Pharmacological treatment of acute stress disorder with propranolol and hypnotics.
BACKGROUND
Pharmacological treatment of traumarelated mobidity has neither the efficacy nor specificity desired. Thus, several attempts have been made to add new drugs to the usual treatments, in this case with propranolol and hypnotic drugs.


METHODS
We offered this treatment to the victims of the March 11, 2004 terrorism attack who were attended within the first week of this attack for psychiatric reasons (n=21) and who also fulfilled criteria for acute stress disorder (ASD) (n=15) and had no contraindications for the treatment (n=3). Trauma intensity was measured with Horowitz impact of events scale (IES). Significant clinical data were collected.


RESULTS
Propranolol treatment was associated with clinical remission of target symptoms in 63.6 % of the cases, partial response in 27.3 % and no response in 9.1%. Hypnotic treatment was also associated with clinical remission in 61.5 % and partial response in 38.5 %. Statistically significant correlations were found at the beginning for IES with disability, and after the first month with the propranolol and hypnotic responses.


CONCLUSIONS
Propranolol and hypnotic treatments are useful in the decrease of ASD symptoms. IES is very useful to predict disability as well as poor response to propranolol or hypnotic drugs. More studies are needed to confirm the data obtained in our sample.
Pastrana Jiménez
J  I
J
Psychiatry and Clinical Psychology Unit, Dirección Médica de Contingencias Comunes de los Servicios Centrales de Ibermutuamur, Madrid, Spain. joseignaciopastrana@ibermutuamur.es
Catalina Romero
C
C
García Diéguez
N
N
Lopez-Ibor Aliño
J J
JJ
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D011433:Propranolol / Q000627:therapeutic use*; D012074:Remission Induction; D040701:Stress Disorders, Traumatic, Acute / Q000188:drug therapy* / Q000453:epidemiology
D000319:Adrenergic beta-Antagonists; D006993:Hypnotics and Sedatives; D011433:Propranolol