PTSD and Alcohol Use Disorder: A Critical Review of Pharmacologic Treatments PMC

This study examined how alcohol use disorder (AUD) patients with post-traumatic stress disorder (PTSD) differed from those without PTSD in terms of demography, drinking patterns and C-reactive protein, inflammatory cytokines, tryptophan metabolism parameters, and brain-derived neurotrophic factor (BDNF). One of the three studies clearly found that sertraline was more effective in decreasing PTSD symptoms than placebo (Hien et al. 2015) while another found a trend-level advantage of sertraline over placebo on PTSD outcomes (Brady). The third study (Petrakis et al. 2012) used an active control (the antidepressant desipramine) and compared it to paroxetine; both antidepressants were equally effective in significantly decreasing PTSD symptoms over time but without a placebo comparison it is difficult to fully interpret these data. Neither of the sertraline studies found the serotonergic antidepressant medications more effective than placebo in decreasing alcohol use outcomes. One study (Petrakis et al. 2012) found that the active control, desipramine, was more effective than the serotonergic medication in terms of alcohol use outcomes.

If you’ve decided to take a break from drinking, it’s wise to adapt your social activities accordingly. Consider alternatives like going out for dinner, brunch, or enjoying non-drinking-friendly activities such as a trip to the cinema or a live sports event. If you fear peer pressure might be overwhelming, it’s perfectly acceptable to decline invitations. As you progress in your alcohol-free or alcohol-reduced journey, you’ll find that navigating social situations becomes easier. Embarking on a journey to cut down or go alcohol-free is a significant step towards a healthier, happier life. To help you along this empowering path, it’s essential to get clear on your reasons for making this positive decision.

The Link Between Alcohol Misuse and PTSD

By shifting your focus to these positive actions, you can dissipate the desire to drink and naturally boost your serotonin levels. Start by creating a list of your “whys.” https://ecosoberhouse.com/article/13-actionable-tips-to-stay-sober-at-different-times/ Why do you want to change your relationship with alcohol? It’s a good practice to keep this list at the back of a notebook, allowing you to add to it over time.

One 2022 review investigated the effectiveness of psychological interventions, such as exposure-based therapy and CBT, for people with adverse childhood experiences at risk of PTSD and SUD. One 2020 study found that people who experienced childhood trauma, particularly emotional and physical abuse, had a statistically higher lifetime rate of AUD. Individuals with CPTSD may use substances like alcohol or drugs to cope with their emotional distress and psychological symptoms resulting from prolonged trauma exposure. Complex trauma typically arises from prolonged and repetitive exposure to traumatic events.

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These surveys include the Epidemiological Catchment Area (ECA) program, the National Comorbidity Survey (NCS), and the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). It is possible for PTSD to be successfully treated many years after the traumatic event occurred, which means it is never too late to seek help. For some, the first step may be watchful waiting, then exploring therapeutic options such ptsd and alcohol abuse as individual or group therapy – but the main treatment options in the UK are psychological treatments such as Eye Movement Desensitisation Reprogramming (EMDR) and Cognitive Behavioural Therapy (CBT). The term alcohol usage disorder covers a broad spectrum that affects individuals differently, and many don’t fit the conventional stereotype. Some may indulge in a nightly glass of wine but find it challenging to stop at one.

Symptoms of common mental disorder (CMD) including somatic symptoms, anxiety/insomnia, social dysfunction and depression were measured using the General Health Questionnaire 12 (GHQ-12) [45]. This assessed symptoms of CMD in ‘the last few weeks’, with caseness defined as a score of 4 or above (out of a possible 12) [46]. Our Medical Affairs Team is a dedicated group of medical professionals with diverse and extensive clinical experience who actively contribute to the development of our content, products, and services.

Treatment for Alcohol usage disorders and PTSD

In a longitudinal study conducted by Chilcoat and Breslau (19), 1,007 adults were reevaluated 3 and 5 years after an initial assessment. The researchers found that preexisting substance abuse did not increase subjects’ risk of subsequent exposure to trauma or their risk of developing PTSD after exposure to trauma. The relationship between exposure to trauma and increased risk for development of a substance use disorder was found to be specific to PTSD, as exposure to trauma without subsequent development of PTSD did not increase risk for development of a substance use disorder (19). Of note, one study of patients with cocaine dependence and PTSD found that patients in whom PTSD preceded the onset of cocaine use were significantly more likely to suffer from comorbid major depression and to use benzodiazepines and opiates than were patients in whom PTSD developed after the onset of cocaine use (12). The consistent association between PTSD and AUD has led to debate about which condition develops first.

Although promising interventions exist, more research is needed to assess the degree to which current interventions are effective for service members and veterans. Also, new interventions that target this population should be developed and tested. When patients who drink heavily report anxiety, it helps to create a timeline with them to discern whether the anxiety is alcohol-induced or, instead, a pre-existing or primary anxiety disorder, which can help set expectations and a treatment plan. Sample timeline queries include the ages of onset of anxiety symptoms and of alcohol use, the longest period of abstinence, the presence or lack of anxiety symptoms during phases of alcohol drinking and extended phases of abstinence, and the family history of anxiety disorders and of AUD.

PTSD and Alcohol Use Disorder: A Critical Review of Pharmacologic Treatments

Different psychotherapeutic techniques and therapies may be used to treat comorbid AUD and PTSD. Psychotherapy, also known as talk therapy, can help people identify their emotions and triggers for symptoms to help them develop better coping mechanisms. The type of treatment that is best for you can depend on the type of trauma you experienced. Since the late 1970s, several U.S. surveys have collected information on mental health conditions, including AUD, SUD, and PTSD.

• The hallmarks of anxiety disorders are excessive and recurrent fear or worry episodes that cause significant distress or impairment and that last for at least 6 months.
• Results from this study suggested an advantage of prazosin over placebo with greater reductions in percent drinking days and heavy drinking days for the prazosin group compared to the placebo group.
• The first prazosin study involved veterans and civilians with PTSD and AD (Simpson et al. 2015) was originally designed as a 12-week study, but because of higher than expected dropout the study was scaled back to 6-weeks.
• Specifically, we examined the relationship between AUD-PTSD comorbidity and serum levels of CRP, inflammatory cytokines, tryptophan metabolism parameters, and BDNF.
• However, these cross-sectional results do not clarify the direction of the association.