Emergency department attenders (, 11 male) exposed to a traffic accident or physical assault
Nonrandomized open trial
Propranolol, 120 mg/day for 7 days ( on propranolol, 8 receiving treatment as usual)
PTSD diagnosis as per DSM-IV; PTSD symptoms as measured by Treatment Outcome PTSD Scale
9.5 ± 6 hours (range 2–20 hours)
2 months
Nonsignificantly lower PTSD diagnoses across groups (3/8 in controls, 1/11 in the propranolol group); significantly lower PTSD Scale symptoms in the propranolol group.
Hydrocortisone, 100–140 mg as a single dose ( on hydrocortisone, 8 on placebo)
PTSD symptoms as per CAPS
<6 hours
3 months
Significantly lower PTSD symptom scores in the hydrocortisone group at 2 weeks and 3 months, but not at 1 month; trend to less frequent PTSD diagnosis at 3 months in the hydrocortisone group (0/9 versus 3/8 on placebo)
Hydrocortisone, 40 mg/d orally for 10 days ( on hydrocortisone, 33 on placebo)
PTSD diagnosis and PTSD symptoms as per CAPS
<12 hours
3 months
Significantly lower PTSD symptom scores in the hydrocortisone group at 1 and 3 months (); less frequent PTSD diagnosis in the hydrocortisone group at 3 months, but not significant
Adult survivors of trauma admitted to emergency services (; 107 male)
Randomized, double-blind, placebo-controlled study
Escitalopram, 20 mg/day for 12 weeks ( on escitalopram, 23 on placebo; 93 wait-list controls; 63 on prolonged exposure; 40 on cognitive therapy)
PTSD diagnosis and PTSD symptoms as per CAPS
29.35 ± 4.91 days
9 months
Similar rates of PTSD in the escitalopram and placebo groups at 5 months (61.9% versus 55.6% placebo) and 9 months (42.1% versus 47.1% placebo); no difference in PTSD symptoms
Benzodiazepines, either clonazepam (, mean dose 2.7 mg/day) or alprazolam (, mean dose 2.5 mg/day). 13 gender-matched trauma survivors formed the control group
PTSD diagnosis and PTSD symptoms as per CAPS
6.7 ± 5.8 days (range 2–18 days)
6 months
Higher rates of PTSD in the benzodiazepine group at 6 months (9/13 versus 3/13 in controls; )
Adult trauma centre admissions (; 14 male; 15 had traffic accidents)
Randomized, placebo-controlled study
Temazepam, 30 mg for 7 days ( on temazepam, 11 on placebo)
PTSD diagnosis and PTSD symptoms as per CAPS
14.3 ± 10 days
6 weeks
Nonsignificantly higher rates of PTSD in the benzodiazepine group at 6 weeks (6/11 versus 3/11 in controls; no significant effect of treatment on PTSD symptoms)
Patients presenting to an ICU with accidental injuries (; 11 completed the study)
Open-label study
PUFA capsules, 7/day for 12 weeks; no control group
PTSD diagnosis as per DSM-IV; PTSD symptoms as per CAPS
<240 hours (10 days)
12 weeks
Only 1/11 subjects developed PTSD at 4 weeks, and retained the diagnosis at 12 weeks.
1
PTSD: posttraumatic stress disorder, CAPS: clinician-assessed PTSD scale; CAPS-CA: clinician-assessed PTSD scale for children and adolescents, PCL-C: posttraumatic stress disorder checklist-civilian version, ICU: intensive care unit, and PTSS-10: posttraumatic 10 stress symptom inventory.
*Study initially conducted to study the haemodynamic effects of hydrocortisone in septic shock; PTSD assessed at long-term follow-up.
#Study compared prolonged exposure (PE), cognitive therapy (CT), escitalopram and placebo.
$Hydrocortisone given as a loading dose at ICU admission. %Hydrocortisone given as a loading dose during induction of anaesthesia.
&This study included 12 children with acute burns and 14 admitted for reconstructive surgery, so time between trauma and sertraline initiation could not be computed.