title: Pilot study of secondary prevention of posttraumatic stress disorder with propranolol.
abstract: BACKGROUND
  Preclinical considerations suggest that treatment with a beta-adrenergic blocker following an acute psychologically traumatic event may reduce subsequent posttraumatic stress disorder (PTSD) symptoms. This pilot study addressed this hypothesis.
  
  
  METHODS
  Patients were randomized to begin, within 6 hours of the event, a 10-day course of double-blind propranolol (n = 18) versus placebo (n = 23) 40 mg four times daily.
  
  
  RESULTS
  The mean (SD) 1-month Clinician-Administered PTSD Scale (CAPS) score of 11 propranolol completers was 27.6 (15.7), with one outlier 5.2 SDs above the others' mean, and of 20 placebo completers, 35.5 (21.5), t = 1.1, df = 29, p =.15. Two propranolol patients' scores fell above, and nine below, the placebo group's median, p =.03 (sign test). Zero of eight propranolol, but six of 14 placebo, patients were physiologic responders during script-driven imagery of the traumatic event when tested 3 months afterward, p =.04 (all p values one-tailed).
  
  
  CONCLUSIONS
  These pilot results suggest that acute, posttrauma propranolol may have a preventive effect on subsequent PTSD.
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02129, USA.
authors.forename: Roger K
authors.initials: RK
authors.lastname: Pitman
authors.forename: Kathy M
authors.initials: KM
authors.lastname: Sanders
authors.forename: Randall M
authors.initials: RM
authors.lastname: Zusman
authors.forename: Anna R
authors.initials: AR
authors.lastname: Healy
authors.forename: Farah
authors.initials: F
authors.lastname: Cheema
authors.forename: Natasha B
authors.initials: NB
authors.lastname: Lasko
authors.forename: Larry
authors.initials: L
authors.lastname: Cahill
authors.forename: Scott P
authors.initials: SP
authors.lastname: Orr
mesh_terms: D000063:Accidents, Traffic / Q000523:psychology; D000328:Adult; D001143:Arousal / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011433:Propranolol / Q000009:adverse effects / Q000627:therapeutic use*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology
chemical_list: D011433:Propranolol