The efficacy of initial hydrocortisone administration at preventing posttraumatic distress in adult trauma patients: a randomized trial

CNS Spectr. 2013 Apr;18(2):103-11. doi: 10.1017/S1092852913000096.

Abstract

OBJECTIVE/INTRODUCTION: Secondary pharmacological interventions have shown promise at reducing the development of posttraumatic stress disorder symptoms (PTSS) in preclinical studies. The present study examined the preliminary efficacy of a 10-day low-dose (20 mg bid) course of hydrocortisone at preventing PTSS in traumatic injury victims.

Methods: Sixty-four traumatic injury patients (34% female) were randomly assigned in a double-blind protocol to receive either a 10-day course of hydrocortisone or placebo initiated within 12 hours of the trauma. One-month and 3-months posttrauma participants completed an interview to assess PTSS and self-report measures of depression and health-related quality of life.

Results: Hydrocortisone recipients reported fewer PTSD and depression symptoms, and had greater improvements in health-related quality of life during the first 3 months posttrauma than did placebo recipients. Hydrocortisone recipients who had never received prior mental health treatment had the lowest PTSD scores.

Conclusion: Low-dose hydrocortisone may be a promising approach to the prevention of PTSD in acutely injured trauma patients, and may be particularly efficacious in acutely injured trauma victims without a history of significant psychopathology.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anti-Anxiety Agents / therapeutic use*
  • Double-Blind Method
  • Female
  • Humans
  • Hydrocortisone / therapeutic use*
  • Male
  • Middle Aged
  • Risk Factors
  • Stress Disorders, Post-Traumatic / drug therapy
  • Stress Disorders, Post-Traumatic / prevention & control*
  • Treatment Outcome

Substances

  • Anti-Anxiety Agents
  • Hydrocortisone