de Quervain Dominique J-F
Division of Psychiatry Research, University of Zürich, Lenggstr. 31., 8032 Zürich, Switzerland.
Ann N Y Acad Sci. 2006 Jul;1071:216-20. doi: 10.1196/annals.1364.016.
Posttraumatic stress disorder (PTSD) is characterized by traumatic memories that can manifest as daytime recollections, traumatic nightmares, or flashbacks in which components of the event are relieved. These symptoms reflect excessive retrieval of traumatic memories that often retain their vividness and power to evoke distress for decades or even a lifetime. We have reported previously that elevated glucocorticoid levels inhibit memory retrieval in animals and healthy human subjects. We therefore hypothesized that the administration of cortisol might also inhibit the retrieval of traumatic memories in patients with PTSD. In a recent pilot study, we found the first evidence to support this hypothesis. During a 3-month observation period, low-dose cortisol (10 mg/day) was administered orally for 1 month to three patients with chronic PTSD using a double-blind, placebo-controlled, crossover design. In each patient investigated, there was a significant treatment effect with cortisol-related reductions in one of the daily rated symptoms of traumatic memories without causing adverse side effects. Future studies with more patients and longer treatment periods are required to evaluate the efficacy of cortisol treatment for PTSD.
创伤后应激障碍（PTSD）的特征是创伤性记忆，可表现为日间回忆、创伤性噩梦或闪回，在这些闪回中事件的某些部分会重现。这些症状反映出创伤性记忆的过度提取，这些记忆往往几十年甚至一生都保持着生动性和引发痛苦的能力。我们之前报道过，糖皮质激素水平升高会抑制动物和健康人类受试者的记忆提取。因此，我们推测给予皮质醇也可能抑制PTSD患者的创伤性记忆提取。在最近的一项初步研究中，我们发现了支持这一假设的首个证据。在为期3个月的观察期内，采用双盲、安慰剂对照、交叉设计，对3例慢性PTSD患者口服低剂量皮质醇（10毫克/天），持续1个月。在每例接受调查的患者中，皮质醇都产生了显著的治疗效果，与创伤性记忆的每日评分症状之一的减轻相关，且未引起不良副作用。需要更多患者和更长治疗期的未来研究来评估皮质醇治疗PTSD的疗效。
