Undebrief soldiers? PTSD treatment revisited

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At the 23rd ECNP Congress I heard Joseph Zohar speak about posttraumatic stress disorder (PTSD) treatment focusing on early treatment before the development of actual PTSD.

Zohar pointed to a paper by Mayou et al. 2000 which is presumably is this one: Psychological debriefing for road traffic accident victims. This single study found that psychological debriefing was not a good idea. Doing nothing had better prognosis. A paper with meta-analysis by A. A. van Emmerik in Lancet Single session debriefing after psychological trauma: a meta-analysis would also sum up the research with a negative conclusion.

Benzodiazepine seemed neither to be a good idea. Neither did beta-blockers (propranolol).
So is there anything that works?

Yes, according to Zohar.

In a study soldiers got SSRI (escitalopram) after the trauma. Zohar’s preliminary opinion about the effect was the there might be a small modest effect (AFAIR).

The most promising compounds were cortisone and morphine. The study on hydrocortisone was preliminary and seemed to indicate quite a fair effect (AFAIR).

Zohar also pointed Holbrook et al. reporting in Morphine use after combat injury in Iraq and post-traumatic stress disorder from 2010. They found (to me surprisingly) that “morphine during trauma care may reduce the risk of subsequent development of PTSD after serious injury”.

The conclusions we can draw are presently based on rather few studies (AFAIK), but apparently the conclusions so far is that given a traumatic experience you should shut up, grieve and do drugs (that is, the right ones). Interesting.

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One thought on “Undebrief soldiers? PTSD treatment revisited

    Anonymous said:
    September 6, 2010 at 6:37 am

    Morphine should be part of the standard first aid kit.

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