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Allostatic load and the cannabinoid system: implications for the treatment of physiological abnormalities in post-traumatic stress disorder (PTSD)

Published online by Cambridge University Press:  15 July 2019

James B. Lohr ,
Hang Chang ,
Michelle Sexton  and
Barton W. Palmer Open the ORCID record for Barton W. Palmer [Opens in a new window]
James B. Lohr*
Affiliation:
Center of Excellence for Stress & Mental Health, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
Hang Chang
Affiliation:
Center of Excellence for Stress & Mental Health, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
Michelle Sexton
Affiliation:
Department of Anesthesiology, University of California, San Diego, La Jolla, CA, USA
Barton W. Palmer
Affiliation:
Center of Excellence for Stress & Mental Health, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
*
*Address correspondence to: James B. Lohr, M.D., Professor of Neurosciences & Psychiatry, University of California, San Diego, 3350 La Jolla Village, Drive San Diego, CA 92161, USA. (Email: [email protected])
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Abstract

It is becoming clear that post-traumatic stress disorder (PTSD) is not simply a psychiatric disorder, but one that involves pervasive physiological impairments as well. These physiological disturbances deserve attention in any attempt at integrative treatment of PTSD that requires a focus beyond the PTSD symptoms themselves. The physiological disturbances in PTSD range over many systems, but a common thread thought to underlie them is that the chronic effects of PTSD involve problems with allostatic control mechanisms that result in an excess in what has been termed “allostatic load” (AL). A pharmacological approach to reducing AL would be valuable, but, because of the large range of physiological issues involved – including metabolic, inflammatory, and cardiovascular systems – it is unclear whether there exists a simple comprehensive way to address the AL landscape. In this paper, we propose that the cannabinoid system may offer just such an approach, and we outline evidence for the potential utility of cannabinoids in reducing many of the chronic physiological abnormalities seen in PTSD which are thought to be related to excess AL.

Keywords

Psychological traumaallostasisbiomarkersstress disorderstheoretical modelcomorbiditypharmacotherapyaugmentation
Type
Perspectives
Information
CNS Spectrums , Volume 25 , Issue 6 , December 2020 , pp. 743 - 749
Copyright
© Cambridge University Press 2019. This is a work of the U.S. Government and is not subject to copyright protection in the United States.

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