New drug can dramatically reduce flashbacks and nightmares in PTSD patients

Post-traumatic stress disorder (PTSD) rings a bell for many, due to its rampant references in pop culture and, more importantly, its prevalence in today’s society. It is only likely that this disorder, which develops after shocking or dangerous events, would unfortunately affect the lives of many people.

Medical researchers have worked hard to try to find solutions to effectively combat this disease and its manifestations. Unfortunately, the neurological mechanisms of PTSD are unclear, and without knowing it exactly, trying to find a cure is a shot in the dark.

Fortunately, a group of Japanese researchers from the Sogo PTSD Institute, Sogokai Medical Corporation, Japan, led by Dr. Masanobu Sogo, appear to have made a breakthrough in the treatment of PTSD! They identified a drug called trihexyphenidyl, which can dramatically reduce the flashbacks and nightmares experienced by patients with PTSD, according to a study published in Brain and behavior, an open access sister journal of ACTA J.

Trihexyphenidyl is a central anticholinergic drug used to manage conditions such as parkinsonism and to alleviate several side effects caused by drugs acting on the central nervous system (CNS). It works by blocking the activity of a neurotransmitter, acetylcholine, in the CNS. Interestingly, it has been available for therapeutic use for about 66 years.

So what prompted researchers to take this drug? In 2009, they met a patient who suffered from severe flashbacks and nightmares related to PTSD for 9 years, was diagnosed with bacterial diarrhea at another hospital, and gave him a drip infusion containing antibiotics and bromide. butyl scopolamine (SB), which is a peripheral anticholinergic that does not cross the blood brain barrier (BBB, penetration rate 0.01%). Twenty minutes after the infusion, the patient’s flashbacks are completely gone!

Since SB is a “peripheral” anticholinergic agent, it should not be able to cross the BBB, but it is likely that the patient’s brain was in a severe cerebral arousal state due to PTSD. There are eight acetylcholine basal ganglia in the brain, the largest of which, Meynert’s nucleus, is closely associated with the permeability of BBB.

The researchers hypothesized that due to abnormal excitation of Meynert’s basal ganglia, SB enters the brain and activates anticholinergic action to suppress the abnormal secretion of acetylcholine from memory-related circuits. acetylcholine centered on Meynert’s basal ganglia, thus eliminating flashbacks.

From this valuable clinical experience, they understood that PTSD is generated by a Meynert-centered acetylcholine memory-related circuit. On this basis, Dr Sogo and his team considered the use of a central anticholinergic agent: trihexyphenidyl.

Excited by the discovery, the researchers then designed an exploratory study to test whether trihexyphenidyl was effective against similar symptoms in other patients with PTSD. They administered trihexyphenidyl to 34 patients with PTSD, who had already received psychiatric treatment for several years with no therapeutic benefit, and determined its effect through interviews.

A significant 88% of the patients analyzed reported mild or no nightmares related to PTSD. Likewise, 79% of patients analyzed reported similar responses for PTSD-related flashbacks. Notably, the researchers found that trihexyphenidyl has efficacy and a rapid onset (1-2 days) in the treatment of nightmares and flashbacks associated with PTSD. Clearly, trihexyphenidyl is the silver bullet for PTSD!

To our knowledge, this is the first pharmacological report describing the new use of trihexyphenidyl for PTSD-related nightmares, which does not respond to conventional psychiatric treatment. “

Dr. Masanobu Sogo, Study Leader, Sogo PTSD Institute, Sogokai Medical Corporation, Japan

Although more studies are needed to prove the mechanism of PTSD, reusing trihexyphenidyl to treat PTSD would be a promising turn of events, as the drug is inexpensive and has no side effects. Hope for PTSD patients with the discovery of trihexyphenidyl!