New Study Suggests that High-Dose Hormone Treatment Might Reduce Risk for PTSD

New study published in Biological Psychiatry

Philadelphia, PA, October 22, 2008 – Cortisol helps our bodies cope with stress, but what about its effects on the brain? A new study by Cohen and colleagues, appearing in the October 15th issue of Biological Psychiatry, suggests that the answer to this question is complex. In an animal model of posttraumatic stress disorder (PTSD), high doses of a cortisol-related substance, corticosterone, prevented negative consequences of stress exposure, including increased startle response and behavioral freezing when exposed to reminders of the stress. However, low-dose corticosterone potentiated these responses. This finding suggests that corticosterone levels may influence both vulnerability and resilience in a dose-dependent manner through its involvement in memory processes.

One of the complexities in understanding PTSD is the context-dependency of adaptation. In some situations, for example following a car accident in an otherwise secure community, one objective of treatment is to restore a sense of normalcy and control of one’s life. Within this context, the high-dose corticosterone would seem to be the indicated treatment. However, one could imagine scenarios where hypervigilance and heightened emotional reactivity could be adaptive, perhaps in a combat zone. In that case, the lower and more typical corticosterone levels might help soldiers adapt to the continuing risks of combat. But, people do not spend their lives in a single context. “In the case of helping soldiers adjust to the stress of war, we have to think both short-term and long-term, to help soldiers adjust to combat, but also to help them return from combat to resume peacetime life. Thus, we need further guidance from animal research about how to help soldiers adjust flexibly across contexts, from the battlefield to the breakfast table,” as explained by John H. Krystal, M.D., Editor of Biological Psychiatry and affiliated with both Yale University School of Medicine and the VA Connecticut Healthcare System.

Corresponding author Dr. Hagit Cohen concludes that, “single high-dose corticosteroid treatment may thus be worthy of clinical investigation as a possible avenue for early pharmacotherapeutic intervention in the acute phase, aimed at prevention of chronic stress-related disorders, such as PTSD. In this sense, it brings treatment of PTSD to a new era – an era of secondary prevention.”

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Notes to Editors:
The article is “Early Post-Stressor Intervention with High-Dose Corticosterone Attenuates Posttraumatic Stress Response in an Animal Model of Posttraumatic Stress Disorder” by Hagit Cohen, Michael A. Matar, Dan Buskila, Zeev Kaplan, and Joseph Zohar. Authors Cohen, Matar, and Kaplan are affiliated with the Ministry of Health Mental Health Center, Anxiety and Stress Research Unit, and Buskila is from the Department of Medicine, Soroka Medical Center, all at the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Zohar is affiliated with the Chaim Sheba Medical Center, Sackler Medical School, Tel-Aviv University, Israel. The article appears in Biological Psychiatry, Volume 64, Issue 8 (October 15, 2008), published by Elsevier.

The authors’ disclosures of financial and conflicts of interests are available in the article. Dr. Krystal's disclosures of financial and conflicts of interests are available here.

Full text of the article mentioned above is available upon request. Contact Jayne M. Dawkins at (215) 239-3674 or ja.dawkins@elsevier.com to obtain a copy or to schedule an interview.

About Biological Psychiatry
This international rapid-publication journal is the official journal of the Society of Biological Psychiatry. It covers a broad range of topics in psychiatric neuroscience and therapeutics. Both basic and clinical contributions are encouraged from all disciplines and research areas relevant to the pathophysiology and treatment of major neuropsychiatric disorders. Full-length and Brief Reports of novel results, Commentaries, Case Studies of unusual significance, and Correspondence and Comments judged to be of high impact to the field are published, particularly those addressing genetic and environmental risk factors, neural circuitry and neurochemistry, and important new therapeutic approaches. Concise Reviews and Editorials that focus on topics of current research and interest are also published rapidly.

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