CNS Spectrums

Original Research

The efficacy of initial hydrocortisone administration at preventing posttraumatic distress in adult trauma patients: a randomized trial

Douglas L. Delahantya1a7 c1, Crystal Gabert-Quillena1, Sarah A. Ostrowskia2, Nicole R. Nugenta3, Beth Fischera4, Adam Morrisa1, Roger K. Pitmana5, John Bona6 and William Fallon Jr.a7

a1 Kent State University, Department of Psychology, Kent, Ohio, USA

a2 NeuroDevelopmental Science Center, Akron Children's Hospital, Akron, Ohio, USA

a3 Alpert Brown Medical School, RIH Bradley/Hasbro Children's Research Center, Providence, Rhode Island, USA

a4 The Center for Family Safety and Healing, Columbus, Ohio, USA

a5 Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA

a6 Department of Pharmacy, Summa Health System, Akron, Ohio, USA

a7 Department of Trauma Services, Akron, Ohio, USA

Objective/Introduction Secondary pharmacological interventions have shown promise at reducing the development of posttraumatic stress disorder symptoms (PTSS) in preclinical studies. The present study examined the preliminary efficacy of a 10-day low-dose (20 mg bid) course of hydrocortisone at preventing PTSS in traumatic injury victims.

Methods Sixty-four traumatic injury patients (34% female) were randomly assigned in a double-blind protocol to receive either a 10-day course of hydrocortisone or placebo initiated within 12 hours of the trauma. One-month and 3-months posttrauma participants completed an interview to assess PTSS and self-report measures of depression and health-related quality of life.

Results Hydrocortisone recipients reported fewer PTSD and depression symptoms, and had greater improvements in health-related quality of life during the first 3 months posttrauma than did placebo recipients. Hydrocortisone recipients who had never received prior mental health treatment had the lowest PTSD scores.

Conclusion Low-dose hydrocortisone may be a promising approach to the prevention of PTSD in acutely injured trauma patients, and may be particularly efficacious in acutely injured trauma victims without a history of significant psychopathology.

(Received December 21 2012)

(Accepted January 25 2013)


c1 Address for correspondence: Douglas Delahanty, Department of Psychology, 144 Kent Hall, Kent, OH 44242, USA. (Email

p1 Crystal Gabert-Quillen is now a post-doctoral fellow at Wesleyan University, Middletown, Connecticut, USA.

p2 William Fallon, Jr. is now professor of surgery, NJMS/UMDNJ, Newark, New Jersey, USA.


  Funding for this study was provided by the National Institute of Mental Health (R34 MH73014) and the Ohio Board of Regents.