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

  • Douglas L. Delahanty (a1) (a2), Crystal Gabert-Quillen (a1), Sarah A. Ostrowski (a3), Nicole R. Nugent (a4), Beth Fischer (a5), Adam Morris (a1), Roger K. Pitman (a6), John Bon (a7) and William Fallon (a2)
  • DOI:
  • Published online: 01 April 2013

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.


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.


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.


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.

Corresponding author
*Address for correspondence: Douglas Delahanty, Department of Psychology, 144 Kent Hall, Kent, OH 44242, USA. (Email
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Funding for this study was provided by the National Institute of Mental Health (R34 MH73014) and the Ohio Board of Regents.

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