Chapter 3.2 Neuroendocrine aspects of PTSD

This chapter discusses how neuroendocrine findings in posttraumatic stress disorder (PTSD) potentially inform us about hypothalamic-pituitary-adrenal (HPA) alterations in PTSD and highlight alterations relevant to the identification of targets for drug development. The majority of studies demonstrate alterations consistent with an enhanced negative feedback inhibition of cortisol on the pituitary, and/or an overall hyperreactivity of other target tissues (adrenal gland, hypothalamus) in PTSD. However, findings of low cortisol and increased reactivity of the pituitary in PTSD are also consistent with reduced adrenal output. The observations in PTSD are part of a growing body of neuroendocrine data providing evidence of insufficient glucocorticoid signaling in stress-related neuropsychiatric disorders.