Low-Dose Cortisol for Symptoms of Posttraumatic Stress Disorder

Aerni, Amanda; Traber, Rafael; Höck, Christoph; Roozendaal, Benno; Schelling, Gustav; Papassotiropoulos, Andreas; Nitsch, Roger M.; Schnyder, Ulrich; Quervain, Dominique J.‐F. de

doi:10.1176/appi.ajp.161.8.1488

Cited by 311 publications

(206 citation statements)

References 8 publications

Supporting

Mentioning

184

Contrasting

Unclassified

Order By: Relevance

“…Even though propranolol was found to attenuate physiological responding (heart rate and SCL) to traumatic scripts in PTSD patients (Brunet et al 2008), we did not find such effects to negative emotional scripts in healthy young men. These results also contrast the finding by Het and Wolf (2007) that cortisol can affect the emotional experience of negative events and the finding that cortisol can reduce the intensity of traumatic memories (Aerni et al 2004). However, methodological differences between these studies and our study might have caused these conflicting findings, as we will discuss below.…”

Section: Discussioncontrasting

confidence: 99%

“…However, reconsolidation of emotional memories could possibly take longer than a few hours, and longer-acting doses might, therefore, be needed to affect these reconsolidation processes. Cortisol on the other hand, was given in lower doses in the clinical studies by Aerni et al (2004) and Schelling et al (2004), but the doses were given daily instead of once, leading to active cortisol during potentially multiple memory reactivations. While in the present study the dose may have been too low or shortacting to obtain reductions in physiological arousal in response to personalized scripts, in the same population as the present study, we did find long-term impairing effects of the 35-mg cortisol dose on declarative memory retrieval (Tollenaar et al 2008c).…”

Section: Discussionmentioning

confidence: 99%

“…Preliminary results have indeed shown that administration of both cortisol and propranolol can diminish PTSD and anxiety symptoms. 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).…”

mentioning

confidence: 97%

See 2 more Smart Citations

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

et al. 2009

View full text Add to dashboard Cite

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.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 97%

See 1 more Smart Citation

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

et al. 2009

View full text Add to dashboard Cite

show abstract

“…It is possible that the dysfunction in these disorders is related to the inability to normally extinguish fear. Recent clinical studies showed that PTSD patients often appear to have reduced cortisol levels (Yehuda et al, 2004) and daily cortisol administration reduced symptoms of traumatic memory in PTSD patients (Aerni et al, 2004). These results suggest that brain glucocorticoid is involved in the dysregulation of fear memory extinction.…”

Section: Discussionmentioning

confidence: 90%

“…Recent clinical studies showed that PTSD patients often appear to have reduced cortisol levels (Yehuda et al, 2004). Aerni et al (2004) found that daily administration of cortisol reduced symptoms of traumatic memory in PTSD patients. Schelling et al (2004) showed that prolonged high-dose glucocorticoid treatment after trauma reduced the risk of humans developing PTSD.…”

Section: Introductionmentioning

confidence: 99%

Glutamate NMDA Receptors within the Amygdala Participate in the Modulatory Effect of Glucocorticoids on Extinction of Conditioned Fear in Rats

Yang

Chao

et al. 2006

Neuropsychopharmacol

View full text Add to dashboard Cite

Recent results show that brain glucocorticoids are involved in the dysregulation of fear memory extinction in post-traumatic stress disorder patients. The present study was aimed to elucidate the possible mechanism of glucocorticoids on the conditioned fear extinction. To achieve these goals, male SD rats, fear-potentiated startle paradigm, and Western blot were used. We found that (1) systemic administration of the synthetic glucocorticoid agonist dexamethasone (DEX) facilitated extinction of conditioned fear in a dose-dependent manner (0.05, 0.1, 0.5, or 1.0 mg/kg, i.p.); (2) systemic administration of the glutamate NMDA receptor antagonist (7)-HA966 (6.0 mg/kg, i.p.) and intra-amygdala infusion of the NMDA receptor antagonists MK801 (0.5 ng/side, bilaterally) or D,L-2-amino-5-phosphonovaleric acid (AP5, 2.0 ng/side, bilaterally) blocked the DEX facilitation effect; (3) the corticosteroid synthesis inhibitor metyrapone (25 mg/kg. s.c.) blocked extinction and this was prevented by co-administration of NMDA receptor agonist D-cycloserine (DCS, 5.0 mg/kg, i.p.); (4) co-administration of DEX and DCS in subthreshold doses provided a synergistic facilitation effect on extinction (0.2 and 5 mg/kg, respectively). Control experiments indicated that co-administration of DEX and DCS did not alter the expression of conditioned fear and the effect was not due to lasting damage to the amygdala. These results suggest that glutamate NMDA receptors within the amygdala participate in the modulatory effect of glucocorticoids on extinction.

show abstract

Pharmacotherapy for post traumatic stress disorder (PTSD)

Stein

Ipser

Seedat

et al. 2006

Cochrane Database of Systematic Reviews

303

118

View full text Add to dashboard Cite

show abstract

Low-Dose Cortisol for Symptoms of Posttraumatic Stress Disorder

Abstract: The results of this pilot study indicate that low-dose cortisol treatment reduces the cardinal symptoms of PTSD.

Cited by 311 publications

References 8 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

Glutamate NMDA Receptors within the Amygdala Participate in the Modulatory Effect of Glucocorticoids on Extinction of Conditioned Fear in Rats

Pharmacotherapy for post traumatic stress disorder (PTSD)

Contact Info

Product

Resources

About