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

Delahanty, Douglas L.; Gabert-Quillen, Crystal A.; Ostrowski, Sarah A.; Nugent, Nicole R.; Fischer, Bianca; Morris, Adam; Pitman, Roger K.; Bon, John; Fallon, William F.

doi:10.1017/s1092852913000096

Cited by 96 publications

(68 citation statements)

References 59 publications

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“…Patients receiving hydrocortisone had significantly lower PTSD symptoms at 3 months. In another trial, 64 traumatic injury patients received a 10-day course of low-dose hydrocortisone or placebo initiated within 12 h of trauma, and those receiving hydrocortisone had lower PTSD symptoms at 3 months (Delahanty et al, 2013). Overall, while glucocorticoids for PTSD prevention need more study, preliminary studies have shown promise that they may be effective for some trauma survivors.…”

Section: Somatic Approachesmentioning

confidence: 99%

Prevention of Trauma and Stressor-Related Disorders: A Review

Howlett

Stein

2015

Neuropsychopharmacol

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Posttraumatic stress disorder (PTSD) is a common, frequently chronic, and disabling condition which, along with acute stress disorder (ASD), is categorized as a trauma-and stressor-related disorder by the DSM-5. These disorders are unique in requiring exposure to a severe stressor, which implies that potential sufferers could be identified and helped before developing a disorder. Research on prevention strategies for stress-related disorders has taken a number of avenues, including intervention before and after trauma and the use of both psychosocial and somatic approaches. Despite advances in neurobiological understanding of response to trauma, clinical evidence for preventive interventions remains sparse. This review provides an overview of prevention approaches and summarizes the existing literature on prevention of ASD and PTSD, including clinical and preclinical studies. Given the potential benefits to trauma survivors and society, the development of effective preventive interventions should be given greater priority. Resources should be directed to adequately test promising interventions in clinical trials, and research should be conducted according to translational research principles in which preclinical research informs the design of clinical studies.

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Section: Somatic Approachesmentioning

confidence: 99%

Prevention of Trauma and Stressor-Related Disorders: A Review

Howlett

Stein

2015

Neuropsychopharmacol

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“…Two articles reported results compatible with a lower occurrence of PTSD and related symptoms 12,22 . These results were based mainly on scales applied after the intervention and at follow-up assessments.…”

Section: Pharmacological Interventionsmentioning

confidence: 93%

“…Results were divided according to the type of intervention (pharmacological or psychological). From the 29 articles reviewed, 16 reported significant effects of interventions for the prevention of PTSD or symptoms related to the disorder [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] . Of these, 22 studies used psychological interventions and 7 used pharmacological interventions (Table 2).…”

Section: Methodsmentioning

confidence: 99%

Early interventions for the prevention of PTSD in adults: a systematic literature review

Linares¹,

Corchs²,

Chagas³

et al. 2017

Arch. Clin. Psychiatry (São Paulo)

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Background: Secondary interventions are implemented within a short interval following the occurrence of traumatic events with the purpose of preventing the onset of PTSD. Objective: Analyze the results of studies that assessed post-trauma interventions in adults aimed at preventing the onset of PTSD or symptoms related to PTSD. Methods: We performed literature searches using the search expression [(Early intervention OR secondary prevention) AND (Post traumatic stress disorder OR PTSD)] for articles published until October 2016. Among the references found, 29 fulfilled the selection criteria established for the review. Data were divided and analyzed according to the type of intervention: pharmacological or psychological. Results: Psychological measures used in the studies lack homogeneity regarding the type of intervention and the assessment of intervention outcomes. Pharmacological interventions were less frequent and findings require replication, together with an expansion in the types of substances investigated. In general, many of the studies reviewed suggest that both pharmacological and psychological interventions are effective in the prevention of PTSD. Discussion: Future trials should be focused on determining the best interventions for the secondary prevention of PTSD. The combination of psychological and pharmacological interventions for post-trauma patients poses opportunities and challenges that remain unexplored.

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“…Based on the strong and evolving evidence from previous studies [44,45], the treatment included anti-depression pharmacological interventions, psychotherapeutic interventions and Prednisone. 1) Anti-depression pharmacological interventions: Citalopram (Cipramil, 20mg/tablet, 12 tablet, Lundbeck Denmark), which is an orally administered selective serotonin reuptake inhibitor (SSRI).…”

Section: Treatment For the Subjectsmentioning

confidence: 99%

Cortisol Supplement Combined with Psychotherapy and Citalopram Improves Depression Outcomes in Patients with Hypocortisolism after Traumatic Brain Injury

Luo¹,

Chai²,

Jiang³

et al. 2015

Aging and disease

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Depression is one of the most prevalent psychiatric disorders in people with Traumatic brain injury (TBI). Depression after TBI is closely related with social and psychological factors and hypothalamicpituitary -adrenal (HPA) axis dysfunction. However, there is a lack of evidence regarding effective treatment approaches for depression. A total of 68 patients with depression following closed TBI were recruited. Glasgow Coma Scale score (GCS) was employed to demonstrate the severity of neurological deficits and Glasgow Outcome Scale (GOS) was employed to measure functional outcome after TBI. The severity of depression was quantified using the Beck Depression Inventory-II (BDI-II) in line with DSM-IV. Citalopram and Prednisone were administered to subjects with normal cortisol levels or hypocortisolism separately, based on psychotherapeutic interventions. We investigated the relationship between degree of depression of TBI patients and the severity and progression of TBI with the therapeutic effects of Citalopram in combination with psychotherapeutic and Prednisone in depressed patients. There was no relationship between the severity of depression and the severity and progression of TBI. The basic treatment of psychotherapeutic interventions could partially relieve depressive symptoms. Combination of psychotherapeutic support and Citalopram significantly improved depressive symptoms in patients with normal cortisol levels, but not in hypocortisolic patients. Combination of Prednisone administration with psychotherapeutic treatment and Citalopram significantly improved depression outcome in hypocortisolic patients after TBI. Hypocortisolism after TBI may regulate depression. Combination of Prednisone with psychotherapeutic treatment and Citalopram may provide better therapeutic effects in depression patients with hypocortisolism after TBI.

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

Cited by 96 publications

References 59 publications

Prevention of Trauma and Stressor-Related Disorders: A Review

Prevention of Trauma and Stressor-Related Disorders: A Review

Early interventions for the prevention of PTSD in adults: a systematic literature review

Cortisol Supplement Combined with Psychotherapy and Citalopram Improves Depression Outcomes in Patients with Hypocortisolism after Traumatic Brain Injury

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