Pharmacotherapy to prevent PTSD: Results from a randomized controlled proof-of-concept trial in physically injured patients


  • This work was supported by NIMH grants MH62037 (R21) and MH64122 (K24) to MBS. We are indebted to the nurses and physicians of the UCSD Department of Surgery, Division of Trauma for their support and assistance. We also thank Jitender Sareen, MD FRCPC, and Soraya Seedat, MBBS, for their help during the start-up phase of this project, Reena Deutsch, PhD, for her statistical guidance, and Naomi Breslau, PhD, for her advice and support.


Acute physical injury is frequently associated with mental health sequelae, which then accentuate disability and worsen functional outcomes. A pharmacological prevention approach to this problem has been proposed. This proof-of-concept study was a double-blind, randomized controlled trial of 14 days of the beta-blocker propranolol (n = 17), the anxiolytic anticonvulsant gabapentin (n = 14), or placebo (n = 17), administered within 48 hours of injury to patients admitted to a surgical trauma center. Of 569 accessible, potentially eligible subjects, 48 (8%) participated. Outcomes assessments were conducted at 1, 4, and 8 months postinjury. Although well tolerated, neither study drug showed a significant benefit over placebo on depressive or posttraumatic stress symptoms. Implications are discussed for future pharmacological prevention studies in survivors of acute traumatic injury.