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Reduction in the occurrence of distressing involuntary memories following propranolol or hydrocortisone in healthy women
Kamboj, Sunjeev K. Gong, An Tong Sim, ZhiHui Rashid, Adrihani A. Baba, Ami Iskandar, Georges Das, Ravi K. Curran, H. Valerie
Kamboj, Sunjeev K.
Gong, An Tong
Sim, ZhiHui
Rashid, Adrihani A.
Baba, Ami
Iskandar, Georges
Das, Ravi K.
Curran, H. Valerie
Abstract
Background
Pharmacological treatments targeting the neuroendocrine stress response may hold special promise in secondary prevention of posttraumatic stress disorder (PTSD). However, findings from clinical trials have been inconsistent and the efficacy of specific drugs, their temporal window of efficacy, effective doses and the characteristics of likely treatment responders remain unclear.
Method
Using an experimental human model of distressing involuntary memory formation, we compare the effects of two drugs that have theoretical or empirical support as secondary preventive agents in PTSD. Eighty-eight healthy women (average age: 23.5 years) received oral propranolol (80 mg), hydrocortisone (30 mg), or matched placebo immediately after viewing a ‘trauma film’. They then completed daily, time-stamped intrusion diaries for 1 week, at the end of which, voluntary memory was tested.
Results
While neither drug affected voluntary memory for the trauma narrative, propranolol treatment was associated with 42% fewer, and hydrocortisone with 55% fewer intrusions across the week, relative to placebo. Additionally, propranolol reduced general trauma-like symptoms, and post-drug cortisol levels were negatively correlated with intrusion frequency in the hydrocortisone group.
Conclusions
Overall, this study shows substantial reductions in intrusive memories and preserved voluntary narrative-declarative memory following either propranolol or hydrocortisone in an experimental model of psychological trauma. As such, despite some inconsistencies in clinical trials, our findings support continued investigation of propranolol and hydrocortisone as secondary preventive agents for re-experiencing symptoms of PTSD. The findings also suggest that it is critical for future research to identify the conditions governing the preventive efficacy of these drugs in PTSD.
Keywords
acute stress disorder, glucocorticoid, hydrocortisone, intrusions, involuntary memory, noradrenergic, posttraumatic stress disorder, propranolol, secondary prevention
Date
2020
Type
Journal article
Journal
Psychological Medicine
Book
Volume
50
Issue
7
Page Range
1148-1155
Article Number
ACU Department
School of Behavioural and Health Sciences
Faculty of Health Sciences
Faculty of Health Sciences
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled