added by our staff.

About this PTSD and psychedelics research news

Author: Eileen Leahy
Source: Elsevier
Contact: Eileen Leahy – Elsevier
Image: The image is credited to Neuroscience News

Original Research: Open access.
“MDMA and Psilocybin Regulate Oligodendrocyte-Lineage Cell Numbers and Anxiety-Like Behaviors in a Rat Model of Fear” by Mehmet Bostancıklıoğlu, Davut Sinan Kaplan, Ramazan Bal, Elif Yiğit, Hasan Ulusal, and Ebru Temiz. Biological Psychiatry
DOI:10.1016/j.biopsych.2026.01.016

Finally, a New Drug for Posttraumatic Stress Disorder?

 

Since there is a 23% chance of stroke survivors getting PTSD what is your doctor's treatment plan?

Maybe these?

Microbiome and Diet Could Mitigate PTSD Symptoms October 2023 

Psychoactive Ibogaine and Magnesium Show Promise for PTSD January 2024

Harnessing Psilocybin to Treat PTSD

Treating PTSD With Ecstasy? You Might Have Some Questions. May 2018

Ecstasy Was Just Labelled a 'Breakthrough Therapy' For PTSD by The FDA August 2017

But this negative action:

FDA Rejects MDMA-Assisted Therapy for PTSD

Decision largely expected after agency advisors voted against psychedelic's safety and efficacy.

The latest here: Seems like you are totally on your own to figure out how to treat your mental problems! Good luck.

Finally, a New Drug for Posttraumatic Stress Disorder?

A drug that combines the atypical antipsychotic brexpiprazole and the selective serotonin reuptake inhibitor sertraline provides significantly greater relief of posttraumatic stress disorder (PTSD) symptoms than sertraline plus placebo, results of a phase 3 trial showed.

The medication is currently under review by the US Food and Drug Administration (FDA) and if approved, will be the first pharmacologic option for PTSD in more than 20 years.

The trial met its primary endpoint of change in the Clinician Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) (CAPS-5) total score at week 10 and secondary patient-reported outcomes of PTSD symptoms, anxiety, and depression.

“And what is really cool, what’s really impactful is the combination worked better than sertraline plus placebo on a brief inventory of psychosocial functioning,” study investigator Lori L. Davis, a senior research psychiatrist, Birmingham Veterans Affairs Health Care System, Birmingham, Alabama, told Medscape Medical News.

“We can treat symptoms but that’s where the rubber meets the road, in terms of are they functioning better,” added Davis, who is also an adjunct professor of psychiatry, Heersink School of Medicine, The University of Alabama at Birmingham.

The findings were published online on December 18 in JAMA Psychiatry and reported earlier this year as part of a trio of trials conducted by Otsuka Pharmaceutical and Lundbeck Pharmaceuticals, codevelopers of the drug.

Clinically Meaningful

The FDA accepted the companies’ supplemental new drug application in June with a decision on approval expected in early February 2025.

“This study provides promising results for a medication that may be an important new option for PTSD,” John Krystal, MD, director, Clinical Neuroscience Division, National Center for PTSD, US Department of Veterans Affairs, who was not involved in the research, told Medscape Medical News. “New PTSD treatments are a high priority.”

Currently, there are two FDA-approved medication treatments for PTSD — sertraline and paroxetine.

“They are helpful for many people, but patients are often left with residual symptoms or tolerability issues,” noted Krystal, who is also professor and chair of psychiatry, Yale University, New Haven, Connecticut.

“New medications that might address the important ‘effectiveness gap’ in PTSD could help to reduce the remaining distress, disability, and suicide risk associated with PTSD.” 

The double-blind, phase 3 trial included 416 adults aged 18-65 years with a DSM-5 diagnosis of PTSD and symptoms for at least 6 months prior to screening. Patients underwent a 1-week placebo-run in period followed by randomization to daily oral brexpiprazole 2-3 mg plus sertraline 150 mg or daily sertraline 150 mg plus placebo for 11 weeks.

Participants’ mean age was 37.4 years, 74.5% were women, and mean CAPS-5 total score was 38.4, suggesting moderate to high severity PTSD, Davis said. The average time from the index traumatic event was 4 years and three fourths had no prior exposure to PTSD prescription medications.

At week 10, the mean change in CAPS-5 score from randomization was −19.2 points in the brexpiprazole plus sertraline group and −13.6 points in the sertraline plus placebo group (95% CI, −8.79 to −2.38; P < .001).

Asked whether the 5.59-point treatment difference is clinically meaningful, Davis said there is no widely agreed definition for change in CAPS-5 total score but that a within-group reduction of more than 10-13 points is most-often cited as being clinically meaningful.

The key secondary endpoint of least square mean change in the patient-reported Brief Inventory of Psychosocial Function total score from baseline to week 12 was −33.8 with the combination vs −21.8 with sertraline plus placebo (95% CI, −19.4 to −4.62; P = .002).

“That’s clinically meaningful for me as a provider and a clinician and a researcher when you’re getting the PTSD symptom change differences in parallel with the improvement in functional outcome,” she said. “I see that as the clinically meaningful gauge.”

In terms of safety, 3.9% of the participants in the brexpiprazole/sertraline group and 10.2% of those in the sertraline/placebo group discontinued treatment due to adverse events.

In both the combination and control groups, the only treatment-emergent adverse event with an incidence of more than 10% was nausea (12.2% vs 11.7%, respectively).

At the last visit, the mean change in body weight from baseline was an increase of 1.3 kg for brexpiprazole plus sertraline vs 0 kg for sertraline alone. Rates of fatigue (6.8% vs 4.1%) and somnolence (5.4% vs 2.6%) were also higher with brexpiprazole plus sertraline.

A Trio of Clinical Trials

The findings are part of a larger program reported by the drug makers that includes a flexible-dose brexpiprazole phase 2 trial that met the same CAPS-5 primary endpoint and a second phase 3 trial (072 study) that did not.

“We’ve looked at that data and the sertraline/placebo response was a lot higher, so it was not due to a lack of response with the combination but due to a more robust response with the active control,” Davis said. “But we want to point out for that 072 study, there was still important separation between the combination and sertraline plus placebo on the functional outcome.”

All three trials ran for 12 weeks, so longer-term efficacy and safety data are needed, she said. Other limitations of the published phase 3 study are the patient eligibility criteria, restrictions on concomitant therapy, and lack of non-US sites, which many limit generalizability, the authors note.

“Specifically, the exclusion of patients with a current major depressive episode is both a strength (to show a specific effect on PTSD) and a limitation (given the high prevalence of comorbid depression in PTSD),” they added.

Kudos, Caveats

Reached for comment, Vincent F. Capaldi, II, MD, ScM, professor and chair, department of psychiatry, Uniformed Services University of the Health Sciences School of Medicine, Bethesda, Maryland, said the exclusion of these patients is a limitation but that the study was well designed and conducted in a large sample across the United States.

“The findings suggest that brexpiprazole plus sertraline is a more effective treatment for PTSD than sertraline alone,” he told Medscape Medical News. “This finding is significant for our service members, who suffer from PTSD at higher rates than the general population.”

Additionally, the significant improvement in psychosocial functioning at week 12 “is important because PTSD is known to cause significant social and occupational disability, as well as quality-of-life issues,” he said.

Capaldi pointed out, however, that the study was conducted only at US sites and did not specifically target military/veteran persons, which may limit applicability to these unique populations.

“While subgroup analyses were generally consistent with the primary analysis, the study was not powered to detect differences between subgroups,” he added. “These subgroup analyses are quite important when considering military and veteran populations.”

Further research is needed to explore whether certain traumas are more responsive to combination treatment, the efficacy of augmenting existing sertraline therapy, and the specific mechanisms of brexpiprazole driving the improved outcomes, Capaldi said.

This study was funded by Otsuka Pharmaceutical Development & Commercialization, which was involved in the design, conduct, and data analysis. Davis reported receiving advisory board fees from Otsuka and Boehringer Ingelheim; lecture fees from Clinical Care Options; and grants from Alkermes, the Veterans Affairs, Patient-Centered Outcomes Research Institute, Department of Defense, and Social Finance. Several co-authors are employees of Otsuka.

Patent granted for first new forms of MDMA, clearing path to a potential FDA approval

 I'm assuming your competent? doctor has already secured supplies for your recovery as needed.

• MDMA (9 posts to November 2012)

  ecstasy (19 posts to November 2012)

   

Since there is a 23% chance of stroke survivors getting PTSD what is your doctor's treatment plan?

 

The latest here:

Patent granted for first new forms of MDMA, clearing path to a potential FDA approval

Key takeaways:

• The FDA is currently reviewing MDMA HCI for approval and a decision is expected in August.
• Terran Biosciences will pursue a rapid approval pathway for its patented new form of MDMA, pending the FDA decision.

Terran Biosciences has been awarded a U.S. patent for the world’s first new salts and polymorphs of MDMA, pharmaceutical compositions using these forms, and the method of use for treatment of PTSD, according to a company press release.

Terran Biosciences now holds the only composition of matter patent of a new form of MDMA, according to the release.

If the FDA approves MDMA HCI, Terran Biosciences will pursue a rapid 505(b)(2) approval pathway for its new form of MDMA (MDMA hemifumarate).
Image: Adobe Stock

To date, clinical trials of MDMA have been limited to using older forms of MDMA hydrochloride (MDMA HCI). MDMA HCI was submitted for FDA approval on the 505(b)(1) path and is currently under review. A decision is expected in August. If the FDA approves MDMA HCI, Terran Biosciences said it will pursue a rapid 505(b)(2) approval pathway for its new form of MDMA (MDMA hemifumarate).

Terran Biosciences could use this regulatory pathway to bring its MDMA product to market approximately 5 years from the date of the MDMA HCI approval. This would involve leveraging existing safety and efficacy data from completed MDMA trials to bypass any listing in the FDA’s Approved Drug Products with Therapeutic Equivalence Evaluations (Orange Book) for the older MDMA HCI.

The company said in the release that it hopes to increase the affordability and global accessibility of MDMA, and that it has developed a new GMP manufacturing process with this goal in mind.

“With this new breakthrough, we are committed to bringing affordable and accessible MDMA treatment options to patients with PTSD,” Sam Clark, MD, PhD, inventor of the patent and Terran Biosciences’ founder and CEO, said in the release. “We believe this new form of MDMA will enable us to bypass any potential future Orange Book listing, eliminating the potential for a 30-month stay that could otherwise delay the entry of generic MDMA HCl. MDMA-assisted psychotherapy could revolutionize the treatment of PTSD and Terran Biosciences will ensure that affordable MDMA is not delayed.”

PTSD tied to rehospitalization risk after first-time stroke among Black veterans

What is your doctors EXACT PTSD intervention? No intervention; total incompetence!

Maybe these?

Microbiome and Diet Could Mitigate PTSD Symptoms October 2023 

Psychoactive Ibogaine and Magnesium Show Promise for PTSD January 2024

Harnessing Psilocybin to Treat PTSD

Treating PTSD With Ecstasy? You Might Have Some Questions. May 2018

Ecstasy Was Just Labelled a 'Breakthrough Therapy' For PTSD by The FDA August 2017 

The latest here:

PTSD tied to rehospitalization risk after first-time stroke among Black veterans

Key takeaways:

• PTSD at the time of first stroke was associated with increased risk for rehospitalization among Black veterans.
• The elevated risk for rehospitalization was not observed among white veterans.

After first-time stroke, comorbid PTSD was associated with increased risk for hospital readmission among Black veterans that was not observed among white veterans, researchers reported.

In addition, the impact of significant risk factors for readmission such as hypertension and hyperlipidemia varied by race, according to study findings published in Stroke.

PTSD at the time of first stroke was associated with increased risk for rehospitalization among Black veterans. Image: Adobe Stock

“Our findings highlight the important things we can do to improve post-stroke care, such as focusing on high-risk populations, reducing modifiable risk factors, achieving stricter type 2 diabetes control and access for veterans who may need prescription medication treatment,” Chen Lin, MD, MBA, staff neurologist at the Birmingham Veterans Affairs Medical Center and an associate professor of neurology at the University of Alabama at Birmingham, said in a press release.

To assess whether PTSD is associated with readmission after stroke and whether racial disparities were present, Lin and colleagues evaluated data from the VA Corporate Data Warehouse of all patients who received care for a first-time stroke in the Veterans Health Administration.

The cohort included 93,651 veterans with a first inpatient diagnosis of stroke from 1999 to Aug. 6, 2022 (97% men; 63% white).

Overall, 13.8% of the cohort had comorbid PTSD at the time of stroke, and 18% were readmitted for any cause to a VA hospital.

The comorbid presence of PTSD at the time of first stroke was associated with increased risk for hospital readmission among Black veterans (HR = 1.1; 95% CI, 1.02-1.19; P = .01), but the association was not significant among white veterans (HR = 1.05; 95% CI, 0.99-1.11; P = .09).

“We were expecting to see PTSD playing a role in all veterans, so we were surprised at the difference between African American and white veterans in both the impact of PTSD and other risk factors,” Lin said in the release.

Hypertension was associated with reduced risk for hospital readmissions in both Black (HR = 0.81; 95% CI, 0.74-0.89; P .01) and white veterans (HR = 0.89; 95% CI, 0.84-0.95; P .01), whereas only for white veterans was hyperlipidemia associated with a lower risk (HR = 0.92; 95% CI, 0.86-0.97; P .01), and only for black veterans was diabetes (HR = 1.13; 95% CI, 1.04-1.23; P .01) and drug abuse (HR = 1.22; 95% CI, 1.1-1.35; P .01) associated with increased risk.

“In both the African American and white populations, there are important health conditions that can play a role in the risk of readmission after a stroke. Post-discharge care after stroke is always a challenge — people find it hard to get to the clinic, especially if they have disabilities limiting their walking and driving ability. However, there is certainly a role for more targeted care focused on the modifiable risk factors, such as type 2 diabetes and illicit drug use,” Lin said.

Reference:

• African American veterans with PTSD had higher risk of re-hospitalization after stroke. https://newsroom.heart.org/news/african-american-veterans-with-ptsd-had-higher-risk-of-re-hospitalization-after-stroke. Published March 14, 2024. Accessed March 14, 2024.

Published by:

Sources/Disclosures

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Source:

Lin C, et al. Stroke. 2024;doi:10.1161/STROKEAHA.123.044795.

ED evaluation of stroke-like symptoms may be more traumatic than actual stroke diagnosis

 Does your competent? doctor have a protocol for treating such PTSD?

Maybe ecstasy? Or

Psychoactive Ibogaine and Magnesium Show Promise for PTSD

The latest here:

ED evaluation of stroke-like symptoms may be more traumatic than actual stroke diagnosis

Key takeaways:

• Hospitalization for stroke-like symptoms was tied to higher odds of PTSD at 1 month than true stroke diagnosis.
• Preexisting PTSD was linked to higher odds of 1-month PTSD, regardless of the final diagnosis.

Patients who are hospitalized with stroke-like symptoms, but do not experience a stroke, may yet develop PTSD at a higher rate than patients who actually had a stroke, a speaker reported.

Stroke-like symptoms — or stroke mimics — included migraine, numbness and dizziness.

Hospitalization for stroke-like symptoms was tied to higher odds of PTSD at 1 month than true stroke diagnosis.

Image: Adobe Stock

Findings from the ReACH Stroke study were presented at the International Stroke Conference.

“Stroke mimics matter. As clinicians, we may be quick to dismiss a patient’s less life-threatening diagnosis, such as migraine or vertigo. However, these patients may experience significant psychological distress, which can increase their risk for poorer cardiovascular health,” Melinda Chang, MS, ANP-BC, research nurse at the Center for Behavioral Cardiovascular Health at Columbia University Irving Medical Center, said in a press release. “Knowing that being evaluated for stroke in an emergency department can itself be a traumatic experience for many people may help health care professionals recognize PTSD symptoms and connect patients quickly to the appropriate resources.

“Stroke specialists typically view stroke mimics as less serious than a confirmed stroke, so we did not expect patients with stroke mimics to be at higher risk for having PTSD at 1-month follow-up,” Chang said. “However, the neurologists on our team have noted that patients with stroke mimics can suffer significant distress from their stroke-like conditions, so our findings support these clinical experiences.”

To assess the association between stroke mimic, stroke or transient ischemic attack diagnosis and likelihood of PTSD 1 month after the index event, Chang and colleagues enrolled 1,000 patients with suspected stroke or TIA (mean age, 62 years; 51% women) who presented at the Columbia University Irving Medical Center from June 2016 to March 2022.

PTSD was evaluated using the PTSD Checklist-5 at index hospitalization and at 1 month after discharge.

The patients’ charts were reviewed by a neurologist, who was masked to PTSD status and provided a final diagnosis of stroke, TIA, stroke mimic or equivocal.

Overall, 59.6% of the cohort was diagnosed with stroke, 7.9% with TIA and 27.4% with stroke mimic, whereas 5.1% was equivocal or missing.

The researchers reported that the most common stroke mimics were migraine and other headaches, peripheral or cranial neuropathy and peripheral vertigo.

At 1 month, the prevalence of PTSD was 15.1% for patients with stroke mimic, 6.3% for those with stroke and 5.5% for those with TIA.

After adjusting for age, gender, ethnicity, NIH Stroke Scale, modified Rankin Scale score and prior PTSD, the odds for PTSD at 1 month were higher for patients diagnosed with a stroke mimic compared with those who actually experienced a stroke (OR = 2.99, 95% CI, 1.45-6.18; P < .01) but not TIA (P = .45).

Preexisting PTSD was the only covariate linked to PTSD at 1 month and was associated with a 10-fold increased likelihood across all diagnoses (OR = 10.32; 95% CI, 5.3-20.1; P < .01), according to the study.

“It is important for people who are evaluated for stroke to know they are not alone if they experience flashbacks, disrupted sleep or feel on edge after their medical event. They should feel comfortable and empowered to report any concerning symptoms to their health care team so they can get the help they need,” Chang said in the release.

Reference:

• Experiencing “stroke-like” symptoms may be more traumatic than an actual stroke. https://newsroom.heart.org/news/experiencing-stroke-like-symptoms-may-be-more-traumatic-than-an-actual-stroke. Published Feb. 1, 2024. Accessed Feb. 7, 2024.

Published by:

Sources/Disclosures

Collapse

Source:

Chang M, et al. Abstract Poster WP35. Presented at: International Stroke Conference; Feb. 7-9, 2024; Phoenix.

Disclosures: Chang reports no relevant financial disclosures.

Psychoactive Ibogaine and Magnesium Show Promise for PTSD

 Well, isn't your competent? doctor already treating your PTSD successfully? Maybe ecstasy?

 What is your doctor's EXACT PROTOCOL to prevent your chances of PTSD? If it's not 100% recovery protocols, WHY NOT?

23% chance of stroke survivors getting PTSD

• PTSD (92 posts to July 2012)

Psychoactive Ibogaine and Magnesium Show Promise for PTSD

Summary: Ibogaine, a plant-based psychoactive drug combined with magnesium, effectively reduces PTSD, anxiety, and depression in veterans with traumatic brain injuries (TBI). The study, involving 30 U.S. special forces veterans, showed significant and lasting improvements in mental health and functioning post-treatment.

Ibogaine’s potential extends beyond TBI, offering hope for broader applications in neuropsychiatric conditions like PTSD and depression. The drug’s safety profile and positive results suggest a promising avenue for veterans’ mental health treatment.

Key Fact:

1. Ibogaine, in combination with magnesium, leads to significant and lasting improvements in veterans’ mental health and functioning.
2. This research offers hope for treating traumatic brain injuries (TBI) and broader neuropsychiatric conditions such as PTSD and depression.
3. Ibogaine’s safety profile and effectiveness suggest potential benefits for veterans’ mental health treatment.

Source: Stanford

For military veterans, many of the deepest wounds of war are invisible: Traumatic brain injuries resulting from head trauma or blast explosions are a leading cause of post-traumatic stress disorder, anxiety, depression and suicide among veterans. Few treatments have been effective at diminishing the long-term effects of TBI, leaving many veterans feeling hopeless. 

Now, Stanford researchers have discovered that the plant-based psychoactive drug ibogaine, when combined with magnesium to protect the heart, safely and effectively reduces PTSD, anxiety and depression and improves functioning in veterans with TBI.

Their new study, to be published online Jan. 5 in Nature Medicine, includes detailed data on 30 veterans of U.S. special forces.

“No other drug has ever been able to alleviate the functional and neuropsychiatric symptoms of traumatic brain injury,” said Nolan Williams, MD, an associate professor of psychiatry and behavioral sciences. “The results are dramatic, and we intend to study this compound further.”

Alternative options

Traumatic brain injury is defined as a disruption in the normal functioning of the brain resulting from external forces — such as explosions, vehicle collisions or other bodily impacts. The trauma associated with TBI can lead to changes in the function and/or structure of the brain, which, in turn, contributes to neuropsychiatric symptoms.

Hundreds of thousands of troops serving in Afghanistan and Iraq have sustained TBIs in recent decades, and these injuries are suspected of playing a role in the high rates of depression and suicide seen among military veterans. With mainstream treatment options not fully effective for some veterans, researchers have sought therapeutic alternatives.

Ibogaine is a naturally occurring compound found in the roots of the African shrub iboga, and it has been used for centuries in spiritual and healing ceremonies.

More recently, it has gained interest from the medical and scientific communities for its potential to treat opioid and cocaine addiction, and research has suggested that it increases signaling of several important molecules within the brain, some of which have been linked to drug addiction and depression.

Since 1970 ibogaine has been designated as a Schedule I drug, preventing its use within the U.S., but clinics in both Canada and Mexico offer legal ibogaine treatments.

“There were a handful of veterans who had gone to this clinic in Mexico and were reporting anecdotally that they had great improvements in all kinds of areas of their lives after taking ibogaine,” Williams said. “Our goal was to characterize those improvements with structured clinical and neurobiological assessments.”

Capturing ‘before and after’

Williams and his colleagues at Stanford teamed up with VETS, Inc., a foundation that helps facilitate psychedelic-assisted therapies for veterans. With support from VETS, 30 special operations veterans with a history of TBI and repeated blast exposures, almost all of whom were experiencing clinically severe psychiatric symptoms and functional disabilities, had independently scheduled themselves for treatment with magnesium and ibogaine at a clinic in Mexico.

Before the treatment, Stanford researchers gauged the participants’ levels of PTSD, anxiety, depression and functioning based on a combination of self-reported questionnaires and clinician-administered assessments.

Participants then traveled to a clinic in Mexico run by Ambio Life Sciences, where under medical monitoring they received oral ibogaine along with magnesium to help prevent heart complications that have been associated with ibogaine. The veterans then returned to Stanford for post-treatment assessments.

“These men were incredibly intelligent, high-performing individuals who experienced life-altering functional disability from TBI during their time in combat,” Williams said. “They were all willing to try most anything that they thought might help them get their lives back.”

At the beginning of the study, participants were experiencing clinically significant levels of disability as measured by the World Health Organization Disability Assessment Scale 2.0, which assesses disability in six functional domains, including cognition, mobility, self-care, getting along, life activities and community participation. In addition, 23 met the criteria for PTSD, 14 for an anxiety disorder and 15 for alcohol use disorder. In their lifetimes, 19 participants had been suicidal and seven had attempted suicide.

Life-changing results

On average, treatment with ibogaine immediately led to significant improvements in functioning, PTSD, depression and anxiety. Moreover, those effects persisted until at least one month after treatment — the endpoint of the study.

Before treatment, the veterans had an average disability rating of 30.2 on the disability assessment scale, equivalent to mild to moderate disability. One month after treatment, that rating improved to 5.1, indicating no disability.

Similarly, one month after treatment participants experienced average reductions of 88% in PTSD symptoms, 87% in depression symptoms and 81% in anxiety symptoms relative to how they were before ibogaine treatment. Formal cognitive testing also revealed improvements in participants’ concentration, information processing, memory and impulsivity.

“I wasn’t willing to admit I was dealing with any TBI challenges. I just thought I’d had my bell rung a few times — until the day I forgot my wife’s name,” said Craig, a 52-year-old study participant from Colorado who served 27 years in the U.S. Navy.

“Since [ibogaine treatment], my cognitive function has been fully restored. This has resulted in advancement at work and vastly improved my ability to talk to my children and wife.”

“Before the treatment, I was living life in a blizzard with zero visibility and a cold, hopeless, listless feeling,” said Sean, a 51-year-old veteran from Arizona with six combat deployments who participated in the study and says ibogaine saved his life. “After ibogaine, the storm lifted.”

Importantly, there were no serious side effects of ibogaine and no instances of the heart problems that have occasionally been linked to ibogaine. During treatment, veterans reported only typical symptoms such as headaches and nausea.

Lessons for PTSD, depression and anxiety

Williams and his team are planning further analysis of additional data collected on the veterans but not included in the current study, including brain scans that could help reveal how ibogaine led to improvements in cognition. They also hope to launch future studies to further understand how the drug might be used to treat TBI.

However, they think ibogaine’s drastic effects on TBI also suggest that it holds broader therapeutic potential for other neuropsychiatric conditions.

“In addition to treating TBI, I think this may emerge as a broader neuro-rehab drug,” Williams said. “I think it targets a whole host of different brain areas and can help us better understand how to treat other forms of PTSD, anxiety and depression that aren’t necessarily linked to TBI.”

Funding: The study was independently funded by philanthropic gifts from Steve and Genevieve Jurvetson and another anonymous donor. Stanford received no funding from VETS, Inc. or Ambio.

About this PTSD and psychopharmacology research news

Author: Lisa Kim
Source: Stanford
Contact Lisa Kim – Stanford
Image: The image is credited to Neuroscience News

Original Research: The findings will appear in Nature Medicine

Microbiome and Diet Could Mitigate PTSD Symptoms

 What is your doctor's EXACT PROTOCOL to prevent your chances of PTSD? If it's not 100% recovery protocols, WHY NOT?

23% chance of stroke survivors getting PTSD

The latest here:

Microbiome and Diet Could Mitigate PTSD Symptoms

Summary: Researchers explored the potential link between the Mediterranean diet, the gut microbiome, and PTSD symptoms. Their study, involving 191 participants, revealed that those following a Mediterranean diet exhibited fewer PTSD symptoms.

A notable discovery was the presence of Eubacterium eligens, a bacteria positively associated with key components of the Mediterranean diet, which showed consistent negative correlation with PTSD symptoms.

Key Facts:

1. Adherence to a Mediterranean diet was found to reduce PTSD symptoms.
2. The bacterium Eubacterium eligens, positively associated with Mediterranean diet components, was identified as a potential protective species against PTSD.
3. The study suggests an intricate link between diet, gut microbiome, and mental health, with the Mediterranean diet offering potential therapeutic benefits.

Source: Brigham and Women’s Hospital

The human gut microbiome has a significant impact on our health. Research has shown that it can influence the development and response of emotions, but the relationship between posttraumatic stress disorder (PTSD) and the gut microbiome has been unexplored. PTSD is a fear-based mental health disorder that develops in some individuals who experience a disturbing and horrifying situation involving severe injury, actual or threat of death, or violence.

A new study by investigators from Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system, and Harvard T.H. Chan School of Public Health systematically investigated the relationship between PTSD, diet, and the gut microbiome. Their study found that participants who adhered to a Mediterranean diet experienced decreased PTSD symptoms.

Their results are published in Nature Mental Health.

“There is a very intriguing relationship between the human gut microbiome and the brain,” said co-corresponding author Yang-Yu Liu, PhD, of the Channing Division of Network Medicine within the Department of Medicine at Brigham and Women’s Hospital.

“Through our study, we examined how factors, like diet, are associated with PTSD symptoms. While further research is needed, we are closer to being able to provide dietary recommendations for PTSD prevention or amelioration.”

The burden of PTSD often extends beyond the individual; family members, the healthcare industry and society are also affected by the mental health disorder. In addition, individuals with PTSD have an increased risk of developing chronic diseases such as coronary heart disease, stroke, diabetes, autoimmune diseases and premature death. Understanding the role of diet and the microbiome could improve recommendations and outcomes for patients with PTSD.     

“Examining the gut-brain axis can provide insights on the interdependence of mental and physical health,” said co-corresponding author Karestan Koenen, PhD, of the Department of Epidemiology at Harvard T.H Chan School of Public Health. “Our findings suggest the PTSD and human gut microbiome relationship is a promising area of research that may lead to recommendations for alleviating the down-stream negative health consequences of PTSD.”

The team collected data from 191 participants in sub-studies of the Nurses’ Health Study-II (NHS-II), which included the Mind-Body Study (MBS) and the PTSD Substudy. Participants were assigned to three groups: probable PTSD, exposed to trauma but no PTSD, and no trauma exposure.

All the participants submitted two sets of four stool samples, once at the beginning of the study and again six months later. The samples were collected to provide microbial DNA information and to confirm that the participant’s gut microbiome was stable over six months.

The team evaluated the associations between overall microbiome structure and host factors, including PTSD symptoms, age, body mass index (BMI) and dietary information. From this evaluation, the researchers found several host factors (BMI, depression, and antidepressants) associated with the microbiome structure.

Next, the researchers assessed the relationship between the available dietary information and PTSD symptoms. The team found that participants who adhered to a Mediterranean diet experienced fewer PTSD symptoms. In particular, they found that the consumption of red and processed meats was positively associated with PTSD symptoms, while the consumption of plant-based foods was negatively associated with PTSD symptoms. 

Lastly, the team employed the generalized microbe–phenotype triangulation (GMPT) method to examine the link between PTSD symptoms and the gut microbiome signatures, aiming to identify putative PTSD protective species. They identified Eubacterium eligens as the top PTSD putative protective species.  

To test the consistency of this signature over time, the team found that the inverse association of E. eligens abundance with PTSD symptoms was highly consistent across all four time points.

They further demonstrated that E. eligens was positively associated with the enriched components of the Mediterranean diet (such as vegetables, fruits, and fish) and that E. eligens was negatively associated with red/processed meat, which people following a Mediterranean diet limit or avoid.

The team notes limitations to their study, including using a short screening scale for PTSD (instead of a formal clinical diagnosis of PTSD). However, the results offer insights for future studies examining other mental health disorders and dietary interventions to improve recommendations to alleviate or prevent symptoms.

“It’s exciting that our results imply that the Mediterranean diet may provide potential relief to individuals experiencing PTSD symptoms,” said Liu. “We are eager to learn more about the relationship between PTSD, diet, and the gut microbiome. In a future study, we will attempt to validate the efficacy of probiotics as a method to prevent PTSD.”

Disclosures:  The authors declare no competing interests.

Funding: This work was supported by the National Institutes of Health (R01AI141529, R01HD093761, RF1AG067744, UH3OD023268, U19AI095219, and U01HL089856, R01MH101269), the Harvard T.H. Chan School of Public Health Dean’s Fund for Scientific Advancement Incubation Award, the Biology of Trauma Initiative (BTI) of Broad Institute, the Traumatic Brain Injury and Psychological Health Research Program (Focused Program Award) under Award No. (w81XWH-22-S-TBIPH2) endorsed by the Office of the Assistant Secretary of Defense for Health Affairs in the Department of Defense.

About this PTSD, diet, and microbiome research news

Author: Angela Christoforos
Source: Brigham and Women’s Hospital
Contact: Angela Christoforos – Brigham and Women’s Hospital
Image: The image is credited to Neuroscience News

Original Research: Closed access.
“Association of probable post-traumatic stress disorder with dietary pattern and gut microbiome in a cohort of women” by Ke, S. et al. Nature Mental Health

Harnessing Psilocybin to Treat PTSD

Isn't your doctor already prescribing psilocybin for you?

23% chance of stroke survivors getting PTSD

So what  is your doctor doing to prevent your PTSD?

Do you prefer your doctor incompetence in this NOT KNOWING? OR NOT DOING?

 

Psilocybin: Magic mushrooms have been found to boost neurogenesis. August 2013

Psilocybin induces time-dependent changes in global functional connectivity: Psi-induced changes in brain connectivity February 2020 

Psilocybin induces rapid and persistent growth of dendritic spines in frontal cortex in vivo

The latest here:

 

Harnessing Psilocybin to Treat PTSD

Summary: Psilocybin, the active ingredient in magic mushrooms, can restore fear extinction and help treat post-traumatic stress disorder (PTSD). The study found that psilocybin promotes the growth of new neurons and synapses in the hippocampus, a brain region involved in memory formation, and was found to reverse the decline in proteins associated with neuroplasticity and fear extinction. The findings provide a promising potential for using psilocybin in the treatment of PTSD.

Key Facts:

1. The study investigated whether psilocybin, the active component in magic mushrooms, could be the key to restoring fear extinction in patients with PTSD by increasing neuroplasticity in the hippocampus.
2. Psilocybin-treated mice exhibited significantly improved fear extinction compared to untreated ones, with the hippocampi of psilocybin-treated mice having dendrites similar to those of control mice, whereas untreated mice exhibited a sharp decline in dendritic complexity and density.
3. Psilocybin is currently considered a ‘breakthrough therapy’ for depression, a condition that frequently occurs alongside PTSD, with multiple studies showing that it promotes neuronal growth and the formation of new synapses, which could explain its antidepressant effects.

Source: Cactus Communications

Post-traumatic stress disorder (PTSD) is a mental health condition triggered by a terrifying event. Its symptoms include flashbacks, nightmares, and severe anxiety. Most people experience PTSD at some point in their lives, with symptoms slowly resolving with time.

For many, however, the symptoms are persistent, debilitating, and difficult to treat. This is because PTSD halts the ‘fear extinction’ process.

Put simply, patients have trouble learning that certain harmless stimuli they associated with a traumatic event or memory pose no immediate threat to them.

Although science does not fully understand the mechanisms by which PTSD impairs fear extinction, some studies have found that patients with PTSD have a smaller hippocampus (a region of the brain) than healthy people.

Moreover, it appears that neuroplasticity—the brain’s ability to change and adapt over time—appears to be reduced in the hippocampus of patients with PTSD. Given that this region is involved in memory formation and retrieval, improving hippocampal neuroplasticity may restore fear extinction in patients with PTSD.

Against this backdrop, a research team from China investigated whether psilocybin, the active component in magic mushrooms, could be the key to restore fear extinction and thus help treat PTSD. The study, led by Dr. Liming Zhang from Beijing Key Laboratory of Neuropsychopharmacology and Dr. Guyan Wang from Capital Medical University was published in the Chinese Medical Journal on March 30, 2023.

But why psilocybin? Psilocybin is currently considered a ‘breakthrough therapy’ for depression, a condition that frequently occurs alongside PTSD. Moreover, multiple studies have shown that psilocybin promotes neuronal growth and the formation of new synapses, which could explain its antidepressant effects. Thus, the research team hypothesized that psilocybin would also be useful for restoring fear extinction by increasing neuroplasticity in the hippocampus.

They found that the hippocampi of psilocybin-treated mice had dendrites (tree-like structures in a brain cell that receive signals) similar to those of control mice, whereas untreated mice exhibited a sharp decline in dendritic complexity and density. Credit: Neuroscience News

“Our study is the first to investigate the long-term effect of psilocybin on the facilitation of fear extinction and to assess whether this effect is mediated by the promotion of hippocampal neuroplasticity,” highlights Dr. Wang.

To put this theory to the test, they induced a sound-based fear conditioning (FC) in mice and studied their freezing time in response to the induced fear. Briefly, the mice were first presented with a harmless neutral stimulus (NS; a 5 kHz tone for 30 seconds) followed by an aversive stimulus (AS; an electric shock to the feet). This setup conditioned the mice to freeze in fear whenever they heard a 5 kHz tone.

Two days later, some of these fear-conditioned mice were administered a single dose of psilocybin and given fear reduction training, which included 12 NS fear resolution training sessions. The mice were then tested for short- and long-term fear resolution. The researchers wanted to see if psilocybin from naked mushroom extract facilitated fear extinction, and if the mice spent less time frozen in fear.

Psilocybin-treated mice, however, exhibited significantly improved fear extinction compared to the untreated ones. But how did this happen?

To shed light on the possible mechanisms behind their observations, the team dissected and analyzed the brains of mice used in their experiments.

They found that the hippocampi of psilocybin-treated mice had dendrites (tree-like structures in a brain cell that receive signals) similar to those of control mice, whereas untreated mice exhibited a sharp decline in dendritic complexity and density. Furthermore, psilocybin reversed the decline in proteins associated with neuroplasticity and fear extinction.

The findings of this study improve our understanding of the restorative effects of psilocybin on the brain. Currently, only two drugs are approved for treating PTSD, both with limited efficacy and severe side effects. Thus, finding alternative treatments is paramount, and this study may put us one step closer to this goal.

“Collectively, there is increasing evidence suggesting that psilocybin has the potential to treat PTSD. Our findings suggest promising potentials of psilocybin for the treatment of PTSD at the preclinical level and provide impetus for future clinical studies,” Dr. Wang concludes.

About this PTSD and psychopharmacology research news

Author: Peifang Wei
Source: Cactus Communications
Contact: Peifang Wei – Cactus Communications
Image: The image is credited to Neuroscience News

Original Research: Open access.
“Psilocybin facilitates fear extinction in mice by promoting hippocampal neuroplasticity” by Liming Zhang et al. Chinese Medical Journal

Psychedelics' Healing Potential for Minds in Need

Because your doctors have nothing to get you 100% recovered and thus prevent PTSD and depression they should be vastly interested in this. Is this "critical periods" available immediately post stroke? WHOM will answer that question?

If your doctors are having to treat depression and PTSD post stroke,  they are COMPLETE FUCKING FAILURES!

23% chance of stroke survivors getting PTSD

• 33% survivor depression (29 posts to September 2016)

 

Psychedelics' Healing Potential for Minds in Need

In a recent study published in Nature, researchers at Johns Hopkins University explored the potential therapeutic effects of psychedelic drugs on the brain. The study focused on the concept of "critical periods" in brain development, which are times when the brain is more open to new information and learning. The researchers found that psychedelic drugs could potentially "reopen" these critical periods, leading to improved recovery from trauma and other mental health conditions.

The study involved administering psychedelic drugs to mice and observing their ability to learn from their environment. The results showed that all of the psychedelic drugs tested, including MDMA, LSD, and psilocybin, were able to open critical periods of social learning for varying lengths of time. For example, ketamine opened the critical period for 2 days, while the other drugs opened critical periods for 2 to 4 weeks.

Lead researcher Gul Dolen, MD, PhD, emphasized the importance of establishing an intention for psychedelic therapy and being guided through the experience by a therapist. She also cautioned that patients need to be carefully supported after the therapy due to their heightened state of vulnerability.

Other experts in the field see promise in the study's findings. Matthew Lowe, PhD, executive director and chief science officer for Unlimited Sciences, a psychedelics research nonprofit, believes that psychedelic drugs could help break negative behavior patterns and treat conditions such as depression, PTSD, and addiction.

The growing interest in psychedelic therapy is reflected in changing legislation. Several states have made moves toward decriminalization or permitting the use of psychedelics under medical supervision. In fact, Australia recently became the first country to allow psilocybin and MDMA to be prescribed by doctors to treat psychiatric conditions. The U.S. may also potentially approve MDMA for therapy later this year.

While the research is still in its early stages, the potential therapeutic applications of psychedelic drugs are promising. Opening critical periods in the brain could have wide-ranging benefits, including the treatment of physical disabilities, addiction, and even hearing loss. As legislative attitudes toward psychedelics continue to evolve, more opportunities for research and clinical trials are likely to emerge, leading to improved mental health treatment options for millions of individuals.

Supportive psychological therapy can effectively treat post-stroke post-traumatic stress disorder at the early stage

NO! You're trying to solve a secondary problem, solve the primary problem of 100% recovery and you don't need to worry about these secondary problems. DO YOU NOT UNDERSTAND?

Supportive psychological therapy can effectively treat post-stroke post-traumatic stress disorder at the early stage

Che Jiang^1†, Zhensheng Li^2†, Chenggang Du³, Xiwu Zhang¹, Zhuang Chen¹, Gaoquan Luo¹, Xiaona Wu¹, Jiajia Wang¹, Yan Cai¹, Gang Zhao^1*‡ and Hongmin Bai^1*‡

• ¹Department of Neurosurgery, General Hospital of Southern Theatre Command, Guangzhou, China
• ²Department of Neurology, General Hospital of Southern Theatre Command, Guangzhou, China
• ³Department of Health Service, General Hospital of Southern Theatre Command, Guangzhou, China

Post-traumatic stress disorder (PTSD) can develop after stroke attacks, and its rate ranges from 4 to 37% in the stroke population. Suffering from PTSD not only decreases stroke patient’s quality of life, but also relates to their non-adherence of treatment. Since strokes often recur and progress, long-term medical management is especially important. However, previous studies generally focused on the epidemiological characteristics of post-stroke PTSD, while there are literally no studies on the psychological intervention. In our study, 170 patients with a first-ever stroke during the acute phase were recruited. They were randomized into Psycho-therapy group 1 and Control group 1, and were administered with preventive intervention for PTSD or routine health education, respectively. At 2-month follow-up, PTSD symptoms were evaluated. Participants who were diagnosed with post-stroke PTSD were further randomized into Psycho-therapy group 2 and Control group 2, and received supportive therapy or routine health counseling, respectively. At 6-month follow-up (1°month after the therapy was completed), PTSD symptoms were re-evaluated. Our results showed that at 2-month, the PTSD incidence in our series was 11.69%, and the severity of stroke was the only risk factor for PTSD development. The preventive intervention was not superior to routine health education for PTSD prevention. At 6-month, results indicated the supportive therapy did have a fine effect in ameliorating symptoms for diagnosed PTSD patients, superior to routine health counseling. Thus, our study was the first to provide evidence that the supportive therapy was effective in treating post-stroke PTSD early after its diagnosis. This clinical trial was preregistered on www.chictr.org.cn (ChiCTR2100048411).

Introduction

Post-traumatic stress disorder (PTSD) is a mental disorder which may develop after individuals exposed to traumatic events. The common events include accidents, combat, physical attack, childhood abuse, robbery, natural disasters, and so on. According to the Statistical Manual of Mental Disorders-version 5 (DSM-5) (American Psychiatric Association [APA], 2013), PTSD is characterized by four clusters of symptoms including persistent intrusive memories, avoidance of reminders, negative alterations in mood and cognition, and hyper-arousal (American Psychiatric Association [APA], 2013). PTSD is also associated with increased risk of drug abuse, suicide, and other mental disorders (Kessler et al., 1995). In the general population, the lifetime incidence of trauma exposure is estimated to be over 50%, and the incidence of PTSD to be 3–7% (McManus et al., 2007; Kessler et al., 2017).

Stroke presents one of the leading causes of death and disability worldwide (Béjot et al., 2016). Secondary psychological symptoms such as depression and anxiety commonly occur (Towfighi et al., 2017). Stroke features sudden onset of neurologic deficits and is potentially life-threatening, thus conforms to the definition of traumatic events in post-traumatic disorder (PTSD). Emerging studies have focused on post-stroke PTSD in the past two decades. The prevalence of PTSD (or PTSD symptom) in stroke population ranged from 4 to 37% (Garton et al., 2017), and even mild stroke (Bruggimann et al., 2006) and transient ischemic stroke (TIA) (Kiphuth et al., 2014) can cause PTSD. Since strokes often recur and progress, long-term medical management is especially important. Suffering from PTSD not only decreases stroke patient’s quality of life (QOL) (Noble et al., 2008), but also relates to their non-adherence of treatment (Kronish et al., 2012; Edmondson et al., 2013a).

Psychotherapies for prevention or treatment of PTSD primarily include exposure therapy, cognitive processing therapy (CPT), and eye movement desensitization and reprocessing (EMDR). After treatment, although most patients can attain clinically meaningful symptom improvement, approximately two-thirds retained PTSD diagnosis (Maria et al., 2015). On the other hand, there are also pharmacotherapeutic ways for the management of PTSD, such as selective serotonin reuptake inhibitors (SSRIs), norepinephrine and dopamine reuptake inhibitors (NDRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), anticonvulsants, antidepressants, and benzodiazepines (Akhtar and Pilkhwal Sah, 2021). Yet, they showed limited efficacy, excessive adverse effects, and lower patient compliance. As for post-stroke PTSD, previous studies generally focused on the rate and risk factors, while there are literally no studies on its prevention or treatment (Garton et al., 2017). Compared with PTSD caused by non-medical factors, post-stroke PTSD has its unique pathophysiological characteristics and may require different psychological therapies.

Within the first 3°months of a traumatic event, the traumatic memory remains fragmented (Van der Kolk, 1994; Foa et al., 2010; Shapiro, 2012). Early psychological intervention conducted during this period may keep these memories from accumulation (McFarlene, 2010), so it is crucial for the prevention and treatment of PTSD. Thus, our study focused on the early psychological intervention for the prevention and treatment of post-stroke PTSD. It is argued that stroke patients’ maladaptive coping strategies and their exaggerated belief of stroke’s harmfulness may be the main cause for PTSD. Therefore, extended health education in the acute stage of the stroke, guiding patients to adopt suitable coping styles, and correctly understand the risk of stroke seems likely to help prevent secondary PTSD (Noble et al., 2008; Kiphuth et al., 2014). As for the treatment of post-stroke PTSD, we hypothesized that supportive therapy with medical counseling implemented early after the PTSD diagnosis may be effective. In our prospective clinical trial, we showed the efficacy of supportive therapy, but not extended health education.

More at link.