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Propranolol for Post-Traumatic Stress Disorder: A Review of Clinical EffectivenessYoung C; Butcher RPropranolol for Post-Traumatic Stress Disorder: A Review of Clinical Effectiveness-/-CADTH Rapid Response Reports 2020[Mar]; ä (ä): äPost-traumatic stress disorder (PTSD) is a chronic mental health condition that may develop in individuals following direct or indirect exposure to a traumatic event. Research indicates that the lifetime prevalence of trauma, which can be caused by numerous distressing events (e.g., exposure to actual or threatened death, serious injury, or sexual violence), is as high as 70% in the general population.(,) Although not every individual who experiences trauma will develop subsequent mental health issues such as PTSD, acute stress disorder, or depression, these conditions are associated with decreased quality of life and disability(,) and are among the leading contributors to the global burden of disease. It is estimated that nearly 1 in 10 Canadians will experience PTSD at some point in their lifetime. Research dating back to the 1980s has postulated that epinephrine and norepinephrine may play a role in the formation of traumatic memories, and thus in the development of PTSD. Although the mechanism is not fully understood, literature suggests that epinephrine and norepinephrine released by the beta-adrenergic system as a result of trauma may enhance the formation of memories associated with emotional experiences and strengthen fear conditioning.(,) These findings have prompted subsequent research investigating the use of propranolol, a beta-blocker that inhibits the effects of these catecholamines by acting as a competitive antagonist on beta-adrenergic receptors, for the treatment and prevention of PTSD. Research in this field has primarily focused on two main indications: 1) propranolol given to individuals prior to trauma memory reactivation in patients diagnosed with PTSD, and 2) propranolol given following trauma as a preventative measure for subsequent PTSD or acute stress disorder. The purpose of this report is to summarize the clinical evidence regarding the effectiveness of propranolol for the treatment and prevention of PTSD.ä |
