Immediate treatment with propranolol decreases posttraumatic stress disorder two months after trauma

Vaïva, Guillaume; Ducrocq, François; Jézéquel, Karine; Averland, Benoit; Lestavel, P.; Brunet, Alain; Marmar, Charles R.

doi:10.1016/s0006-3223(03)00412-8

Cited by 453 publications

(285 citation statements)

References 12 publications

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“…In animal research, these substances are usually given after reactivation to only affect postretrieval processes. In the study by Brunet et al (2008), a similar postreactivation approach was taken, although in the clinical trials mentioned in the introduction (Aerni et al 2004;Pitman et al 2002;Soravia et al 2006;Vaiva et al 2003), cortisol and propranolol were administered during a longer time span or before retrieval as well. The fact that, in this study, drugs were active during both retrieval and postretrieval processes could potentially explain our nonresults with regard to the prolonged effects of cortisol and propranolol.…”

Section: Discussionmentioning

confidence: 99%

“…Namely, perioperative cortisol administration reduced PTSD symptoms at 6 months after cardiac surgery ) and repeated cortisol administration was found to reduce symptoms of re-experiencing and intensity of the traumatic memories in PTSD patients (Aerni et al 2004) and also to reduce phobic fears (Soravia et al 2006). Propranolol administered within hours of a traumatic experience was found to reduce subsequent physiologic responding to traumatic memories (Pitman et al 2002) and development of PTSD symptoms (Vaiva et al 2003). Although these studies show clinically relevant effects of cortisol and propranolol, the mechanisms through which these substances work are still unclear.…”

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confidence: 98%

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Psychophysiological responding to emotional memories in healthy young men after cortisol and propranolol administration

et al. 2009

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Rationale Propranolol is found to reduce physiological hyper-responsiveness in post traumatic stress disorder (PTSD), possibly by affecting reconsolidation after the reactivation of traumatic memories. Cortisol is found to attenuate declarative memory retrieval, but it is unknown whether it also reduces physiological responses to emotional memories. Objectives To examine whether the effects of propranolol on physiological responding to emotional memories can also be found in healthy controls and to investigate the immediate and prolonged effects of cortisol on physiological responding to emotional memories, we tested these effects in 79 healthy young men. Materials and methods After preparing a script of a negative disturbing memory, participants were instructed to imagine this event 1 week later after ingestion of either 35 mg cortisol, 80 mg propranolol, or a placebo. Physiological responding to the script-driven imagery was recorded. Another week later, after washout, the imagery was repeated again. During all three sessions as well as 8 months later, subjective emotional reactions to the memories were assessed. ResultsThe emotionality of the memories was reduced over time, which was not affected by the treatments, however. The personal emotional script did evoke higher skin conductance responses than a neutral story, which decreased 1 week later, but no effects were found of either propranolol or cortisol on this responsiveness. Conclusions Whereas healthy males do show psychophysiological responding to personal emotional scripts, the effects of cortisol and propranolol on physiological responses to emotional memories might be specific to clinical groups characterized by hyper-responsiveness, like PTSD. Future studies using longer-acting doses and more elaborate reactivation procedures in both healthy men and women could shed more light on the effects of cortisol and propranolol on psychophysiological responding to emotional memories.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 98%

Psychophysiological responding to emotional memories in healthy young men after cortisol and propranolol administration

et al. 2009

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“…Several studies have examined the utility of cortisol and a beta-adrenergic blocker (propranolol) in the treatment of PTSD. These studies have shown promising results, with reductions in re-experiencing and chronic stress symptoms after cortisol administration (Aerni et al, 2004;Weis et al, 2006) and reduced physiological reactivity after propranolol treatment (Brunet et al, 2008;Pitman et al, 2002;Vaiva et al, 2003). Phobic fears and mood responses to stress also seem to be reduced by cortisol administration (Het & Wolf, 2007;Soravia et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Immediate and prolonged effects of cortisol, but not propranolol, on memory retrieval in healthy young men

Tollenaar

Elzinga

Spinhoven

et al. 2009

Neurobiology of Learning and Memory

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a b s t r a c tBackground: While acute cortisol administration has been found to impair retrieval of emotional memories in healthy subjects, the duration of this memory impairment is still unknown. Propranolol, on the other hand, may impair the reconsolidation of emotional memories during reactivation, although human studies examining such effects are scarce. The present investigation was therefore undertaken to examine the immediate and prolonged effects of a single administered dose of cortisol or propranolol on memory retrieval in a double-blind placebo controlled design. Methods: Eighty-five healthy male participants were asked to retrieve previously learned emotional and neutral information after ingestion of 35 mg cortisol, 80 mg propranolol or placebo. After a washout period of 1 week, recall was again tested. Results: Memory retrieval of neutral and emotional information was impaired by a single dose of cortisol compared to placebo. The memory impairment due to cortisol remained, even after a washout period of 1 week. No immediate or prolonged effects of propranolol on memory retrieval were found, despite significant reductions in sympathetic arousal. Conclusions: These results lend support to the hypothesis that cortisol is able to attenuate (emotional) memory recall in men over longer time spans and may therefore augment the treatment of disorders like post-traumatic stress disorder and phobias, but do not clarify the mechanism(s) through which propranolol exerts its therapeutic effects.

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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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Immediate treatment with propranolol decreases posttraumatic stress disorder two months after trauma

Cited by 453 publications

References 12 publications

Psychophysiological responding to emotional memories in healthy young men after cortisol and propranolol administration

Psychophysiological responding to emotional memories in healthy young men after cortisol and propranolol administration

Immediate and prolonged effects of cortisol, but not propranolol, on memory retrieval in healthy young men

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

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