Table of Contents
Advances in Psychiatry
Volume 2014 (2014), Article ID 529562, 10 pages
http://dx.doi.org/10.1155/2014/529562
Review Article

Pharmacological Prevention of Posttraumatic Stress Disorder: A Systematic Review

1Department of Psychiatry, Disaster Management Committee, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605 006, India
2Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605 006, India

Received 26 July 2014; Accepted 26 September 2014; Published 12 October 2014

Academic Editor: Takahiro Nemoto

Copyright © 2014 Ravi Philip Rajkumar and Balaji Bharadwaj. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Various interventions, both psychological and pharmacological, have been studied for their efficacy in preventing posttraumatic stress disorder (PTSD) following trauma exposure. However, the preventive effect of pharmacotherapy has not been systematically assessed. Methodology. A systematic review of all clinical trials of drug therapy to prevent PTSD, available through the PubMed and EMBASE databases, was conducted. This included an assessment of each study’s quality. Results. A total of 13 studies were reviewed. The drugs examined in these papers included propranolol, hydrocortisone, serotonin reuptake inhibitors, gabapentin, omega-3 fatty acids, and benzodiazepines. There was marked heterogeneity across studies in terms of quality, study populations, and methodology. Analysis of the outcomes revealed preliminary evidence for the efficacy of hydrocortisone, particularly in critical care settings. There was no consistent evidence to support the use of other drugs to prevent PTSD. Discussion. There may be a limited role for hydrocortisone in preventing the development of PTSD in specific settings. Results with other drugs are inconsistent. Further large-scale studies should assess the efficacy of these approaches in other contexts, such as natural disasters, and the time frame within which they should be used.