Dexamethasone in Clinical Treatment of Acute Exacerbation of Chronic PTSD

Driscoll, Helen

doi:10.1037/e517292011-177

Cited by 1 publication

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“…On the other hand, dexamethasone suppression of cortisol does not appear to affect memory in PTSD (Bremner et al, 2004). Interestingly, chronic daily administration of low dose cortisol appears to ameliorate PTSD symptoms (Aerni et al, 2004), while case studies of acute dexamethasone administration have also indicated improvement in symptoms (Driscoll, 2009). Future studies should focus on GR system targets as a possible adjunct therapy to other treatment strategies in patients with PTSD.…”

Section: Discussionmentioning

confidence: 99%

Cortisol suppression by dexamethasone reduces exaggerated fear responses in posttraumatic stress disorder

Jovanović

Phifer

Sicking

et al. 2011

Psychoneuroendocrinology

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Summary PTSD symptoms are associated with heightened fear responses in laboratory fear conditioning paradigms. This study examined the effects of dexamethasone administration on hypothalamic–pituitary–adrenal (HPA) function and fear-potentiated startle (FPS) in trauma-exposed individuals with and without PTSD. We used an established fear discrimination procedure, in which one visual stimulus (CS+, danger cue) was paired with aversive airblasts to the throat (unconditioned stimulus, US), and another stimulus (CS−, safety cue) was presented without airblasts. In addition to FPS, the dexamethasone suppression test (DST) was performed. The study sample (N = 100) was recruited from a highly traumatized civilian population in Atlanta, GA. Half of the subjects (n = 54, 16 PTSD, 38 controls) underwent conditioning at baseline and the other half (n = 46, 17 PTSD, 29 controls) after DST, in a cross-sectional design. We found a significant interaction effect of diagnostic group and dexamethasone treatment. Under baseline conditions, subjects with PTSD showed more than twice as much fear-potentiated startle to the danger cue compared to traumatized controls, F(1,53) = 8.08, p = 0.006. However, there was no group difference in subjects tested after dexamethasone suppression. Furthermore, there was a significant treatment effect in PTSD subjects but not in controls, with dexamethasone reducing fear-potentiated startle to the CS+, F(1,32) = 4.00, p = 0.05. There was also a positive correlation between PTSD subjects’ FPS and cortisol levels, r = 0.46, p = 0.01. These results suggest that transient suppression of HPA function via dexamethasone suppression may reduce exaggerated fear in patients with PTSD.

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Section: Discussionmentioning

confidence: 99%