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Related Experiment Videos

Conceptually driven pharmacologic approaches to acute trauma.

Roger K Pitman1, Douglas L Delahanty

  • 1Massachusetts General Hospital, Charlestown, MA 02129, USA. roger_pitman@hms.harvard.edu

CNS Spectrums
|February 3, 2005
PubMed
Summary

Early use of medications like propranolol after trauma may prevent posttraumatic stress disorder (PTSD). Research suggests blocking stress hormone effects can reduce PTSD development in trauma survivors.

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Area of Science:

  • Neuroscience
  • Psychopharmacology
  • Trauma Studies

Background:

  • Posttraumatic stress disorder (PTSD) has a clear cause and onset, yet limited psychopharmacologic research exists for its secondary prevention.
  • A translational model suggests traumatic events lead to overconsolidation of memory traces, mediated by stress hormones and noradrenergic hyperactivity in the amygdala, potentially causing PTSD.

Purpose of the Study:

  • To explore the potential of psychopharmacologic interventions for the secondary prevention of posttraumatic stress disorder (PTSD).
  • To review existing research on medications that may prevent PTSD development after traumatic events.

Main Methods:

  • Review of translational models of PTSD pathogenesis, focusing on the role of stress hormones and memory consolidation.
  • Analysis of controlled studies and clinical observations involving medications such as propranolol, morphine, and cortisol in trauma victims.

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  • Examination of the effects of alpha2-adrenergic agonists, opioids, beta-adrenergic antagonists, and cortisol on memory and fear conditioning.

    • Main Results:

    • Posttrauma administration of propranolol showed promise in reducing subsequent PTSD in trauma victims.
    • Morphine treatment in burned children was associated with reduced PTSD in a naturalistic study.
    • Cortisol administration in intensive care unit patients reduced PTSD, despite mixed predictions regarding its effects on memory consolidation and retrieval.
    • Benzodiazepines were found ineffective in preventing PTSD in one study.

    Conclusions:

    • Pharmacologic strategies targeting the noradrenergic system, such as beta-blockers (e.g., propranolol), may be effective in preventing PTSD after trauma.
    • Further research is needed to investigate other potential pharmacologic agents, including selective serotonin reuptake inhibitors and antiepileptics, for PTSD prevention.