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Recent Developments in Alcoholism pp 49–68Cite as

Biological Mechanisms in Posttraumatic Stress Disorder Relevance for Substance Abuse

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Abstract

Recent studies suggest a significant biological contribution to posttraumatic stress disorder (PTSD). In particular, central catecholamine and endogenous opioid systems have been implicated both in this syndrome and in substance abuse. We review relevant animal and human studies that support these hypotheses and suggest that this overlap may contribute to the incidence of substance abuse in PTSD. The animal studies have primarily employed the learned helpless and conditioned emotional response models and have included assessments of brain catecholamines, locus ceruleus activity, and behavioral correlates in rodents and nonhuman primates. Human studies have used only indirect measures to assess these variables. However, both therapeutic approaches and attempts at self-medication for PTSD have supported this hypothesis.

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References

  1. Robins LN: The Vietnam Drug User Returns. Special Actions Office Monograph, Series A, No. 2, 1974. Washington, DC, US Government Printing Office, 1974.

    Google Scholar 

  2. Figley CR (ed): Stress Disorders among Vietnam Veterans: Theory, Research, and Treatment. New York, Brunner/Mazel, 1978.

    Google Scholar 

  3. van der Kolk B, Greenberg M, Boyd H, Krystal J: Inescapable shock, neurotransmitters, and addiction to trauma: Toward a psychobiology of post traumatic stress. Biol Psychiatry 20:314–325, 1985.

    PubMed  Google Scholar 

  4. Sierles FS, Chen J-J, McFarland RE, Taylor MA: Posttraumatic stress disorder and concurrent psychiatric illness: A preliminary report. Am J Psychiatry 140:1177–1179, 1983.

    PubMed  CAS  Google Scholar 

  5. Davidson J, Lipper S, Kilts CD, et al: Platelet MAO activity in posttraumatic stress disorder. Am J Psychiatry 142:1341–1343, 1985.

    PubMed  CAS  Google Scholar 

  6. Yager T, Laufer R, Gallops M: Some problems associated with war experience in men of the Vietnam generation. Arch Gen Psychiatry 41:327–333, 1984.

    PubMed  CAS  Google Scholar 

  7. Mirin SM, McKenna GJ: Combat zone adjustment: The role of marihuana use. Milit Med 140:482–484, 1975.

    CAS  Google Scholar 

  8. Krystal H: Trauma and affects. Psychoanal Stud Child 33:81–116, 1978.

    PubMed  CAS  Google Scholar 

  9. Krystal H, Raskin H: Drug Dependence: Aspects of Ego Function. Detroit, Wayne State University Press, 1970.

    Google Scholar 

  10. Khantzian EJ, Mack JE, Schatzberg AF: Heroin use as an attempt to cope: Clinical observations. Am J Psychiatry 131:160–164, 1974.

    PubMed  CAS  Google Scholar 

  11. Lacoursiere RB, Bodfrey KE, Ruby LM: Traumatic neurosis in the etiology of alcoholism: Viet Nam combat and other trauma. Am J Psychiatry 137:966–968, 1980.

    PubMed  CAS  Google Scholar 

  12. Campbell CM: The role of instinct, emotion and personality in disorders of the heart. JAMA 71:1621–1626, 1918.

    Google Scholar 

  13. Bury JS: Pathology of war neuroses. Lancet 1:97–99, 1918.

    Google Scholar 

  14. Kardiner A: The Traumatic Neuroses of War. Psychosomatic Medicine Monograph II-III. Washington, DC, National Research Council, 1941.

    Google Scholar 

  15. Hartshorne H: On heart disease in the army. Am J Med Sci 47:89–92, 1863.

    Google Scholar 

  16. DaCosta JM: On irritable heart: A clinical study of a form of functional cardiac disorder and its consequences. Am J Med Sci 61:17–52, 1871.

    Google Scholar 

  17. Fraser F, Wilson RM: The sympathetic nervous system and the “irritable heart of soldiers.” Br Med J 2:27–29, 1918.

    PubMed  CAS  Google Scholar 

  18. Peabody FW, Clough HD, Sturgis CC, et al: Effects of the injection of epinephrin in soldiers with “irritable heart.” JAMA 71:1912–1915, 1918.

    Google Scholar 

  19. Cannon WB: Bodily Changes in Pain, Fear, and Rage. New York, Appleton, 1915.

    Google Scholar 

  20. Pavlov IP: Thuong Conditioned Reflexes, trans. G.V. Anrep. London, Oxford University Press, 1927.

    Google Scholar 

  21. Crile G: Results in 152 denervations of the adrenal glands in treatment of neurocirculatory asthenia. Military Surgeon 87:509–513, 1940.

    Google Scholar 

  22. Dent RRM, Guilleminault G, Albert LH, et al: Diurnal rhythm of plasma immunoreactive beta-endorphin and its relationship to sleep stages and plasma rhythms of Cortisol and prolactin.J Clin Endocrinol Metab 52:942–947, 1981.

    PubMed  CAS  Google Scholar 

  23. Dobbs D, Wilson WP: Observations on persistence of war neurosis. Dis Nerv Sys 21:40–46, 1960.

    Google Scholar 

  24. Blanchard EB, Kolb LC, Pallmeyer TP, Gerardi RJ: A psycho-physiologic study of posttraumatic stress disorder in Vietnam veterans. Psychiatr Q 54:220–228, 1983.

    Google Scholar 

  25. Brende JO: Electrodermal responses in post-traumatic syndromes.J Nerv Ment Dis 170:352–361, 1982.

    PubMed  CAS  Google Scholar 

  26. Malloy PE, Fairbank JA, Keane TM: Validation of a multimethod assessment of post-traumatic stress disorder in Vietnam veterans.J Consult Clin Psychol 51:488–494, 1983.

    PubMed  CAS  Google Scholar 

  27. Kosten TR, Mason JW, Giller EL, et al: Sustained urinary norepinephrine elevation in posttraumatic stress disorder. Psychoneuroendocrinology 12:13–20, 1987.

    PubMed  CAS  Google Scholar 

  28. Kopin IJ: Metabolic degradation of catecholamines. The relative importance of different pathways under physiological conditions and after administration of drugs, in Blaschko H, Muscholl E (eds): Catecholamines. Handbuch der Experimentellen Pharmakologie, Vol 33. Berlin, Springer-Verlag, 1972, pp 271–282.

    Google Scholar 

  29. Davidson JRT, McLeod MN, Turnbull CD, et al: Platelet monoamine oxidase activity and the classification of depression. Arch Gen Psychiatry 37:771–776, 1980.

    PubMed  CAS  Google Scholar 

  30. Gudeman JE, Schatzberg AF, Samsom JA, et al: Toward a biochemical classification of depressive disorders VI: Platelet MAO activity and clinical symptoms in depressed patients. Am J Psychiatry 139:630–633, 1982.

    PubMed  CAS  Google Scholar 

  31. Giller EL Jr, Hall H: Platelet MAO activity in recovered alcoholics after long-term abstinence. Am J Psychiatry 140:114–115, 1983.

    PubMed  Google Scholar 

  32. Sullivan JL, Stanfield C, Schanberg S, et al: Platelet monoamine oxidase activity and serum dopamine beta-hydroxylase activity in chronic alcoholics. Arch Gen Psychiatry 35:1209–1212, 1978.

    PubMed  CAS  Google Scholar 

  33. Selye H: A syndrome produced by diverse noxious agents. Nature 196:32, 1936.

    Google Scholar 

  34. Kendall JW: Pituitary adrenocortical dysfunction in severe depressive illness, in Brown GM, Koslow SH, Reichlin S, (eds): Neuroendocrinology and Psychiatric Disorder. New York, Raven Press, 1984, pp. 201–207.

    Google Scholar 

  35. Mason JW: A review of psychoendocrine research on the sympathetic-adrenal medullary system. Psychosom Med 30:631–653, 1968.

    PubMed  Google Scholar 

  36. Mason JW, Giller EL, Kosten T, et al: Urinary free-cortisol levels in posttraumatic stress disorder patients.J Nerv Ment Dis 174:145–159, 1986.

    PubMed  CAS  Google Scholar 

  37. Price LH, Charney DS, Rubin AL, Heninger GR: Alpha-2 adrenergic receptor function in depression: The Cortisol response to yohimbine. Arch Gen Psychiatry 43:849–858, 1986.

    PubMed  CAS  Google Scholar 

  38. Reisine T, Heisler S: Desensitization of beta adrenergic receptors linked to adrenocorticotropin secretion.J Pharmacol Exp Ther 227:107–114, 1983.

    PubMed  CAS  Google Scholar 

  39. Cohen MR, Pickar D, Dubois M: The role of the endogenous opioid system in the human stress response. Psychiatr Clin North Am 6:457–471, 1983.

    PubMed  CAS  Google Scholar 

  40. Kolb LC, Burris BC, Griffiths S: Propranolol and Clonidine in the treatment of the chronic post traumatic stress disorders of war, in van der Kolk BA (ed): Post Traumatic Stress Disorder: Psychological and Biological Sequelae. Washington, DC, American Psychiatric Press, 1984, pp 98–105.

    Google Scholar 

  41. Charney DS, Brier A, Jatlow PI, Heninger GR: Behavioral, biochemical, and blood pressure responses to alprazolam in healthy subjects: Interactions with yohimbine. Psychopharmacology 88:133–140, 1986.

    PubMed  CAS  Google Scholar 

  42. Dunner FJ, Edwards WP, Copeland PC: Clinical efficacy of alprazolam in PTSD patients. Program and Papers on New Research. American Psychiatric Assoc. 138th Annual Meeting. Los Angeles, APA, 1985, p 50.

    Google Scholar 

  43. Hogben GL, Cornfield RB: Treatment of traumatic war neurosis with phenelzine. Arch Gen Psychiatry 38:440–445, 1981.

    PubMed  CAS  Google Scholar 

  44. Milanes FJ, Mack CN, Dennison J, Slater VL: Phenalzine treatment of post-Vietnam stress syndrome. VA Practitioner 15:40–4, 1984.

    Google Scholar 

  45. Shen WW, Park S: The use of monoamine oxidase inhibitors in the treatment of traumatic war neurosis: Case report. Military Med 148:430–431, 1983.

    CAS  Google Scholar 

  46. Charney DS, Menkes DB, Heninger GR: Receptor sensitivity and the mechanism of action of antidepressant treatment: Implications for the etiology and therapy of depression. Arch Gen Psychiatry 38:1160–1180, 1981.

    PubMed  CAS  Google Scholar 

  47. Babor TF, Meyer RE, Mirin SM, et al: Behavioral and social effects of heroin self-administration and withdrawal. Arch Gen Psychiatry 33:363–367, 1976.

    PubMed  CAS  Google Scholar 

  48. Redmond DE, Krystal JH: Multiple mechanisms of withdrawal from opioid drugs. Ann Rev Neurosci 7:443–478, 1984.

    PubMed  CAS  Google Scholar 

  49. Giacobini E, Izikowitz S, Wegmann A: Urinary norepinephrine and epinephrine excretion in delerium tremens. Arch Gen Psychiatry 3:289–296, 1960.

    PubMed  CAS  Google Scholar 

  50. Tyrer P, Owen R: Gradual withdrawal of diazepam after long-term therapy. Lancet 2:1402–1406, 1983.

    Google Scholar 

  51. Redmond DE: New and old evidence for the involvement of a brain norepinephrine system in anxiety, in Fann WE, Karacan I, Pokorney AD, Williams RL (eds): Phenomenology and Treatment of Anxiety. New York, Spectrum, 1979, pp 153–203.

    Google Scholar 

  52. Grant SJ, Redmond DE Jr: The neuroanatomy and pharmacology of the nucleus locus coeruleus, in Lal H, Fielding S (eds): Psychopharmacology of Clonidine. New York, Liss, 1981, pp 5–27.

    Google Scholar 

  53. Lynch M, Littleton J, McKernan RM, et al: Alpha-adrenoceptor number and function in rat cortex after ethanol and immobilization stress. Brain Res. 288:145–159, 1983.

    PubMed  CAS  Google Scholar 

  54. Brick J, Poherecky LA: Ethanol-stress interaction: Biochemical findings. Psychopharmacology 77:81–84, 1983.

    Google Scholar 

  55. Goddard PJ: Effect of alcohol on excretion of catechol aminees in conditions giving rise to anxiety.J Appl Physiol 13:118–120, 1958.

    PubMed  CAS  Google Scholar 

  56. Leahy DJ, Stogin JM, Moore MR, et al: Natural social and nonsocial behaviors associated with fear in cercopithecus aethiops sabeus. Antoplogia Contemp 3:227, 1980.

    Google Scholar 

  57. Korf J: Locus coeruleus, noradrenaline metabolism, and stress, in Usdin E, Kvetnansky R, Kopin IJ (eds): Catecholamines and Stress. New York, Pergamon, 1976, pp 105–111.

    Google Scholar 

  58. Rubin RT, Miller RG, Clark BR, et al: The stress of aircraft carrier landings: II. 3-Methoxy-4-hydroxyphenylglycol excretion in naval aviators. Psychosom Med 32:589–597, 1970.

    PubMed  CAS  Google Scholar 

  59. Stone EA: Stress and catecholamines, in Friedhoff AJ (ed): Catecholamines and Behavior-2: Neuropsychopharmacology. New York, Plenum Press, 1975, pp 31–72.

    Google Scholar 

  60. Charney DS, Heninger GR, Breier A: Noradrenergic function in panic anxiety: Effects of yohimbine in healthy subjects and patients with agoraphobia and panic disorder. Arch Gen Psychiatry 41:751–763, 1984.

    PubMed  CAS  Google Scholar 

  61. O’Neill TP, Haigier HJ: Effects of Clonidine on neuronal firing evoked by a noxious stimulus. Brain Res 327:97–103, 1985.

    PubMed  Google Scholar 

  62. Cassens G, Roffman M, Kuruc A, et al: Alterations in brain norepinephrine metabolism induced by environmental stimuli previously paired with inescapable shock. Science 209:1138–1140, 1980.

    PubMed  CAS  Google Scholar 

  63. Desiderato O, Newman A: Conditioned suppression produced in rats by tones paired with escapable or inescapable shock.J Comp Physiol Psychol 77:427–431, 1971.

    PubMed  CAS  Google Scholar 

  64. Tsuda A, Tanaka M, Ida Y, et al: Effects of preshock experience on enhancement of rat brain noradrenaline turnover induced by psychological stress. Pharmacol Biochem Behav 24:115–119, 1986.

    PubMed  CAS  Google Scholar 

  65. Knopf IJ, Worell J, Wolff HD: Effect of meprobamate on stimulus generalization under experimental stress. AMA Arch Gen Psychiatry 1:630–633, 1959.

    PubMed  CAS  Google Scholar 

  66. Frith CD, Dowdy J, Ferrier IN, Crow TJ: Selective impairment of paired associate learning after administration of a centrally-acting adrenergic agonist (Clonidine). Psychopharmacology 87:490–493, 1985.

    PubMed  CAS  Google Scholar 

  67. Jacobs WJ, Nadel L: Stress-induced recovery of fears and phobias. Psychol Rev 92:512–531, 1985.

    PubMed  CAS  Google Scholar 

  68. Davis M: Neurochemical modulation of sensory-motor reactivity: Acoustic and tactile startle reflexes. Neurosci Biobehav Rev 4:241–263, 1980.

    PubMed  CAS  Google Scholar 

  69. Davis M: Potentiation of startle reflex behavior by anxiety: Neural localization and attenuation by diazepam. Psychopharmacol Bull 19:457–465, 1983.

    Google Scholar 

  70. Davis M, Redmond DE Jr, Baraban JM: Noradrenergic agonists and antagonists: Effects on conditioned fear as measured by the potentiated startle paradigm. Psychopharmacology 65:111–118, 1979.

    PubMed  CAS  Google Scholar 

  71. Gibbins RJ, Kalant H, LeBlanc AE, Clark JW: The effects of chronic administration of ethanol on startle threshold in rats. Psychopharmacologia 19:95–104, 1971.

    PubMed  CAS  Google Scholar 

  72. Cassella JV, Davis M: Fear-enhanced startle is not attentuated by acute or chronic imipramine treatment in rats. Psychopharmacology 87:278–282, 1985.

    PubMed  CAS  Google Scholar 

  73. Freud S: Inhibitions, symptoms and anxiety. Standard Edition 20:77–175, 1926.

    Google Scholar 

  74. Krystal H: Self representation and the capacity for self care. Ann Psychoanal 6:209–246, 1978.

    Google Scholar 

  75. Krystal H: Trauma and the stimulus barrier. Psychoanal Inquiry 6:131–161, 1985.

    Google Scholar 

  76. Maier SF, Seligman MEP: Learned helplessness: Theory and evidence.J Exp Psychol 105:3–46, 1976.

    Google Scholar 

  77. Anisman H, Irwin J, Sklar LS: Deficits of escape performance following catecholamine depletion: Implications for uncontrollable stress. Psychopharmacology 64:163–170, 1979.

    PubMed  CAS  Google Scholar 

  78. Anisman H, Beauchamp C, Zacharko RM: Effects of inescapable shock and norepinephrine depletion induced by DSP4 on escape performance. Psychopharmacology 83:56–61, 1984.

    PubMed  CAS  Google Scholar 

  79. Anisman H, deCatanzaro D, Remington G: Escape performance following exposure to inescapable shock: Deficits in motor response maintenance.J Exp Psychol: Animal Behav Processes 4:197–218, 1978.

    Google Scholar 

  80. Anisman H, Grimmer L, Irwin J, et al: Escape performance after inescapable shock in selectively bred lines of mice: Response maintenance and catecholamine activity.J Comp Physiol Psychol 93:229–241, 1979.

    PubMed  CAS  Google Scholar 

  81. Anisman H, Ritch M, Sklar LS: Noradrenergic and dopaminergic interactions in escape behavior: Analysis of uncontrollable stress effects. Psychopharmacology 74:263–268, 1981.

    PubMed  CAS  Google Scholar 

  82. Anisman H, Sklar LS: Catecholamine depletion in mice upon reexposure to stress: Mediation of the escape deficits produced by inescapable shock.J Comp Physiol Psychol 93:610–625, 1979.

    PubMed  CAS  Google Scholar 

  83. Anisman H, Sklar LS: Social housing conditions influence escape deficits produced by uncontrollable stress: Assessment of the contribution of norepinephrine. Behav Neural Biol 32:406–427, 1981.

    PubMed  CAS  Google Scholar 

  84. Anisman H, Suissa A, Sklar LS: Escape deficits induced by uncontrollable stress: Antagonism by dopamine and norephinephrine agonists. Behav Neural Biol 28:37–47, 1980.

    Google Scholar 

  85. Weiss JM, Glazer HI, Poherecky LA: Effects of chronic exposure to stressors on avoidance-escape behavior and on brain norepinephrine. Psychosom Med 37:522–534.

    Google Scholar 

  86. Weiss JM, Stone EA, Harreil N: Coping behavior and brain norepinephrine level in rats.J Comp Physiol Psychol 72:153–160, 1970.

    PubMed  CAS  Google Scholar 

  87. Glazer HI, Weiss JM, Poherecky LA, et al: Monoamines as mediators of avoidance-escape behavior. Psychosom Med 37:535–543, 1975.

    PubMed  CAS  Google Scholar 

  88. Plaznik A, Danysz W, Kostowski W: A stimulatory effect of intraacumbens injections of noradrenaline on the behavior of rats in the forced swim test. Psychopharmacology 87:119–123, 1985.

    PubMed  CAS  Google Scholar 

  89. Sherman AD, Petty F: Neurochemical basis of the action of antidepressants on learned helplessness. Behav Neural Biol 30:119–134, 1980.

    PubMed  CAS  Google Scholar 

  90. Biggio G, Concas A, Serra M, et al: Stress and beta-carbolines decrease the density of low affinity GABA binding sites: An affect reversed by diazepam. Brain Res 305:13–18, 1984.

    PubMed  CAS  Google Scholar 

  91. Concas A, Corda MG, Biggio G: Involvement of the benzodiazepine recognition sites in the foot shock-induced decrease of low affinity GABA receptors in the rat cerebral cortex. Brain Res 341:50–56, 1985.

    PubMed  CAS  Google Scholar 

  92. Edwards E, Johnson J, Anderson D, Leyra P, Henn FA: Effects of p-chlorophenylalanine on learned helplessness in the rat. Soc Neurosci Abstr 10:1172, 1984.

    Google Scholar 

  93. Amir S, Brown ZW, Amit Z: The role of endorphins in stress: Evidence and speculations. Neurosci Biobehav Rev 4:77–86, 1980.

    PubMed  CAS  Google Scholar 

  94. Williams JL, Drugan RC, Maier SF: Exposure to uncontrollable stress alters withdrawal from morphine. Behav Neurosci 98:836–846, 1984.

    PubMed  CAS  Google Scholar 

  95. Girardot M-N, Holloway FA: Naltrexone antagonizes the biobehavioral adaption to cold water stress in rats. Pharmacol Biochem Behav 22:769–779, 1985.

    PubMed  CAS  Google Scholar 

  96. Mendelson JH, Mello NK: Biologic concomitants of alcoholism. N Engl J Med 301:912–921, 1979.

    PubMed  CAS  Google Scholar 

  97. Weeks JR, Collins RJ: Factors affecting voluntary morphine intake in self-maintained addicted rats. Psychopharmacologia 6:267–279, 1964.

    PubMed  CAS  Google Scholar 

  98. Berman RF, Cannon DS: The effect of prior ethanol experience on ethanol-induced saccharin aversions. Physiol Behav 12:1041–1044, 1974.

    PubMed  CAS  Google Scholar 

  99. Vogel JR, Nathan BA: Reduction of learned taste aversions by pre-exposure to drugs. Psychopharmacology 49:167–172, 1976.

    PubMed  CAS  Google Scholar 

  100. Stewart J, Eikelboom R: Pre-exposure to morphine and the attenuation of conditioned taste aversion in rats. Pharmacol Biochem Behav 9:639–645, 1978.

    PubMed  CAS  Google Scholar 

  101. Mello NK, Mendelson JH: Factors affecting alcohol consumption in primates. Psychosom Med 28:529–550, 1966.

    Google Scholar 

  102. Orloff ER, Masserman JH: Effects of abstinence on self-selection of ethanol induced by uncertainty in monkeys. Q J Stud Alcohol 39:499–504, 1978.

    CAS  Google Scholar 

  103. Myers RD, Holman RB: Failure of stress of electric shock to increase ethanol intake in rats.Q J Stud Alcohol 28:132–137, 1967.

    PubMed  CAS  Google Scholar 

  104. Ton MJNC, Brown A, Michalakeas A, Amit Z: Stress induced suppression of maintenance but not of acquisition of ethanol consumption in rats. Pharmacol Biochem Behav 24:115–119, 1983.

    Google Scholar 

  105. Volpicelli JR, Tiven J, Kimmel SC: The relationship between tension reduction and ethanol consumption in rats. Physiol Psychol 10:114–116, 1982.

    CAS  Google Scholar 

  106. Caplan MA, Publisi K: Stress and conflict conditions leading to and maintaining voluntary alcohol consumption in rats. Pharmacol Biochem Behav 24:271–280, 1986.

    PubMed  CAS  Google Scholar 

  107. Casey A: The effect of stress on the consumption of alcohol and reserpine.Q J Stud Alcohol 21:208–216, 1960.

    PubMed  CAS  Google Scholar 

  108. Poherecky LA: The interaction of alcohol and stress: A review. Neurosci Biobehav Rev 5:209–229, 1981.

    Google Scholar 

  109. Cowen JD: Testing the escape hypothesis: Alcohol helps users to forget their feelings.J Nerv Ment Dis 171:40–48, 1983.

    Google Scholar 

  110. Mueller CW, Klajner F: The effect of alcohol on memory for feelings: Does it really help users to forget? J Nerv Ment Dis 172:225–227, 1984.

    PubMed  CAS  Google Scholar 

  111. Krystal JH, Giller EL Jr, Cicchetti DV: Assessment of alexithymia in posttraumatic stress disorder and somatic illness: Introduction of a reliable measure. Psychosom Med 48:84–94, 1986.

    PubMed  CAS  Google Scholar 

  112. Dole VP, Nyswander ME: Heroin addiction—A metabolic disease. Arch Intern Med 120:19–24, 1967.

    PubMed  CAS  Google Scholar 

  113. Goldstein A: Heroin addiction and the role of methadone in its treatment. Arch Gen Psychiatry 26:291–298, 1972.

    PubMed  CAS  Google Scholar 

  114. Sawynok J, Pinsky C, Labella FS: Minireview: On the specificity of naloxone as an opiate antagonist. Life Sci 25:1221–1232, 1981.

    Google Scholar 

  115. Charney DS, Heninger GR, Kleber HD: The combined use of Clonidine and naltrexone as a rapid, safe, and effective treatment of abrupt withdrawal from methadone. Am J Psychiatry 143:831–837, 1986.

    PubMed  CAS  Google Scholar 

  116. Kleber HD, Kosten TR: Naltrexone induction: Psychologic and pharmacologic strategies.J Clin Psychiatry 9:29–38, 1984.

    Google Scholar 

  117. Kleber HD, Riordan CE, Rounsaville B, Kosten T, et al: Clonidine in outpatient detoxification from methadone maintenance. Arch Gen Psychiatry 42:391–394, 1985.

    PubMed  CAS  Google Scholar 

  118. Kleber HD, Topazian M, Gaspari J, et al: Clonidine and naltrexone in the outpatient treatment of heroin withdrawal. Am J Drug Alcohol Abuse 13:1–18, 1987.

    PubMed  CAS  Google Scholar 

  119. Jasinski DR, Pevnick JS, Griffith JD: Human pharmacology and abuse potential of the analgesic buprenorphine. Arch Gen Psychiatry 35:501–516, 1978.

    PubMed  CAS  Google Scholar 

  120. Kleber HD, Weissman MM, Rounsaville BJ, et al: Imipramine as treatment for depression in addicts. Arch Gen Psychiatry 40:649–653, 1983.

    PubMed  CAS  Google Scholar 

  121. Woody GE, O’Brien CP, McLellan AT, et al: The use of antidepressants with methadone in depressed maintenance patients. Ann NY Acad Sci 398:120–127, 1982.

    PubMed  CAS  Google Scholar 

  122. Persson L-O, Sjoberg L, Svensson E: Mood effects of alcohol. Psycho-pharmacology 68:295–299, 1980.

    CAS  Google Scholar 

  123. Redmond DE: Clonidine and the primate locus coeruleus: Evidence suggesting anxiolytic and antiwithdrawal effects, in Lord H, Fielding S (eds), Psycho-pharmacology of Clonidine. New York, Alan R. Liss, pp. 147–163.

    Google Scholar 

  124. Krystal JH, Redmond DE: Ameleminary description of acute physical dependence on morphine in the vervet monkey. Pharmacol Biochem Behav 18:289–291, 1983.

    PubMed  CAS  Google Scholar 

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  1. Department of Psychiatry, Substance Abuse Treatment Unit, Yale University School of Medicine, New Haven, Connecticut, 06511, USA

    Thomas R. Kosten & John Krystal

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  1. Thomas R. Kosten
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  1. New York University School of Medicine, New York, New York, USA

    Marc Galanter

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Kosten, T.R., Krystal, J. (1988). Biological Mechanisms in Posttraumatic Stress Disorder Relevance for Substance Abuse. In: Galanter, M., et al. Recent Developments in Alcoholism. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-7718-8_3

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  • DOI: https://doi.org/10.1007/978-1-4615-7718-8_3

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