2024
Dexmedetomidine HCL (BXCL501) as a potential treatment for alcohol use disorder and comorbid PTSD: A phase 1b, placebo‐controlled crossover laboratory study
Petrakis I, Nolen T, Vandergrift N, Hirsch S, Krystal J, De Vivo M, Sabados J, Pisani E, Newcomb J, Kosten T. Dexmedetomidine HCL (BXCL501) as a potential treatment for alcohol use disorder and comorbid PTSD: A phase 1b, placebo‐controlled crossover laboratory study. American Journal On Addictions 2024 PMID: 39152094, DOI: 10.1111/ajad.13637.Peer-Reviewed Original ResearchPathophysiology of posttraumatic stress disorderAlcohol use disorderSubjective effects of alcoholEffects of alcoholUse disorderComorbid alcohol use disorderAlcohol cue reactivityPosttraumatic stress disorderCrossover laboratory studyCue reactivityAlcohol cravingNoradrenergic dysregulationStress disorderBlood pressureSubjective effectsEthanol administrationClinically significant adverse effectsPharmacotherapeutic approachesTest daysReceptor agonistsPotential treatmentDouble-blind fashionCravingDrinking alcoholDisordersMedial prefrontal cortex neurotransmitter abnormalities in posttraumatic stress disorder with and without comorbidity to major depression
Swanberg K, Prinsen H, Averill C, Campos L, Kurada A, Krystal J, Petrakis I, Averill L, Rothman D, Abdallah C, Juchem C. Medial prefrontal cortex neurotransmitter abnormalities in posttraumatic stress disorder with and without comorbidity to major depression. NMR In Biomedicine 2024, 37: e5220. PMID: 39054694, DOI: 10.1002/nbm.5220.Peer-Reviewed Original ResearchPosttraumatic stress disorderMedial prefrontal cortexStress disorderPosttraumatic stress disorder patientsPosttraumatic stress disorder diagnosisChronic psychiatric conditionImpact of psychiatric comorbiditiesComorbid MDDPrefrontal cortexDepressive disorderTraumatic stressorsPsychiatric conditionsMDDPsychiatric comorbiditiesNeurotransmitter abnormalitiesConcentrations of glutamateMetabolite abnormalitiesHealthy controlsDisordersPattern of abnormalitiesParticipantsGlutamateIn vivo protonMetabolic abnormalitiesDepressionA Systematic Review Evaluating PTSD Treatment Effects on Intermediate Phenotypes of PTSD
Palmisano A, Meshberg-Cohen S, Petrakis I, Sofuoglu M. A Systematic Review Evaluating PTSD Treatment Effects on Intermediate Phenotypes of PTSD. Psychological Trauma Theory Research Practice And Policy 2024, 16: 768-783. PMID: 36595460, DOI: 10.1037/tra0001410.Peer-Reviewed Original ResearchPosttraumatic stress disorderBehavioral treatment outcomesEvidence-based treatmentsCognitive controlThreat processingBody of researchPTSD outcomesPTSD treatmentPaucity of researchStress disorderPreliminary supportIntermediate phenotypesTreatment dropoutMethodological limitationsStudy limitationsTreatment effectsCurrent researchTreatment approachesStrong conclusionsNovel treatment approachesEmpirical studyTreatment outcomesTreatment efficacyResearchMemoryCognitive processing therapy (CPT) versus individual drug counseling (IDC) for PTSD for veterans with opioid use disorder maintained on buprenorphine
Petrakis I, Meshberg‐Cohen S, Nich C, Kelly M, Claudio T, Jane J, Pisani E, Ralevski E. Cognitive processing therapy (CPT) versus individual drug counseling (IDC) for PTSD for veterans with opioid use disorder maintained on buprenorphine. American Journal On Addictions 2024, 33: 525-533. PMID: 38624259, DOI: 10.1111/ajad.13557.Peer-Reviewed Original ResearchCognitive processing therapyIndividual drug counselingPosttraumatic stress disorderOpioid use disorderSubstance use disordersDrug counselingProcessing therapyPTSD symptomsUse disorderCognitive processing therapy groupEvidence-based trauma-focused psychotherapiesSelf-reported PTSD symptomsPosttraumatic stress disorder symptomsPosttraumatic stress disorder treatmentRemission of PTSD symptomsPosttraumatic Stress Disorder ChecklistComorbid opioid use disorderTrauma-focused psychotherapyTrauma-focused treatmentRates of comorbidityTreatment group differencesPCL-5Stress disorderGroup differencesRandomized clinical trialsProblem Opioid Use Among US Military Veterans: Prevalence, Correlates, and Psychiatric Characteristics
Na P, Petrakis I, Krystal J, Pietrzak R. Problem Opioid Use Among US Military Veterans: Prevalence, Correlates, and Psychiatric Characteristics. Journal Of Addiction Medicine 2024, 18: 313-318. PMID: 38498625, PMCID: PMC11150085, DOI: 10.1097/adm.0000000000001286.Peer-Reviewed Original ResearchInstrumental activities of daily livingInstrumental activities of daily living disabilityLifetime suicide attemptsProblem opioid useUS military veteransUS veteransPsychiatric characteristicsSuicide attemptsMilitary veteransAssociated with black race/ethnicityActivities of daily livingNational Health and ResilienceLifetime alcohol use disorderMental health morbidityPosttraumatic stress disorderMental health disordersAlcohol use disorderNon-Hispanic race/ethnicityMultivariate logistic regression modelNationally representative sampleOpioid useLogistic regression modelsInstrumental activitiesHealth morbidityDaily livingThe Management of Posttraumatic Stress Disorder and Acute Stress Disorder: Synopsis of the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline.
Schnurr P, Hamblen J, Wolf J, Coller R, Collie C, Fuller M, Holtzheimer P, Kelly U, Lang A, McGraw K, Morganstein J, Norman S, Papke K, Petrakis I, Riggs D, Sall J, Shiner B, Wiechers I, Kelber M. The Management of Posttraumatic Stress Disorder and Acute Stress Disorder: Synopsis of the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline. Annals Of Internal Medicine 2024, 177: 363-374. PMID: 38408360, DOI: 10.7326/m23-2757.Peer-Reviewed Original ResearchConceptsClinical practice guidelinesU.S. Department of Veterans AffairsDepartment of Veterans AffairsVeterans AffairsPosttraumatic stress disorderManagement of posttraumatic stress disorderAcute stress disorderExternal group of expertsPractice guidelinesDefense Clinical Practice GuidelinesStress disorderPatient-centered careIndividual health outcomesRevised CPGDepartment of Defense Clinical Practice GuidelinesVideo teleconferencingStrength of evidenceQuality of lifeCo-occurring conditionsHealth outcomesPatient perspectiveEvidence-basedPosttraumatic stress disorder treatmentSystematic searchCognitive processing therapyWritten exposure therapy for veterans with co-occurring substance use disorders and PTSD: Study design of a randomized clinical trial
Meshberg-Cohen S, Cook J, Bin-Mahfouz A, Petrakis I. Written exposure therapy for veterans with co-occurring substance use disorders and PTSD: Study design of a randomized clinical trial. Contemporary Clinical Trials 2024, 139: 107475. PMID: 38365173, DOI: 10.1016/j.cct.2024.107475.Peer-Reviewed Original ResearchWritten exposure therapyPosttraumatic stress disorderEvidence-based psychotherapiesSubstance use disordersExposure therapyReduce symptoms of posttraumatic stress disorderSymptoms of posttraumatic stress disorderPTSD specialty clinicRates of posttraumatic stress disorderCo-occurring substance use disordersComorbid posttraumatic stress disorderSubstance use disorder outcomesDays of substance useTreatment-seeking veteransSubstance use disorder treatmentStress disorderAddiction outcomesTherapist involvementAddiction programsSUD treatmentSubstance useTrauma treatmentRandomized clinical trialsWriting conditionsHomework assignmentsThe role of neurosteroids in posttraumatic stress disorder and alcohol use disorder: A review of 10 years of clinical literature and treatment implications
Peltier M, Verplaetse T, Altemus M, Zakiniaeiz Y, Ralevski E, Mineur Y, Gueorguieva R, Picciotto M, Cosgrove K, Petrakis I, McKee S. The role of neurosteroids in posttraumatic stress disorder and alcohol use disorder: A review of 10 years of clinical literature and treatment implications. Frontiers In Neuroendocrinology 2024, 73: 101119. PMID: 38184208, PMCID: PMC11185997, DOI: 10.1016/j.yfrne.2023.101119.Peer-Reviewed Original ResearchPosttraumatic stress disorderAlcohol use disorderStress disorderContext of PTSDPTSD/AUDConcurrent posttraumatic stress disorderUnderlying neurobiological mechanismsUse disordersAlcohol-related variablesNeurobiological mechanismsPTSD diagnosisTreatment developmentTreatment implicationsBody of literatureNovel interventionsClinical literatureRole of neurosteroidsDisordersTreatment outcomesYears of researchAlcohol consumptionExogenous pregnenolonePharmacological treatmentBiological variablesAllopregnanolone
2023
Comorbid alcohol use disorder and posttraumatic stress disorder: A proof‐of‐concept randomized placebo‐controlled trial of buprenorphine and naltrexone combination treatment
Davis L, Petrakis I, Pilkinton P, Nolen T, Vandergrift N, Hirsch S, Norrholm S, Kosten T. Comorbid alcohol use disorder and posttraumatic stress disorder: A proof‐of‐concept randomized placebo‐controlled trial of buprenorphine and naltrexone combination treatment. Alcohol Clinical And Experimental Research 2023, 47: 1756-1772. PMID: 37468230, DOI: 10.1111/acer.15155.Peer-Reviewed Original ResearchComorbid alcohol use disorderAlcohol use disorderPosttraumatic stress disorderPlacebo-controlled trialWorld Health OrganizationReceptor antagonismOpioid receptorsUse disordersExtended-release injectable naltrexoneKappa-opioid receptor antagonistStress disorderClinician-Administered PTSD ScalePrimary composite outcomeEffective pharmacologic treatmentOpioid receptor antagonistOpioid receptor antagonismMu-opioid receptorsCombination of buprenorphineBinary primary outcomeTimeline Follow-BackAUD outcomesBuprenorphine 2Injectable placeboPrimary timepointInjectable naltrexoneTrajectories of alcohol consumption in U.S. military veterans: Results from a 10-year population-based longitudinal study
Na P, Montalvo-Ortiz J, Petrakis I, Krystal J, Polimanti R, Gelernter J, Pietrzak R. Trajectories of alcohol consumption in U.S. military veterans: Results from a 10-year population-based longitudinal study. Drug And Alcohol Dependence 2023, 246: 109833. PMID: 36963160, PMCID: PMC10811960, DOI: 10.1016/j.drugalcdep.2023.109833.Peer-Reviewed Original ResearchConceptsAlcohol consumption groupCurrent mental health treatmentDysphoric arousal symptomsMental health treatmentUS veteransAlcohol consumptionHealth treatmentConsumption groupArousal symptomsYounger agePopulation-based longitudinal studyPublic health problemLongitudinal studyExcessive alcohol consumptionAlcohol use disorderPosttraumatic stress disorderU.S. military veteransMedical comorbiditiesChronic courseNational HealthClose monitoringUse disordersHealth problemsVeterans StudyStress disorder
2019
Pharmacotherapies for PTSD and Substance Use Disorders
Kachadourian L, Jensen K, Sofuoglu M, Petrakis I. Pharmacotherapies for PTSD and Substance Use Disorders. 2019, 239-259. DOI: 10.4324/9781315442648-13.ChaptersOpioid use disorderAlcohol use disorderPosttraumatic stress disorderUse disordersPTSD/SUDPharmacological treatmentComorbid posttraumatic stress disorderUse of pharmacotherapySubstance use disordersEffectiveness of foodIntramuscular naltrexoneLabel medicationsEpidemiological studiesMedication developmentDrug AdministrationPharmacotherapyStress disorderAvailable evidenceDisordersNew targetsNaltrexoneTreatmentBiological mechanismsSpecific substancesSUDChapter 13 Trauma and Addiction—How to Treat Co-occurring PTSD and Substance Use Disorders
Vojvoda D, Petrakis I. Chapter 13 Trauma and Addiction—How to Treat Co-occurring PTSD and Substance Use Disorders. 2019, 189-196. DOI: 10.1016/b978-0-323-54856-4.00013-4.Peer-Reviewed Original ResearchSubstance use disordersAlcohol use disorderPosttraumatic stress disorderComorbid substance use disorderPTSD symptomsCo-occurring posttraumatic stress disorderRandomized clinical studyWorse clinical outcomesTreatment of patientsSeverity of AUDSeverity of symptomsCo-occurring disordersReduction of severityRecent pharmacological advancesAnticonvulsant topiramateClinical outcomesPharmacological treatmentPTSD comorbidityClinical studiesPharmacological advancesInconstant effectsMedicationsUse disordersAlcohol consumptionN-acetylcysteine
2015
Alcohol Use Disorders and Comorbid Posttraumatic Stress Disorder in US Military Veterans: Etiology and Current Treatment Approaches
Kachadourian L, McCarthy E, Petrakis I. Alcohol Use Disorders and Comorbid Posttraumatic Stress Disorder in US Military Veterans: Etiology and Current Treatment Approaches. 2015, 1-13. DOI: 10.1007/978-3-319-08613-2_108-1.Peer-Reviewed Original ResearchAlcohol use disorderPosttraumatic stress disorderComorbid posttraumatic stress disorderUse disordersAlcohol dependenceStress disorderCurrent treatment approachesSubstance use disordersUS military veteransPharmacological interventionsDual diagnosisTreatment approachesDisordersPotential mechanismsMilitary veteransHigh ratePsychotherapeutic approachesComorbiditiesEtiologyDiagnosis