The news that Viagra is being approved for use as a treatment for PTSD in adults shook the world of pharmaceuticals in the summer of 2016. With an estimated 26.2 million prescriptions written annually worldwide, and a market value of over $15 billion, this small drug could become ubiquitous.
For those in the pharmaceutical industry, the excitement was palpable. However, for veterans and war survivors suffering from PTSD, the news was met with mixed emotions. For many, the drug represents a chance at a better life and a cure for their trauma-related symptoms. For others, it is a symbol of drug companies selling out and ignoring the needs of the vulnerable.
There is also the risk of abuse. A recent study found that 23.3% of US adults aged 45 and over reported using prescription drugs for non-prescribed purposes in the past year. This includes 5% who admitted to having used Viagra for a sexual performance boost. While this type of behavior is considered highly addictive and dangerous, it is still considered “undesirable” in the same way as illicit drug use. In the same way that drug companies are racing to develop treatments for opioids, it is likely that they will develop a drug for PTSD as well.
Why Are Pharmaceutical Companies Interested In Developing A Treatment For PTSD?
Despite its name, the post-traumatic stress disorder (PTSD) is not strictly related to trauma. The diagnostic criteria for PTSD were first introduced in the DSM-III in 1980, and can be found in all of its subsequent editions. The disorder can develop following natural disasters, such as tsunamis, hurricanes, and earthquakes. It can also occur in direct relation to the experience of war and armed conflict.
In the years following the introduction of PTSD, its diagnostic criteria continued to expand, and it became clear that the boundaries of the disorder were blurring. Today, the DSM-5 lists 14 distinct types of trauma that can cause PTSD, including exposure to violence, sexual assault, terror, and war. It is also considered an important differential diagnosis in relation to those who have recently experienced a loss or bereavement. As a result of this, the interest of pharmaceutical companies in developing a treatment for PTSD has increased dramatically. This is in part due to the fact that the disorder is now considered to be a prominent issue in the Veteran’s community, with up to 40% of those who serve in the military suffering from PTSD. The disorder can be significantly debilitating, and has a wide range of associated problems, including depression, anxiety, and substance abuse. These problems can lead to significant challenges with social and occupational functioning, as well as a decrease in life quality. According to the Department of Veterans Affairs, of the nearly eight million veterans who served in the US during the past decade, almost half of them have PTSD. This is a significant portion of the population affected by this disorder, and the numbers are expected to rise as a result of ongoing combat operations in the Middle East and North Africa. The problem is that there are currently no approved effective treatments for PTSD. While there are certainly drugs that can be used to treat its symptoms, there is still no cure.
What Is The Current Treatment For PTSD?
The mainstay of treatment for PTSD is psychotherapy or counseling, which focuses on helping the patient rebuild their inner strength and self-image. In cases where this is ineffective or undesirable due to certain aspects of the patient’s personality, or existing relationships, medication may be considered as an adjunct to treatment. This can be especially beneficial in cases where the patient is unable to access or participate in sufficient psychotherapy or counseling sessions due to logistical or financial constraints. In these situations, medications can give the patient the mental health benefits of therapy, while also allowing them to participate in their treatment on a regular basis.
One of the most commonly prescribed medications for PTSD is the selective serotonin reuptake inhibitor (SSRI). Most people are familiar with the effects of serotonin on the brain, as it is already well-established that this neurotransmitter is responsible for sending messages from one brain cell to another, regulating mood, and enabling sleep. What is less well known is that serotonin is also crucial for the functioning of the endocrine system, which regulates our bodies’ hormonal levels and production. As a result of this, drugs that increase the availability of serotonin in the brain are also capable of raising our natural body’s glucocorticoid levels — a process known as “serotonin synthetase inhibition” — this in turn could have significant effects on our physical health. In particular, high levels of glucocorticoids can lead to osteoporosis, diabetes, and weight gain. This is why some researchers have hypothesized that the obesity epidemic could be a result of the widespread use of SSRIs in the 1950s and 1960s.
What Role Could Viagra Play In The Treatment Of PTSD?
As we have seen, the selective serotonin reuptake inhibitor (SSRI) medications are one of the mainstays of treatment for PTSD. These drugs increase the brain’s serotonin levels, which in turn can have beneficial effects on a number of different mental and physical processes. One of the most relevant to the discussion at hand is the fact that SSRIs are known to reduce the hyper-vigilance and startle responses that are characteristic of the disorder. For those with PTSD, this can help to reduce their anxiety, depression, and fears that arise as a result of their traumatic experiences. As a result of this, they may be less likely to encounter negative situations that could potentially lead to trauma. In other words, SSRIs can help to “ground” the patient in reality, and reduce their chances of experiencing traumatic events. This is why they are typically prescribed to patients after they have already endured a significant trauma.
The hyper-vigilance and startle responses characteristic of patients with PTSD can be observed in a number of different situations, and can include behavioral and physiological responses such as increased anxiety, anger, or fearfulness. One of the most common triggers for these responses is the presence of a snake or spider. As a result of this, some researchers have hypothesized that patients with PTSD may be able to benefit from treatments involving exposure to animals. This could involve interactions that are safe and non-threatening, such as a therapy dog’s visit. It could also involve interactions with venomous animals, such as snakes and spiders, that the patients are not yet accustomed to.
The Precautionary Principle In Drug Development
It is well-established that pharmaceutical companies are in the business of making money, and that this is usually prioritized over all other aspects of their research. As a result of this, they may be tempted to develop a treatment for a disease or condition without truly being confident that their product will be effective or safe. While this may be acceptable in cases involving lifestyle issues (such as high blood pressure or cholesterol), it is still a major red flag in cases involving psychoactive substances, particularly in relation to medications that have been approved for use in the treatment of mental disorders. This is why it is important to remember that even if a drug is eventually found to be safe and effective, it does not necessarily follow that it should be marketed or prescribed without caution. Some of the most significant issues regarding the safety of pharmaceuticals can be found in the “black box” warning that many medications, including Paxil and Zoloft, are now being assigned due to the risk of suicide.
The Legal And Ethical Issues
Another important consideration involves the fact that pharmaceutical companies are now dealing with lawsuits from various individuals and groups of people who claim that their medications were either ineffective or unsafe. One of the most recent examples of this involves the anticoagulant drug Eliquis, which was approved for use by the FDA in 2012. The drug is prescribed for the prevention of stroke and cardiovascular disease, and has been assigned a black box warning for its associated increased risk of death. However, in April of 2017, the manufacturer of Eliquis, Pfizer, settled lawsuits filed by the states of New York and Florida, paying $750 million to patients who took the drug and were later diagnosed with cancers.
While it is important to learn from these mistakes and be more vigilant regarding the safety of pharmaceuticals, it must be said that the judicial system as a whole is still working in favor of the consumer, and it is now considered “unlikely” that a pharmaceutical company will be able to get away with murder if they deliberately harm or kill a patient. This does not mean that lawsuits will not occur or that patients cannot be harmed by the medications that they are prescribed, but it does mean that the judicial system is taking steps to ensure that the general public is protected, and that negligence, or misconduct, on the part of a medical professional cannot be swept under the rug.