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Randomized Controlled Trial
. 2013 Apr;18(2):103-11.
doi: 10.1017/S1092852913000096.

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

Douglas L Delahanty  1 , Crystal Gabert-Quillen, Sarah A Ostrowski, Nicole R Nugent, Beth Fischer, Adam Morris, Roger K Pitman, John Bon, William Fallon
Affiliations
Randomized Controlled Trial

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

Douglas L Delahanty et al. CNS Spectr. 2013 Apr.

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.

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Figures

Figure 1
Figure 1
Consort flow diagram of participants through the protocol.
Figure 2
Figure 2
Adjusted mean CAPS total PTSD symptom scores (± std. error) for the placebo and hydrocortisone groups at 1 and 3 months posttrauma.
Figure 3
Figure 3
CESD depression scores (estimated marginal means) for the placebo and hydrocortisone groups at 1 and 3 months posttrauma.
See this image and copyright information in PMC

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