title: Prevention of posttraumatic stress disorder with propranolol: A meta-analytic review.
abstract: OBJECTIVE
  PTSD is associated with significant morbidity and its prevention could reduce a significant burden of individual and societal suffering. The aim of this study is to conduct a systematic review of the literature on the prevention of PTSD by using propranolol following exposure to a traumatic event.
  
  
  METHODS
  Authors searched all studies published in the MEDLINE database up to November 2014 and reviewed textbooks and reference lists. Authors of relevant articles were contacted. Clinical trials and observational studies were included if they investigated the effect of propranolol in the acute post-trauma phase to prevent PTSD symptoms for subjects 18 years of age or older. PTSD was diagnosed according to DSM or widely accepted and validated diagnostic tools. A random-effects model was used to perform meta-analysis.
  
  
  RESULTS
  Five studies were included in the review for meta-analysis. Heterogeneity was not significant (τ2=0.0, S.E=0.247; Cochran's Q(4)=1.870, p=0.760; I2=0%). Relative risk point estimate to the effect of propranolol to prevent PTSD was 0.92 (95% CI: 0.55-1.55). Asymmetry was not significant under the Egger test (z=-1.34; p=0.180).
  
  
  CONCLUSIONS
  The findings suggest that propranolol treatment after the traumatic event did not alter the incidence of PTSD, although physiological responses are generally attenuated. The studies included small sample sizes, which can preclude the detection of significant results. Authors believe future studies should achieve larger sample sizes and longer follow-up periods.
authors.affiliation: Departamento de Neurociências e Saúde Mental, Faculdade de Medicina da Bahia e Serviço de Psiquiatria, Com-HUPES, Universidade Federal da Bahia, Salvador, Brazil.
authors.forename: Felipe C
authors.initials: FC
authors.lastname: Argolo
authors.affiliation: Programa de Pós-graduação em Medicina e Saúde (PPgMS), Faculdade de Medicina da Universidade Federal da Bahia, Salvador, Brazil; Escola Multicampi de Ciências Médicas (EMCM), Universidade Federal do Rio Grande do Norte (UFRN), Caicó, Brazil.
authors.forename: Patrícia
authors.initials: P
authors.lastname: Cavalcanti-Ribeiro
authors.affiliation: Programa de Pós-graduação em Medicina e Saúde (PPgMS), Faculdade de Medicina da Universidade Federal da Bahia, Salvador, Brazil.
authors.forename: Liana R
authors.initials: LR
authors.lastname: Netto
authors.affiliation: Departamento de Neurociências e Saúde Mental, Faculdade de Medicina da Bahia e Serviço de Psiquiatria, Com-HUPES, Universidade Federal da Bahia, Salvador, Brazil; Programa de Pós-graduação em Medicina e Saúde (PPgMS), Faculdade de Medicina da Universidade Federal da Bahia, Salvador, Brazil. Electronic address: lcq@ufba.br.
authors.forename: Lucas C
authors.initials: LC
authors.lastname: Quarantini
mesh_terms: D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006801:Humans; D064887:Observational Studies as Topic; D011433:Propranolol / Q000627:therapeutic use*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology
chemical_list: D014151:Anti-Anxiety Agents; D011433:Propranolol
keywords: Posttraumatic stress disorder; Prevention; Propranolol