Treatment Options for PTSD

Dr. Herrold’s Transcranial magnetic stimulation: potential treatment for co-occurring alcohol, traumatic brain injury and posttraumatic stress disorders  focuses on intertwining the treatment of Alcohol Use Disorder (AUD), Mild Traumatic Brain Injury (mTBI), and post-traumatic stress disorder (PTSD). She mentions that repetitive transcranial magnetic stimulation (rTMS) has been a noninvasive method to treating these conditions separately but not looked at in unison. AUD is most commonly found when a person observes impairments in their control, withdrawal, and social relationships due to intense craving of alcohol. On the other hand, PTSD can be a result of trauma related cues (like an explosion or similar physical act).

            Once again, an advantage of the rTMS is that it is noninvasive and can be used either excitatory or inhibitory. This method of treatment focuses on both the intensity (Motor evoked potential) along with its frequency, which resides in number of pulses per second. Dr. Herrold seeks to treat the dorsolateral prefrontal cortex of these patients, since this section of the brain affects both depression and anxiety in patients. She finds that the H-coiled rTMS actually decreases PTSD significantly with the gradual increase of the frequency of it over time. Yet, an issue seen is that rTMS stimulating deeper subcortical structures intensifies on the cortical surface, leading to possible seizures.

            As we can see, rTMS has proven to be effective with slight fear of possible seizures. However, this fear is not nearly met with the same skepticism as other treatments being offered recently. One that clearly stood out to me was Dave Philipps’ New York Times 2016 article, “F.D.A Agree to New Trials for Ecstasy as a Relief for PTSD Patients.” The article was published explaining the recent use of MDMA (ecstasy) to treat patients suffering with PTSD. Many physicians in the article state how traditional methods of prescription drugs and psychotherapy have had little to sometimes no effect on patients. However, patients given MDMA often showed immediate signs of improvement and control within their lives, leading to extinction of PTSD within a year. Similar to Dr. Herrold’s research, many PTSD patients had AUD problems, which were repressed due to the MDMA addition.

            A few concerns arise with both of these treatments. In regard to rTMS, one must make sure that cortical surfaces are not applied with such high intensities that could result with a seizure. On the other hand, MDMA is far messier. It is a drug known to increase extremely large amounts of serotonin in body. This results in a large sense of euphoria that leads to heightened sensation and emotions, repressing negative emotions. However, once the drug’s effects fade away, the patient is left feeling incredible down and could lead to a more pronounced depression.

Article: https://www.nytimes.com/2016/11/29/us/ptsd-mdma-ecstasy.html?searchResultPosition=3
Scientific Research Paper: https://www.dropbox.com/sh/hdluh1vfs2cphhz/AABHUOxPAP_XWzl0AL7lWWzga/(01.21.20)%20-%20Amy%20Herrold?dl=0&preview=Herrold+2014+Neural+Regeneration+Research+TMS+Review.pdf&subfolder_nav_tracking=1