Cortisol inhibits excessive retrieval of traumatic memories
Sept. 1, 2004
Psychiatry Matters

Pilot study findings suggest a beneficial effect for low-dose cortisol treatment in reducing the excessive retrieval of traumatic memory in people with post-traumatic stress disorder (PTSD).

"PTSD is characterized by traumatic memories that can manifest as daytime recollections, traumatic nightmares, or flashbacks in which components of the event are relived," explain Dominique de Quervain (University of Zurich, Switzerland) and colleagues.

Noting that elevated cortisol levels have been found to inhibit memory retrieval in healthy human individuals, the researchers investigated whether administration of cortisol might also reduce excessive retrieval of traumatic memories and related symptoms in patients with PTSD.

They administered low-dose cortisol (10 mg/day) orally or placebo to three patients with chronic PTSD for 1 month, after which the patients were switched to the alternative treatment.

During a 3-month observation period, a significant treatment effect was evident, with cortisol-related reductions of at least 38% in one of the daily rated symptoms of traumatic memories.

Specifically, one patient experienced a significant reduction in the frequency, but not intensity of nightmares. A second patient reported a reduction in the intensity, but not frequency of physiological distress and the feeling of reliving the traumatic event, while, in the third patient, a significant reduction in the intensity of the feeling of reliving the traumatic event, the physiological distress, and the frequency of nightmares was detected.

Improvements were also observed in the Clinician-Administered PTSD Scale rating for re-experiencing and avoidance symptoms but not for hyperarousal symptoms.

"It is possible that cortisol administration reduced avoidance by reducing re-experiencing symptoms," de Quervain et al suggest in the American Journal of Psychiatry.

They conclude: "The present findings provide the first evidence to suggest that the administration of cortisol reduces the symptoms of PTSD.

"Future studies with more patients and longer treatment periods are required to evaluate the efficacy of cortisol treatment of PTSD."

Am J Psychiatry 2004; 161: 1488-1490