Pharmacological interventions for preventing post-traumatic stress disorder (PTSD)

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There is not sufficient evidence yet to recommend any medication as a preventative treatment for post-traumatic stress disorder (PTSD). 

PTSD is a debilitating disorder which, after a sufficient delay, may be diagnosed among individuals who respond with intense fear, helplessness, or horror to traumatic events. There is some evidence that the use of pharmacological interventions immediately after exposure to trauma may reduce the risk of developing PTSD. This review assesses the effects of pharmacological interventions for the prevention of PTSD in adults, following exposure to a traumatic event. Inclusion criteria stated that studies had to be randomised controlled trials. As well, study participants had to be adults aged over 18, who had experienced traumatic events but did not have a diagnosis of PTSD at the time of starting medication. Authors found nine studies with a total of 345 participants. Seven out of the nine studies had a high risk of bias due to problems with the research design. There was moderate quality evidence that hydrocortisone (a steroid medication) prevented PTSD. There was moderate quality evidence that hydrocortisone reduced the severity of PTSD symptoms. There was no evidence that propranolol (a beta‐blocker), escitalopram (a type of antidepressant), temazepam (a tranquillizer) or gabapentin (an anticonvulsant) prevented PTSD. All medications were acceptable, with low numbers of people dropping out due to side effects; however not all studies provided information on this. Future high quality research is needed to provide stronger evidence for the effectiveness of medications in preventing PTSD.

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