ABSTRACT
Posttraumatic stress disorder (PTSD) is a complex mental disorder often resulting from exposure to sudden or repeatedly extreme traumatic events such as war, terrorism, natural, or human-caused disaster, as well as violent personal assault such as rape, mugging, domestic violence, and accidents. There is also a strong direct relationship between mild traumatic brain injury (TBI) and PTSD.1,2 The symptoms of PTSD often appear within 3 months of the exposure to traumatic stressors, and they include unwanted reexperiencing of the trauma in memory (ashbacks, nightmares, triggered emotional responses), passive and active avoidance (emotional numbing, avoidance of discussions about the traumatic event), and hyperarousal.3 In addition, PTSD is usually accompanied by other psychiatric and medical comorbidities, including depression, substance abuse, cognitive dysfunction, and other problems of physical and mental health. These problems may lead to impairment of the ability to function in social or family life including occupational instability, marital stress, and family problems. Some of the symptoms of PTSD overlap with other diseases including chronic fatigue syndrome, bromyalgia, and multiple chemical sensitivities.4 The current gold standard management of PTSD involves antidepressant medications that rarely yield better than a 40% reduction in the Clinician Administered PTSD Scale (CAPS) scores, but most patients still exhibit PTSD symptoms at the end of any treatment trial.5 Therefore, additional approaches that attenuate some biochemical events that contribute to the progression of PTSD must be developed. In this chapter, among various biochemical events, the role of increased oxidative stress and chronic inammation in the initiation and progression of PTSD will be discussed. If these biochemical processes are involved in PTSD, the role of micronutrients including dietary and endogenous antioxidants alone or in combination with standard therapy will be discussed in order to reduce the progression of PTSD and to improve the efcacy of standard therapy. In addition, a rational formulation of micronutrient to attenuate oxidative stress and chronic inammation will be presented for further evaluation.
