普萘洛尔用于创伤后应激障碍二级预防的初步研究。
Pilot study of secondary prevention of posttraumatic stress disorder with propranolol.
作者信息
Pitman Roger K, Sanders Kathy M, Zusman Randall M, Healy Anna R, Cheema Farah, Lasko Natasha B, Cahill Larry, Orr Scott P
机构信息
Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02129, USA.
出版信息
Biol Psychiatry. 2002 Jan 15;51(2):189-92. doi: 10.1016/s0006-3223(01)01279-3.
BACKGROUND
Preclinical considerations suggest that treatment with a beta-adrenergic blocker following an acute psychologically traumatic event may reduce subsequent posttraumatic stress disorder (PTSD) symptoms. This pilot study addressed this hypothesis.
METHODS
Patients were randomized to begin, within 6 hours of the event, a 10-day course of double-blind propranolol (n = 18) versus placebo (n = 23) 40 mg four times daily.
RESULTS
The mean (SD) 1-month Clinician-Administered PTSD Scale (CAPS) score of 11 propranolol completers was 27.6 (15.7), with one outlier 5.2 SDs above the others' mean, and of 20 placebo completers, 35.5 (21.5), t = 1.1, df = 29, p =.15. Two propranolol patients' scores fell above, and nine below, the placebo group's median, p =.03 (sign test). Zero of eight propranolol, but six of 14 placebo, patients were physiologic responders during script-driven imagery of the traumatic event when tested 3 months afterward, p =.04 (all p values one-tailed).
CONCLUSIONS
These pilot results suggest that acute, posttrauma propranolol may have a preventive effect on subsequent PTSD.
背景
临床前研究提示，在急性心理创伤事件后使用β-肾上腺素能阻滞剂进行治疗，可能会减轻后续创伤后应激障碍（PTSD）的症状。本初步研究探讨了这一假设。
方法
患者在事件发生后6小时内被随机分组，开始为期10天的双盲普萘洛尔治疗（n = 18），每日4次，每次40 mg，与安慰剂组（n = 23）对照。
结果
11名普萘洛尔治疗完成者1个月时临床医生用PTSD量表（CAPS）评分的均值（标准差）为27.6（15.7），其中有1名离群值比其他患者的均值高出5.2个标准差；20名安慰剂治疗完成者的评分为35.5（21.5），t = 1.1，自由度 = 29，p = 0.15。2名普萘洛尔治疗患者的评分高于安慰剂组中位数，9名低于中位数，p = 0.03（符号检验）。3个月后进行创伤事件脚本驱动想象测试时，8名普萘洛尔治疗患者中无一人出现生理反应，而14名安慰剂治疗患者中有6人出现生理反应，p = 0.04（所有p值均为单尾）。
结论
这些初步结果提示，创伤后即刻使用普萘洛尔可能对后续PTSD具有预防作用。
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