Roque Autumn Pearl
a University of Kentucky, College of Nursing , Lexington , Kentucky , USA.
Issues Ment Health Nurs. 2015;36(9):740-51. doi: 10.3109/01612840.2015.1057785.
Post-traumatic stress disorder has a lifetime prevalence of almost 9% in the United States. The diagnosis is associated with increased rates of comorbid substance abuse and increased rates of depression. Providers are taught how to diagnose and treat PTSD, but little discussion is devoted to how to prevent the disorder. Behavioral research in animal studies has provided some evidence for the use of medications in decreasing the fear response and the reconsolidation of memories. A heightened fear response and the re-experience of traumatic memory are key components for diagnosis. The purpose of this literature review is to examine the evidence for pharmacotherapy as prophylactic treatment in acute stress/trauma in order to prevent the development of post-traumatic stress disorder. The body of the review includes discussions on medications, medications as adjunct to script-driven imagery, and special considerations for military, first responders, and women. This article concludes with implications for practice and recommendations for future research. The key words used for the literature search were "prophylactic treatment of PTSD," "pharmacotherapy and trauma," "pharmacological prevention of PTSD," "beta blockers and the prevention of PTSD," "acute stress and prevention of PTSD," "propranolol and PTSD," "secondary prevention of PTSD," and "medications used to prevent PTSD." Findings were categorized by medications and medications as adjunct to script-driven imagery. The literature suggests that hydrocortisone, propranolol, and morphine may decrease symptoms and diagnosis of post-traumatic stress disorder.
创伤后应激障碍在美国的终生患病率近9%。该诊断与共病物质滥用率增加以及抑郁症发病率上升有关。医疗服务提供者接受了如何诊断和治疗创伤后应激障碍的培训，但很少讨论如何预防这种疾病。动物研究中的行为研究为使用药物降低恐惧反应和记忆再巩固提供了一些证据。高度的恐惧反应和创伤性记忆的重现是诊断的关键组成部分。这篇文献综述的目的是研究药物疗法作为急性应激/创伤预防性治疗以预防创伤后应激障碍发生的证据。综述主体包括对药物、作为脚本驱动意象辅助手段的药物以及对军人、急救人员和女性的特殊考虑的讨论。本文最后阐述了对实践的启示以及对未来研究的建议。文献检索使用的关键词有“创伤后应激障碍的预防性治疗”“药物疗法与创伤”“创伤后应激障碍的药物预防”“β受体阻滞剂与创伤后应激障碍的预防”“急性应激与创伤后应激障碍的预防”“普萘洛尔与创伤后应激障碍”“创伤后应激障碍的二级预防”以及“用于预防创伤后应激障碍的药物”。研究结果按药物以及作为脚本驱动意象辅助手段的药物进行分类。文献表明，氢化可的松、普萘洛尔和吗啡可能会减轻创伤后应激障碍的症状并降低其诊断率。
