title: Effects of dexamethasone on declarative memory function in posttraumatic stress disorder.
abstract: Alterations in the hypothalamic-pituitary-adrenal (HPA) axis and hippocampal-based memory have been associated with posttraumatic stress disorder (PTSD), and the administration of exogenous glucocorticoids has been shown to result in a transient verbal declarative memory impairment in healthy human subjects. The purpose of this study was to assess the effects of the glucocorticoid dexamethasone on verbal declarative memory function in patients with PTSD. Forty-two men and women with (n=14) and without (n=28) PTSD received placebo or dexamethasone (1 and 2 mg on two successive days) in a double-blind, randomized fashion. Declarative memory was assessed with paragraph recall at baseline (day 1) and day 3. There was a significant interaction between diagnosis and drug (dexamethasone vs. placebo) on paragraph recall related to a relative detrimental effect of dexamethasone on memory function in healthy subjects, but not those with PTSD. These findings are consistent with an altered sensitivity of declarative memory function in PTSD to regulation by glucocorticoids, possibly explainable by alterations in glucocorticoid receptors in the hippocampus or other brain regions mediating declarative memory.
authors.affiliation: Departments of Psychiatry and Behavioral Sciences and Radiology, Emory Center for Positron Emission Tomography, Emory University School of Medicine, Atlanta 30306 GA, USA. jdbremn@emory.edu
authors.forename: J Douglas
authors.initials: JD
authors.lastname: Bremner
authors.forename: Meena
authors.initials: M
authors.lastname: Vythilingam
authors.forename: Eric
authors.initials: E
authors.lastname: Vermetten
authors.forename: Nadeem
authors.initials: N
authors.lastname: Afzal
authors.forename: Ahsan
authors.initials: A
authors.lastname: Nazeer
authors.forename: John W
authors.initials: JW
authors.lastname: Newcomer
authors.forename: Dennis S
authors.initials: DS
authors.lastname: Charney
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects*; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006624:Hippocampus / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D011939:Mental Recall / Q000187:drug effects; D009483:Neuropsychological Tests; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology / Q000523:psychology*; D013997:Time Factors
chemical_list: D000893:Anti-Inflammatory Agents; D003907:Dexamethasone