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Efficacy of Single Dose IV Hydrocortisone in Post Traumatic Stress Disorder (PTSD) Prevention. Dr. Yahalom Hila Prof. Zohar Joseph Dr. Cwikel-Hamzany Shlomit Dr. Bar- Ziv Danit Sheba Medical Center. כ- ½ ע ד 2/3 מהאוכלוסייה יחשפו לאירוע טראומטי בשלב כלשהו בחייהם

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Efficacy of Single Dose IV Hydrocortisone in Post Traumatic Stress Disorder (PTSD) Prevention

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Efficacy of Single Dose IVHydrocortisone in Post Traumatic StressDisorder (PTSD) Prevention

Dr. Yahalom Hila

Prof. Zohar Joseph

Dr. Cwikel-HamzanyShlomit

Dr. Bar-ZivDanit

Sheba Medical Center


  • - 2/3

  • - National Comorbidity Survey PTSD - 7%

    Kessler et al ; Arch Gen Psychiatry, 2005


"Outside the range of human experience"?


PTSD- ?

  • .

  • 4 PTSD :

  • BETA BLOCKERS (PROPRANOLOL)

  • BENZODIAZEPINES

  • MORPHINE

  • SSRIs


  • Beta Blockers - PROPRANOLOL

  • .

  • Pitman et al; Biol Psych. 2002.

  • Vaiva et al; Biol Psych. 2003.

  • Stein et al; Journal of Traumatic Stress. 2007.


  • ' (2-18). (9 3 - PTSD 6 )

    Gelpin E, Bonne O, Peri T, Brandes D, Shalev AY; J Clin Psychiatry. 1996.


  • PTSD

  • Holbrook TL, Galarneau MR, Dye JL, Quinn K, Dougherty AL.N Engl J Med. 2010


SSRIs

  • ' PTSD - ESCITALOPRAM


PTSD?

  • "" (plasticity) HPA PTSD

  • . "" - PTSD


  • ' PTSD

    Schelling G et al; Ann N Y Acad Sci. 2006

  • ' PTSD

    Cohen H, Matar MA, Buskila D, Kaplan Z, Zohar J; Biol Psychiatry. 2008


  • - golden hours

    ( TPA - STROKE

    - MI)?

  • ?

  • PTSD?


" " - PTSD?

Window of Opportunities?

Time from trauma

ASD

ACUTE PTSD

CHRONIC PTSD

6 hours

4 weeks

3 month


PTSD?

  • 24 "

    ( =20, =4).

  • IV

    (100-140 ") (n=14) (n=10)

  • 6

  • ,

  • , , CAPS


24

19 (=9, = 10)

13 (=5, = 8)

14 3 (=5, = 7)

  • ' , "


  • , 1 8 ASD (12.5%) 7 9 (77.7%)

  • , 1 6 - PTSD (16%), 3 5 (60%)

  • 3 , 1 7 - PTSD(14.3%), 3 5 (60%)


CLINCIAN ADMINISTERD PTSD QUESTIONNAIRE (CAPS) ( ) - PTSD

CAPS

(average)


Golden hours in psychiatry?

  • PTSD

  • PILOT

  • . PTSD


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