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Common Drug May Help Prevent PTSD

When Taken after Trauma, Inderal May Reduce PTSD Symptoms
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WebMD Health News

Oct. 30, 2003 -- Taking a common drug that lowers the heart rate and eases anxiety in the first hours following a major trauma may help prevent posttraumatic stress disorder in people at risk.

A small study suggests that the drug Inderal, which is often prescribed for people with abnormally fast heart rates, high blood pressure, or anxiety, may help stem the cascade of responses in the body caused by the rush of stress-related hormones that occurs when people are confronted with a life or death situation.

Although these results are only preliminary and based on a small number of people, researchers say the findings are encouraging.

"If this model proves accurate after five or 10 replications of studies like this one, it could have very profound ramifications," says researcher Charles Marmar, MD, professor of psychiatry at University of California, San Francisco, in a news release. "From a public health perspective, if you could identify the subgroup of people who are susceptible to PTSD, giving them this course of medication -- which is brief, very well tolerated and inexpensive -- could be very effective prevention."

Making a Model of PTSD

The strategy is based on a model of PTSD that holds that everyone experiences a flood of stress hormones in response to trauma. These hormones prime the body for the "fight or flight" response as well as raise the heart rate, constrict the blood vessels, and provide a surge of adrenaline for energy.

But in about 25% of people, these hormones remain elevated for hours, days, or even weeks following a traumatic experience. According to this model, it is these people who are most at risk for developing PTSD because the longer this adrenaline surge lasts, the more vivid the memories of the event become.

"Our working model is that if you experience a more intense panic reaction in a life-threatening situation and it takes you a longer period of time to calm down afterwards than most people, you are having a sustained [hormonal] reaction and you are more likely to be among those 25% of people who are at risk of developing PTSD," says Marmar.

Preventing PTSD

Researchers say by identifying those people at risk and intervening and calming them down, it may be possible to reduce the symptoms of PTSD or even prevent it.

In this study, which appears in the Nov. 1 issue of Biological Psychiatry, researchers evaluated victims of physical assault or auto accidents for signs of prolonged panic reactions within 24 hours of the trauma and had heart rates higher than 90 beats per minute after they had been lying down for 20 minutes.

The patients were offered an immediate dose of Inderal, followed by three daily doses for seven days and a tapering off period.

Two months later, the patients underwent psychological testing, and researchers found almost all patients had some symptoms of PTSD, but the severity of symptoms was twice as high among those that hadn't taken Inderal. Only one of the Inderal patients had PTSD symptoms strong enough to meet a diagnosis of PTSD, compared with three of eight patients who declined the drug.

Researchers say this is the second study to look at the effects of using Inderal after traumatic injury, and the findings may show that the drug may be useful for reducing PTSD symptoms and perhaps even preventing PTSD from occurring in people at risk for the disorder.

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