The efficacy of initial hydrocortisone administration at preventing posttraumatic distress in adult trauma patients: a randomized trial

TLDR

Secondary pharmacological interventions have shown promise in preclinical studies for reducing posttraumatic stress disorder symptoms. The study evaluated whether a 10‑day low‑dose hydrocortisone course can prevent posttraumatic stress symptoms in trauma patients. Sixty‑four trauma patients were randomized in a double‑blind trial to receive 10 days of low‑dose hydrocortisone or placebo within 12 hours of injury, with PTSS and quality‑of‑life assessments at 1 and 3 months. Hydrocortisone recipients experienced significantly lower PTSD and depression symptoms, better quality of life, and the lowest PTSD scores among patients without prior mental health treatment, indicating a promising preventive effect.

Abstract

Objective/Introduction Secondary pharmacological interventions have shown promise at reducing the development of posttraumatic stress disorder symptoms (PTSS) in preclinical studies. The present study examined the preliminary efficacy of a 10-day low-dose (20 mg bid) course of hydrocortisone at preventing PTSS in traumatic injury victims. Methods Sixty-four traumatic injury patients (34% female) were randomly assigned in a double-blind protocol to receive either a 10-day course of hydrocortisone or placebo initiated within 12 hours of the trauma. One-month and 3-months posttrauma participants completed an interview to assess PTSS and self-report measures of depression and health-related quality of life. Results Hydrocortisone recipients reported fewer PTSD and depression symptoms, and had greater improvements in health-related quality of life during the first 3 months posttrauma than did placebo recipients. Hydrocortisone recipients who had never received prior mental health treatment had the lowest PTSD scores. Conclusion Low-dose hydrocortisone may be a promising approach to the prevention of PTSD in acutely injured trauma patients, and may be particularly efficacious in acutely injured trauma victims without a history of significant psychopathology.