Abstract

Serotonin (5-HT), norepinephrine (NE), and other neurotransmitters are modulated in post-traumatic stress disorder (PTSD). In addition, pro-inflammatory cytokines (PIC) are elevated during the progression of the disorder. Currently, the only approved pharmacologic treatments for PTSD are the selective-serotonin reuptake inhibitors (SSRI) sertraline and paroxetine, but their efficacy in treating PTSD is marginal at best. In combat-related PTSD, SSRIs are of limited effectiveness. Thus, this study sought to analyze the effects of the SSRI sertraline on inflammation and neurotransmitter modulation via a predator exposure/psychosocial stress animal model of PTSD. We hypothesized that sertraline would diminish inflammatory components and increase 5-HT but might also affect levels of other neurotransmitters, particularly NE. PTSD-like effects were induced in male Sprague-Dawley rats (n = 6/group × 4 groups). The rats were secured in Plexiglas cylinders and placed in a cage with a cat for 1 h on days 1 and 11 of a 31-day stress regimen. PTSD rats were also subjected to psychosocial stress via daily cage cohort changes. At the conclusion of the stress regimen, treatment group animals were injected intraperitoneally (i.p.) with sertraline HCl at 10 mg/kg for 7 consecutive days, while controls received i.p. vehicle. The animals were subsequently sacrificed on day 8. Sertraline attenuated inflammatory markers and normalized 5-HT levels in the central nervous system (CNS). In contrast, sertraline produced elevations in NE in the CNS and systemic circulation of SSRI treated PTSD and control groups. This increase in NE suggests SSRIs produce a heightened noradrenergic response, which might elevate anxiety in a clinical setting.

Highlights

  • Post-traumatic stress disorder (PTSD), an anxiety disorder recently reclassified as a trauma- and stressor-related disorder, can develop in response to real or perceived life-threatening situations

  • We utilized a predator exposure/psychosocial stress animal model of PTSD to analyze the effects of sertraline on neurotransmitter modulation and inflammation in the rat hippocampus, prefrontal cortex (PFC), cerebrospinal fluid (CSF), and plasma

  • We found that sertraline increased 5-HT and NE levels in the hippocampus, PFC, and CSF

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Summary

Introduction

Post-traumatic stress disorder (PTSD), an anxiety disorder recently reclassified as a trauma- and stressor-related disorder, can develop in response to real or perceived life-threatening situations. According to the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5), a diagnosis of PTSD necessitates exposure to a traumatic event, intrusive recollections, avoidance of associated stimuli, negative cognitions/mood, hyperarousal, and a significant social impairment. All of these symptoms must persist for at least 30 days and not be due to illness, medication, or substance abuse (American, 2013). To evaluate the effects of sertraline on neurotransmitter modulation, we employed a welldocumented predator exposure/psychosocial stress animal model of PTSD demonstrating three hallmark features of the disorder: hormonal abnormalities, a long-lasting traumatic memory, and persistent anxiety (Zoladz et al, 2008, 2012). This model possesses both predictive and construct validity, making it sensitive to clinically effective pharmacologic agents while displaying similarities to human PTSD (Bourin et al, 2007)

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