The efficacy of early propranolol administration at reducing PTSD symptoms in pediatric injury patients: a pilot study
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Published on: December 18, 2014
Nicole R Nugent1, Norman C Christopher, John P Crow
1Alpert Brown Medical School and Bradley/Hasbro Children's Research Center, One Hoppin Street, Suite 204, Providence, Rhode Island 02903, USA.
Insights
Propranolol may not prevent posttraumatic stress disorder (PTSD) in children. Gender influences treatment effectiveness, with girls showing increased symptoms while boys trended toward improvement.
Area of Science:
- Psychiatry
- Pediatric Medicine
- Pharmacology
Background:
- Posttraumatic stress disorder (PTSD) is a significant concern following trauma in youth.
- Pharmacological interventions for preventing pediatric PTSD are under-researched.
- Propranolol has shown promise in preventing PTSD in adults.
Purpose of the Study:
- To investigate the efficacy of propranolol in preventing PTSD in pediatric injury patients.
- To examine potential gender differences in response to propranolol for PTSD prevention in adolescents.
Main Methods:
- A double-blind, randomized trial involving 29 injury patients (ages 10-18) at risk for PTSD.
- Participants received either propranolol or placebo for 10 days, initiated within 12 hours of admission.
- Assessment of PTSD symptoms and heart rate at six weeks.
Main Results:
- No significant group differences in PTSD symptoms were found in intent-to-treat analyses.
- A significant interaction between gender and treatment was observed in medication-adherent participants.
- Girls receiving propranolol reported increased PTSD symptoms compared to placebo; boys showed a trend toward reduced symptoms.
Conclusions:
- Propranolol's efficacy for preventing pediatric PTSD may be gender-dependent.
- Findings suggest potential differential effects of propranolol on PTSD symptomology in adolescent boys versus girls.
- Further research is needed to understand gender-specific pharmacological approaches to pediatric PTSD prevention.
Abstract:
Initial research supports the use of propranolol to prevent posttraumatic stress disorder (PTSD); research has not examined pharmacological prevention for children. Twenty-nine injury patients (ages 10-18 years old) at risk for PTSD were randomized to a double-blind 10-day trial of propranolol or placebo initiated within 12 hours postadmission. Six-week PTSD symptoms and heart rate were assessed. Although intent-to-treat analyses revealed no group differences, findings supported a significant interaction between gender and treatment in medication-adherent participants, Delta R(2) = .21. Whereas girls receiving propranolol reported more PTSD symptoms relative to girls receiving placebo, Delta R(2) = .44, boys receiving propranolol showed a nonsignificant trend toward fewer PTSD symptoms than boys receiving placebo, Delta R(2) = .32. Findings inform gender differences regarding pharmacological PTSD prevention in youth.