Pilot study of secondary prevention of posttraumatic stress disorder with propranolol.
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.
Pitman
Roger K
RK
Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02129, USA.
Sanders
Kathy M
KM
Zusman
Randall M
RM
Healy
Anna R
AR
Cheema
Farah
F
Lasko
Natasha B
NB
Cahill
Larry
L
Orr
Scott P
SP
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
D011433:Propranolol