The DOI matches its Crossref record; 19 of the 19 references it cites were found in a registry or an index.
Effect of Acute Posttrauma Propranolol on PTSD Outcome and Physiological Responses During Script‐Driven Imagery
Open accessAbstract
SUMMARY: Introduction: Animal and human research suggests that the development of posttraumatic stress disorder (PTSD) may involve the overconsolidation of memories of a traumatic experience. Previous studies have attempted to use pharmaceutical agents, especially the β‐adrenergic blocker propranolol, to reduce this overconsolidation. Aims: In this randomized, placebo‐controlled study of the efficacy of propranolol in reducing the development of PTSD, we optimized dosages and conducted both psychophysiological and clinical assessments 1 and 3 months after the traumatic event. Forty‐one emergency department patients who had experienced a qualifying acute psychological trauma were randomized to receive up to 240 mg/day of propranolol or placebo for 19 days. At 4 and 12 weeks post‐trauma, PTSD symptoms were assessed. One week later, participants engaged in script‐driven imagery of their traumatic event while psychophysiological responses were measured. Results: Physiological reactivity during script‐driven traumatic imagery, severity of PTSD symptoms, and the rate of the PTSD diagnostic outcome were not significantly different between the two groups. However, post hoc subgroup analyses showed that in participants with high drug adherence, at the 5‐week posttrauma assessment, physiological reactivity was significantly lower during script‐driven imagery in the propranolol than in the placebo subjects. Conclusions: The physiological results provide some limited support for a model of PTSD in which a traumatic conditioned response is reduced by posttrauma propranolol. However, the clinical results from this study do not support the preventive use of propranolol in the acute aftermath of a traumatic event.
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“Another study suggests that propranolol given within hours of a psychologically traumatic event reduces physiological responses during subsequent mental imagery of the event.19”
From Resolution of flashbacks of PTSD with propranolol: A case report (2016) · cites this paper as [19]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Beta blockers (e.g., propranolol), a class of compounds that are antagonists of β1- and β2-adrenergic receptors, inhibit the action of norepinephrine and epinephrine at these sites and have shown promise in both animal models and humans when administered during the acute phase of trauma, however, results have been mixed (Cahill et al., 1994; Vaiva et al., 2003; Hoge et al., 2012; Bailey et al., 2”
From Maladaptive autonomic regulation in PTSD accelerates physiological aging (2015) · cites this paper as Hoge et al., 2012
Experimental — accuracy not yet measuredIn the citing paper
“Pharmacologically, prolonged administration of the beta-receptor blocking agent propranolol early after trauma did not result in fewer PTSD symptoms [13,14].”
From Efficacy of oxytocin administration early after psychotrauma in preventing the development of PTSD: study protocol of a randomized controlled trial (2014) · cites this paper as [13]
In the citing paper
“although it does not prevent overall PTSD 69,70 .”
From Post‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges (2019) · cites this paper as [70]
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Citations
Cites
β-Adrenergic activation and memory for emotional events
Cahill, L., Prins, B., Weber, M., & McGaugh, J. L. (1994) · Nature · doi:10.1038/371702a0 · Cited by 1,271
Psychological debriefing for preventing post traumatic stress disorder (PTSD)
Rose, S. C., Bisson, J., Churchill, R., & Wessely, S. (2002) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000560 · Cited by 1,250
Pilot study of secondary prevention of posttraumatic stress disorder with propranolol
Pitman, R. K., Sanders, K. M., Zusman, R. M., Healy, A. R., Cheema, F., Lasko, N. B., Cahill, L., & Orr, S. P. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(01)01279-3 · Cited by 964
Self-citationPsychophysiologic assessment of posttraumatic stress disorder imagery in Vietnam combat veterans
Pitman, R. K. (1987) · Archives of General Psychiatry · doi:10.1001/archpsyc.1987.01800230050009 · Cited by 758
Self-citationThe Peritraumatic Distress Inventory: A Proposed Measure of PTSD Criterion A2
Brunet, A., Weiss, D. S., Metzler, T. J., Best, S. R., Neylan, T. C., Rogers, C. E., Fagan, J., & Marmar, C. R. (2001) · American Journal of Psychiatry · doi:10.1176/appi.ajp.158.9.1480 · Cited by 605
Role of norepinephrine in the pathophysiology and treatment of posttraumatic stress disorder
Southwick, S. M., Bremner, J. D., Rasmusson, A., Morgan, C. A., Arnsten, A., & Charney, D. S. (1999) · Biological Psychiatry · doi:10.1016/s0006-3223(99)00219-x · Cited by 573
Immediate treatment with propranolol decreases posttraumatic stress disorder two months after trauma
Vaiva, G., Ducrocq, F., Jezequel, K., Averland, B., Lestavel, P., Brunet, A., & Marmar, C. R. (2003) · Biological Psychiatry · doi:10.1016/s0006-3223(03)00412-8 · Cited by 499
Post-traumatic stress disorder, hormones, and memory.
Pitman, R. (1989) · Biological Psychiatry · doi:10.1016/0006-3223(89)90033-4 · Cited by 447
Self-citationMorphine use after combat injury in Iraq and post-traumatic stress disorder
Holbrook, T. L., Galarneau, M. R., Dye, J. L., Quinn, K., & Dougherty, A. L. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa0903326 · Cited by 429
Wessely, S. C., Rose, S. K., & Bisson, J. I. (2000) · Research Portal (King's College London) · Cited by 264
Cited by
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Biological studies of post-traumatic stress disorder
Pitman, R. K., Rasmusson, A. M., Koenen, K. C., Shin, L. M., Orr, S. P., Gilbertson, M. W., Milad, M. R., & Liberzon, I. (2012) · Nature Reviews Neuroscience · doi:10.1038/nrn3339 · Cited by 1,529
Self-citationPost‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges
Bryant, R. A. (2019) · World Psychiatry · doi:10.1002/wps.20656 · Cited by 528
Emotion and cognition interactions in PTSD: a review of neurocognitive and neuroimaging studies
Hayes, J. P., VanElzakker, M. B., & Shin, L. M. (2012) · Frontiers in Integrative Neuroscience · doi:10.3389/fnint.2012.00089 · Cited by 393
“Consistent with this notion, patients with PTSD are less satisfied with rewards than controls (Hopper et al., 2008) and expend less effort to obtain positive rewards (Elman et al., 2005).”
BackgroundEARLY INTERVENTIONS FOR PTSD: A REVIEW: Review: Early Intervention
Kearns, M. C., Ressler, K. J., Zatzick, D., & Rothbaum, B. O. (2012) · Depression and Anxiety · doi:10.1002/da.21997 · Cited by 310
“to placebo and failed to identify any decrease in PTSD diagnoses or severity 3 months after the initial trauma.[46] These negative findings on propranolol are likely to lead researchers to look toward other preventative strategies in future work.”
BackgroundZoladz, P. R., & Diamond, D. M. (2013) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2013.03.024 · Cited by 339
“…noradrenergic and SNS in traumatized people, which has led to novel pharmacological-based strategies in the treatment of PTSD (Brunet et al., 2011; Hoge et al., 2012; van Stegeren, 2008; Pitman and Delahanty, 2005; Schelling, 2002; Miller, 2008; Boehnlein and Kinzie, 2007; Raskind et al., 2007).”
Metadata
- Authors
- Hoge, E. A., Worthington, J. J., Nagurney, J. T., Chang, Y., Kay, E. B., Feterowski, C. M., Katzman, A. R., Goetz, J. M., Rosasco, M. L., Lasko, N. B., Zusman, R. M., Pollack, M. H., Orr, S. P., & Pitman, R. K.
- Affiliations
- Massachusetts General Hospital (US)
- Harvard University (US)
- Corresponding author
- Hoge, Elizabeth A.
- ORCID
- Venue
- CNS Neuroscience & Therapeutics
- Publisher
- Wiley
- Published
- 2011-01-10
- Volume
- 18
- Issue
- 1
- Pages
- 21-27
- ISSN
- 1755-5930 (ISSN-L)
- 1755-5949
- PMC
- PMC6493400
- OpenAlex
- W1542396424
- Cited by
- 174
- References
- 19
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 6 · 2023: 6 · 2022: 13 · 2021: 8 · 2020: 10 · 2019: 12 · 2018: 6 · 2017: 7 · 2016: 15 · 2015: 20 · 2014: 20 · 2013: 27 · 2012: 11
- FWCI
- 20.66
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- CNS Neuroscience & Therapeutics (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (R01MH068603, MH068603)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory Processes and Influences
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Keywords
- propranolol, post-traumatic stress disorder, memory reconsolidation, beta-adrenergic blockade, script-driven imagery, physiological reactivity, medication adherence, injury prevention, emergency department patients
- MeSH terms
- Adolescent, Adrenergic beta-Antagonists, Adult, Aged, Drive, Electromyography, Female, Follow-Up Studies, Galvanic Skin Response, Heart Rate, Humans, Imagination, Male, Middle Aged, Propranolol, Psychiatric Status Rating Scales, Psychometrics, Retrospective Studies, Severity of Illness Index, Stress Disorders, Post-Traumatic, Medication Adherence, Young Adult
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